Open bridging repair with artificial material in treating large abdominal wall defect: a report of 58 cases

Abstract

Objective To analyze the clinical application of open bridging repair with artificial material in treating large abdominal wall defect. Methods A retrospective analysis was performed for 58 patients with large abdominal wall defect from June 2007 to June 2020 in our department, including 19 cases of defect after resection of abdominal space-occupying lesions, 35 cases of giant incision hernia, 3 cases of local deficient abdominal wall after abdominal trauma or infection, and 1 case of delayed abdominal closure after congenital diaphragmatic hernia repair due to insufficient abdominal volume. Therapeutic effect was followed up. Results The reconstruction was achieved in all cases. Postoperative complication was found seroma in 5 cases cured with double tubes negative drainage. One case had both skin necrosis and incision dehiscence treated with vacuum sealing drainage (VSD). There was 1 case with hematoma treated by pressure dressing and 1 case with mesh infection treated by upper mesh removal and VSD later. One case had temporary abdominal closure and planned mesh exposure due to insufficient abdominal volume using bridging repair of intraperitoneal onlay mesh and Inlay, who was treated VSD 3 times and staged abdominal closure. Mesh bulging was in 1 case treated with follow-up and observation. Duration of follow-up ranged from 12 to 156 months, with 94.8% follow-up rate and 3 cases lost. No recurrence of hernia or defect was present. Conclusions Open bridging repair with artificial material can be an indispensable skill for large abdominal defects which can not be closed and the complication can be treated.

Keywords

• |open bridging repair|artificial material|large abdominal defect|reconstruction of abdominal wall|complication