title: A Case of Pediatric Abdominal Wall Reconstruction: Components Separation within the Austere War Environment.
abstract: Reconstructive surgeons supporting military operations are required to definitively treat severe pediatric abdominal injuries in austere environments. The safety and efficacy of using a components separation technique to treat large ventral hernias in pediatric patients in this setting remains understudied. Components separation technique was required to achieve definitive closure in a 12-month-old pediatric patient in Kandahar, Afghanistan. Her course was complicated by an anastomotic leak after small bowel resection. Her abdominal was successfully reopened, the leak repaired, and closed primarily without incident on postinjury day 9. Abdominal trauma with a large ventral hernia requiring components separation is extremely rare. A pediatric patient treated with components separation demonstrated minimal complications, avoidance of abdominal compartment syndrome, and no mortality.
authors.affiliation: Plastic and Reconstructive Surgery Service, Walter Reed National Military Medical Center, Bethesda, Md.; The Department of Trauma and General Surgery, The Role 3 NATO Multinational Medical Unit, Kandahar, Afghanistan; Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Md.; and Department of Plastic and Reconstructive Surgery, The University of Pittsburgh Medical Center, Pittsburgh, Pa.
authors.forename: Ian
authors.initials: I
authors.lastname: Valerio
authors.affiliation: Plastic and Reconstructive Surgery Service, Walter Reed National Military Medical Center, Bethesda, Md.; The Department of Trauma and General Surgery, The Role 3 NATO Multinational Medical Unit, Kandahar, Afghanistan; Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Md.; and Department of Plastic and Reconstructive Surgery, The University of Pittsburgh Medical Center, Pittsburgh, Pa.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sabino
authors.affiliation: Plastic and Reconstructive Surgery Service, Walter Reed National Military Medical Center, Bethesda, Md.; The Department of Trauma and General Surgery, The Role 3 NATO Multinational Medical Unit, Kandahar, Afghanistan; Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Md.; and Department of Plastic and Reconstructive Surgery, The University of Pittsburgh Medical Center, Pittsburgh, Pa.
authors.forename: Anand
authors.initials: A
authors.lastname: Kumar