Literature DB >> 24664165

Difficult abdominal wall closure: component separation versus partition technique.

P-K Shih1.   

Abstract

BACKGROUND: Partition technique and component separation techniques are natural methods of fascia-fascia closure. We present our experiences and research the differences between the two techniques.
METHODS: From January 2006 to August 2013, 41 patients with complex abdominal wall defects reconstructed with partition (N = 18) or component separation technique (N = 23) alone were enrolled into this study. The related data including gender, age, size of defect, operation time, hospital stay, duration of follow-up, comorbidities, body mass index (BMI) and complications were collected. Nonparametric Mann-Whitney test was used to evaluate the differences between the two groups in continuous data; Chi-square test was used to assess the categorical data.
RESULTS: The mean defect size of patients with partition technique (N = 18) was 12.55 cm (range 8.2-18.9 cm) with 148.63 min for average operation time, 8.66 days for hospital stay, and 28.8 months for mean follow-up. There were nine cases with postoperative complications (three cases with skin and soft tissue necrosis; two cases with fascia dehiscence; and three cases with wound infection). One case with fascia dehiscence suffered from pneumonia simultaneously. Four cases received secondary operation (fascia repair and split-thickness skin graft), and the other four cases healed spontaneously with mild wound debridement. The mean defect size of the patients with component separation (N = 23) technique was 9.45 cm (range 5.7-12.6 cm) with 143.27 min for average operation time, 7.43 days for hospital stay, and 34.33 months for mean follow-up. One case with skin and soft tissue necrosis underwent reconstruction with split-thickness skin graft and debridement. Two cases with wound infection healed spontaneously with mild wound debridement. There were no significant differences in gender, age, operation time, hospital stay, duration of follow-up, comorbidities, BMI and long-term postoperative complications between the two groups, except for size of defect and short-term postoperative complications.
CONCLUSIONS: The partition technique could close larger abdominal fascia defects than component separation technique, but simultaneously run the higher opportunities for short-term postoperative complications.

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Mesh:

Year:  2014        PMID: 24664165     DOI: 10.1007/s10029-014-1238-4

Source DB:  PubMed          Journal:  Hernia        ISSN: 1248-9204            Impact factor:   4.739


  10 in total

1.  Risks associated with "components separation" for closure of complex abdominal wall defects.

Authors:  Gregory Dumanian
Journal:  Plast Reconstr Surg       Date:  2004-01       Impact factor: 4.730

2.  Reconstruction of a full-thickness abdominal wall defect using an anterolateral thigh free flap.

Authors:  R Sinna; M Gianfermi; T Benhaim; Q Qassemyar; M Robbe
Journal:  J Visc Surg       Date:  2010-06-26       Impact factor: 2.043

3.  Temporary silastic mesh closure for adult liver transplantation: a safe alternative for the difficult abdomen.

Authors:  Mubeen A Jafri; Amit D Tevar; Mark Lucia; Thav Thambi-Pillai; Andreas Karachristos; Leslie Trumbull; Joseph F Buell; Mark J Thomas; Michael J Hanaway; E Steve Woodle; Steven M Rudich
Journal:  Liver Transpl       Date:  2007-02       Impact factor: 5.799

4.  "Components separation" method for closure of abdominal-wall defects: an anatomic and clinical study.

Authors:  O M Ramirez; E Ruas; A L Dellon
Journal:  Plast Reconstr Surg       Date:  1990-09       Impact factor: 4.730

5.  Challenging abdominal wall defects.

Authors:  S M Sukkar; G A Dumanian; S M Szczerba; M G Tellez
Journal:  Am J Surg       Date:  2001-02       Impact factor: 2.565

6.  Ventral/incisional abdominal herniorrhaphy by fascial partition/release.

Authors:  W O Thomas; S W Parry; C B Rodning
Journal:  Plast Reconstr Surg       Date:  1993-05       Impact factor: 4.730

7.  Reconstruction of complex abdominal wall defects with free flaps: indications and clinical outcome.

Authors:  Chin-Ho Wong; Chih-Hung Lin; Brian Fu; Jen-Feng Fang
Journal:  Plast Reconstr Surg       Date:  2009-08       Impact factor: 4.730

8.  Abdominal wall reconstruction: lessons learned from 200 "components separation" procedures.

Authors:  Jason H Ko; Edward C Wang; David M Salvay; Benjamin C Paul; Gregory A Dumanian
Journal:  Arch Surg       Date:  2009-11

9.  Abdominal wall partitioning (the accordion effect) for reconstruction of major defects: a retrospective review of 10 patients.

Authors:  John T Lindsey
Journal:  Plast Reconstr Surg       Date:  2003-08       Impact factor: 4.730

10.  Repair of giant midline abdominal wall hernias: "components separation technique" versus prosthetic repair : interim analysis of a randomized controlled trial.

Authors:  T S de Vries Reilingh; H van Goor; J A Charbon; C Rosman; E J Hesselink; G J van der Wilt; R P Bleichrodt
Journal:  World J Surg       Date:  2007-04       Impact factor: 3.352

  10 in total
  2 in total

1.  Feasibility of pedicled anterolateral thigh flap with tensor fascia lata and vastus lateralis for difficult abdominal wall closure.

Authors:  P-K Shih
Journal:  Hernia       Date:  2018-11-13       Impact factor: 4.739

Review 2.  Current Trends in Laparoscopic Ventral Hernia Repair.

Authors:  Evangelos P Misiakos; Paul Patapis; Nick Zavras; Panagiotis Tzanetis; Anastasios Machairas
Journal:  JSLS       Date:  2015 Jul-Sep       Impact factor: 2.172

  2 in total

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