Techniques for abdominal wall reconstruction in intestinal transplantation.
OBJECTIVE
One of the most important challenges in the intestinal (ITx) and multivisceral transplant (MVTx) is to achieve a successful abdominal wall closure.


RESULTS
A tension-free primary closure should be our aim. In most of the cases, we need to perform a component separation technique, alone or combined, to the use of a synthetic mesh. If those options are not feasible, the abdominal wall composite vascularized allograft transplant (AW-CVA) utilizing direct orthotopic vascularization can be considered. The nonvascularized abdominal rectus fascia has also become an alternative method used worldwide, proving to be simple and well tolerated procedure. Furthermore, the use of the AW has been recently proposed as a new tool for a sentinel monitoring of the intestinal or pancreas allograft.


CONCLUSIONS
There are different validated options for abdominal wall closure following intestinal transplantation. The long-term benefits of transplanting the abdominal wall, full or partial thickness and vascularized or nonvascularised, were shown. New developments might help to expand their applications in different areas such as reconstructive surgery and immunology.
aUnidad de Insuficiencia, Rehabilitatición y Trasplante Intestinal, Hospital Universitario Fundación Favaloro bServicio de Cirugia General, Hospital Universitario Fundación Favaloro, MAAC, Buenos Aires, Argentina.
Gabriel E
GE
Gondolesi
Nicolás F
NF
Aguirre
D034861:Abdominal Wall / Q000601:surgery*; D064595:Composite Tissue Allografts / Q000637:transplantation*; D006801:Humans; D007422:Intestines / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*