eMedicine Specialties > Plastic Surgery > Trunk

Abdominal Wall Reconstruction: Follow-up

Author: Mark A Grevious, MD, FACS, Assistant Professor of Surgery, Associate Program Director, Division of Plastic and Reconstructive Surgery, University of Illinois at Chicago
Coauthor(s): Mimis Cohen, MD, FACS, FAAP, Professor and Chief, Division of Plastic, Reconstructive and Cosmetic Surgery, University of Illinois at Chicago; Consulting Staff Craniofacial Center, University of Illinois at Chicago; Aisha D White, MBA, MD, Staff Physician, Department of Plastic Surgery, University of Illinois at Chicago; Bradon J Wilhelmi, MD, Endowed Leonard Weiner, MD, Professor and Chief of Division of Plastic Surgery, Residency Program Director, University of Louisville School of Medicine
Contributor Information and Disclosures

Updated: Jul 18, 2008

Future and Controversies

Conclusion

The management of complex abdominal wall defects continues to evolve. Successful abdominal wall reconstruction relies on careful perioperative planning, thorough technical execution, close follow-up, and appropriate selection of prosthetic or bioprosthetic material, when indicated.

Smaller defects can be reconstructed with local or regional tissue rearrangement procedures. Larger defects of the abdominal wall, which may have resulted from trauma or tumor extirpation, may require the use of myocutaneous flaps, prosthetic or bioprosthetic material, or both. These reconstructions can be performed in either 1 stage or 2 stages. Posttraumatic abdominal wall reconstruction may require a 2-stage reconstruction. 

The onus continues to fall on the reconstructive surgeon to be well informed about the indications, properties, and complications associated with the use of these very important biomedical tools to improve the quality of the lives of the patients who are being treated for these complex defects.

Defect size, location, depth of involvement, contamination, and comorbidity are all considerations that influence the management of abdominal wall defects. As the potential for complications of abdominal wall reconstruction is significant, patients with comorbid conditions must be appropriately evaluated and screened. However, with meticulous planning, application of operative techniques which incorporate the principle of reconstruction with minimal tension, and diligent postoperative care, abdominal wall reconstruction can be achieved with reasonable functional and cosmetic outcomes, patient satisfaction, and acceptable complication rates.

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors Michael Neumeister, MD, FRCSC, FACS; Arian Mowlavi, MD; and Elvin G Zook, MD to the development and writing of this article.



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References
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Further Reading

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Keywords

abdominal wall reconstruction, abdominal reconstruction, abdominal defect, abdominal wall defect, tissue rearrangement, regional flap, free tissue transfer, abdominal layer, abdominal wall, abdominal procedure, abdomen defect, abdominal wall function, ventral hernia repair, ventral defect, abdominal viscera herniation, hernia, hernia reconstruction, incisional hernia, celiotomy, intraabdominal pressure, herniorrhaphies, desmoid tumor, abdominal tumor, abdominal gunshot injury, abdominal gunshot

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Contributor Information and Disclosures

Author

Mark A Grevious, MD, FACS, Assistant Professor of Surgery, Associate Program Director, Division of Plastic and Reconstructive Surgery, University of Illinois at Chicago
Mark A Grevious, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, and Association for Academic Surgery
Disclosure: Nothing to disclose.

Coauthor(s)

Mimis Cohen, MD, FACS, FAAP, Professor and Chief, Division of Plastic, Reconstructive and Cosmetic Surgery, University of Illinois at Chicago; Consulting Staff Craniofacial Center, University of Illinois at Chicago
Mimis Cohen, MD, FACS, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Association of Pediatric Plastic Surgeons, American Association of Plastic Surgeons, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, American Society for Aesthetic Plastic Surgery, American Society of Maxillofacial Surgeons, American Society of Plastic and Reconstructive Surgery, Association for the Advancement of Automotive Medicine, Chicago Medical Society, Illinois State Medical Society, and Plastic Surgery Research Council
Disclosure: Nothing to disclose.

Aisha D White, MBA, MD, Staff Physician, Department of Plastic Surgery, University of Illinois at Chicago
Disclosure: Nothing to disclose.

Bradon J Wilhelmi, MD, Endowed Leonard Weiner, MD, Professor and Chief of Division of Plastic Surgery, Residency Program Director, University of Louisville School of Medicine
Bradon J Wilhelmi, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for Hand Surgery, American Association of Clinical Anatomists, American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Society for Aesthetic Plastic Surgery, American Society for Reconstructive Microsurgery, American Society for Surgery of the Hand, American Society of Plastic Surgeons, Association for Surgical Education, Plastic Surgery Research Council, and Wound Healing Society
Disclosure: Nothing to disclose.

Medical Editor

Dennis P Orgill, MD, PhD, Associate Professor, Harvard Medical School; Director, Burn Center, Brigham and Women's Hospital
Dennis P Orgill, MD, PhD is a member of the following medical societies: American Burn Association, American Medical Association, American Society for Reconstructive Microsurgery, Massachusetts Medical Society, and Plastic Surgery Research Council
Disclosure: Kinetic Concepts, Inc. Grant/research funds Principle Investigator; Marine Polymers  Grant/research funds Principle Investigator; Naval Blood Research Lab Grant/research funds Principle Investigator

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

R Edward Newsome, MD, Associate Professor, Program Director and Chief, Department of Surgery, Section of Plastic Surgery, Tulane University Health Sciences Center
R Edward Newsome, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society of Plastic Surgeons, and Louisiana State Medical Society
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Practice Director, Colorado Plastic Surgery Center at Swedish Medical Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

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