title: Abdominal Wall Defect Reconstructed by Breast Flaps Using a Mercedes Closure Pattern.
abstract: BACKGROUND
  Surgery of the abdominal cavity may lead to postoperative defects to the ventricular segment of the abdominal wall. The reconstruction of these defects, especially in the area of the median line, represents an issue during the course of healing due to the role of the abdominal cavity in respiratory processes.
  
  
  METHODS
  Reconstructive surgical procedure was performed on an infected vast defect to the ventral segment of the abdominal wall in a 77-year-old woman by a modified "Mercedes closure pattern," i.e., by combining three fasciocutaneous flaps: bipedicle flap of the upper segment of the abdominal wall and two sliding breast flaps.
  
  
  RESULTS
  Application of a modified complex Mercedes closure pattern was successful and positively affected the redistribution of pressure forces at the places where the edges of the wound were in contact.
  
  
  CONCLUSIONS
  The applied and described technique of closing the abdominal cavity decreased the possibility of infection to the prosthetic material, because direct contact between the sutures and the prosthetic no longer existed.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Department of Plastic Surgery, University Hospital Center Zagreb, Kišpatićeva 12, HR-10000, Zagreb, Croatia.|Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Veir
authors.affiliation: Department of Plastic Surgery, University Hospital Center Zagreb, Kišpatićeva 12, HR-10000, Zagreb, Croatia. ninofuchs84@gmail.com.
authors.forename: Nino
authors.identifier: http://orcid.org/0000-0002-3691-1346
authors.initials: N
authors.lastname: Fuchs
authors.affiliation: Department of Plastic Surgery, University Hospital Center Zagreb, Kišpatićeva 12, HR-10000, Zagreb, Croatia.
authors.forename: Davor
authors.initials: D
authors.lastname: Mijatović
authors.affiliation: Department of Plastic Surgery, University Hospital Center Zagreb, Kišpatićeva 12, HR-10000, Zagreb, Croatia.
authors.forename: Kristijan
authors.initials: K
authors.lastname: Kunjko
authors.affiliation: Department of Plastic Surgery, University Hospital Center Zagreb, Kišpatićeva 12, HR-10000, Zagreb, Croatia.
authors.forename: Nataša
authors.initials: N
authors.lastname: Beader
mesh_terms: D034861:Abdominal Wall / Q000503:physiopathology / Q000601:surgery*; D000368:Aged; D003646:Debridement / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006554:Hernia, Umbilical / Q000601:surgery; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D064827:Myocutaneous Flap / Q000637:transplantation*; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D013530:Surgical Wound Infection / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D058106:Wound Closure Techniques; D014945:Wound Healing / Q000502:physiology
keywords: Abdominal plastic surgery; Bipedicle flap; Breast flaps; Reconstructive techniques