“Components Separation” Method for Closure of Abdominal-Wall Defects

Abdominal wall reconstruction

“…Bilateral relaxing fascial releases provide a total of 10, 18, and 6 to 10 cm of advancement in the upper, middle, and lower thirds of the abdomen, respectively. 11 Large complete defects of the midline often require local or distant flaps for reconstruction of the abdominal wall, coupled with either skin grafting or tissue expansion for skin coverage. Flap choice is dictated by the position of the defect on the abdominal wall and ability of the flap to reach without tension.…”

Complex abdominal wall repair using a combination of porcine dermal matrix and omentum flap in patient with digestive tract fistula: report of a case and review of the literature

“…[24] For the above mentioned reasons, the use of autologous tissue flap and graft has been advocated. [25] However, a meta-analysis of the component separation technique [8] for ventral hernia repair showed an 18.9% infection rate, contributing to an overall complication rate of 23.8%, including flap necrosis and donor-site related complications, thus even higher than synthetic mesh repair complication rate. [25,26] Collagen-based biological materials have been developed to overcome these problems.…”

“…[5,6] Adsorbable mesh can be used in these situations; however, this solution is temporary and predisposes the patient to multiple operations and a staged abdominal wall reconstruction to achieve an acceptable functional result (sometimes, the very high operative risk precludes a two-stage surgical procedure [7] ). A number of techniques such as component separation, [8] musculocutaneous [9,10] or pedicled omentum [11][12][13] flaps have been suggested as a good alternative for autologous tissue repair, but the size of the defect often limit such possibilities, and the potential risk for donor site morbidity should be taken into account. [14] Recently, the development of biologic meshes has shown successful rates in the management of these parietal wall defects.…”

Post-traumatic Massive Abdominal Wall Defect- A Challenge

“…Their use as a first line option for reconstruction of large midline defects is dubious and ought to be discouraged [2]. Component separation technique as described by Ramirez is ideal for midline musculo-fascial defects greater than 3 cm in size and by the use of bilateral relaxing incisions and release, advancements up to 10 cm in upper, 18 cm in middle and 6-10 cm in lower thirds of the abdomen may be obtained [5]. This technique however requires an intact and innervated rectus abdominis muscle, which may not be available in victims of blast trauma or after ablative surgery for cancer [1].…”