Comparison of component separation technique, partition technique, and extended anterolateral thigh flap in complex abdominal wall closure.

Abstract

This study tries to compare three methods in complex abdominal wall reconstruction. A retrospective review was conducted at a single medical center between December 2008 and May 2019. Forty-seven patients who received abdominal fascia repair were enrolled. The patients were divided into three groups: A [component separation technique (CST)], B (partition technique), and C [extended anterolateral thigh (ALT) flap]. All relevant patient information was collected. Statistical analysis including one-way analysis of variance, Chi-square test, and the receiver operating characteristic curve were used. There were no significant differences between the group results related to gender, age, BMI, follow-up, diabetes mellitus, tobacco, or short-, and long-term complications. However, there were significant differences in fascia defect size between groups (group A: 7.6 cm vs. group B: 10.76 cm vs. group C: 13.64 cm). The averaged operative time in group C (339.25 mins) was significantly longer than that in group A (145.40 mins) and B (152.37 mins). The hospitalization in group C (24.1 days) was significantly longer than that in group A (8.2 days) and B (10.3 days). The complication thresholds of group A and group B are 9.45 cm and 11.75 cm, respectively. This study suggests that extended ALT flap provides the largest fascia defect closure, followed orderly by partition technique and CST, but requires longer operative time and hospitalization. There are no significant differences in postoperative complications between three groups. A prospective study with indications based on these findings is suggested.