Multimodality approach to a big defect of the abdominal wall

Aim. Abdominal wound dehiscence is common, usually resulting from laparotomies associated with contamination and necrosis. Dehiscences are managed by controlling the infection and local wound toilet, until local conditions at the site allow for wound closure. When this is not feasible, healing is by secondary intention. The objective of our study was to find a simple and reproducible method for abdominal wall reconstruction after trauma. Methods. This paper describes our experience in four cases of post-trauma reconstruction of complex abdominal wall defects by means of skin expansion associated with the use of a prosthetic mesh to repair the fascial defects. Results. In the cases described, we found a method for restoring abdominal wall integrity, with the use of skin expansion and a mesh for fascial closure. Tissue expansion has the advantage of ensuring a well vascularised and innervated autologous tissue reconstruction. Conclusion. This method was simple and had good clinical, functional and aesthetic results, achieving reconstructions with a long term stability and patients' satisfaction.