title: Component separation for complex congenital abdominal wall defects: not just for adults anymore.
abstract: OBJECTIVE
  Operative repair of large abdominal wall defects in infants and children can be challenging. Component separation technique (CST) is utilized in adults to repair large abdominal wall defects but rarely used in children. The purpose of this report is to describe our experience with the CST in pediatric patients including the first description of CST use in newborns.
  
  
  METHODS
  After IRB approval, we reviewed all patients who underwent CST between June 1, 2010 and December 31, 2012 at a large children's hospital. CST included dissection of abdominal wall subcutaneous tissue from the muscle and fascia and an incision of the external oblique aponeurosis one centimeter lateral to the rectus sheath. Biologic mesh onlay or underlay was used to reinforce this closure. Patients were followed for complications.
  
  
  RESULTS
  Nine children, two patients with gastroschisis and seven with omphalocele, were repaired with CST at median (range) 1.1 years (5 days-10.1 years) of age. CST was the first surgical intervention for five children. There were minor wound complications and no recurrences after a median (range) follow up of 16 months (3-34 months).
  
  
  CONCLUSIONS
  CST can be a very useful technique to repair large abdominal wall defects in children with a loss of abdominal domain.
authors: Department of Pediatric Surgery and Center for Surgical Trials and Evidence-based Practice, University of Texas Medical School at Houston and The Children's Memorial Hermann Hospital, Houston TX. Electronic address: kuojen.tsao@uth.tmc.edu.
authors: Shauna
authors: S
authors: Levy
authors: KuoJen
authors: K
authors: Tsao
authors: Charles S
authors: CS
authors: Cox
authors: Uma R
authors: UR
authors: Phatak
authors: Kevin P
authors: KP
authors: Lally
authors: Richard J
authors: RJ
authors: Andrassy
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D020139:Gastroschisis / Q000601:surgery*; D006554:Hernia, Umbilical / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome
keywords: Abdominal wall defect; Component separation; Gastroschisis; Omphalocele; Ventral hernia