Component separation technique for closure of burst abdomen

Abstract

Background: Burst abdomenis a continuing problem for thegeneral surgeon as theincidence of such complication may reach 3% with a mortality rate exceeding 25%. Methods: Component separation of all layers of anterior abdominal wall would give an extra length on each side towards medial advancement. 20 patients, 12 men and 8 women aged 35-65 {mean, 48.6) years, with burst abdomen after major gastrointestinal and hepatobiliary surgery whose abdomen could not be closed primarily were managed using this technique. Long term follow up of patients was done for development of complications. Results: One patient died on the fourth postoperative day from pulmonary embolism {mortality 5%), and 2 patients developed subincisional abscesses (10.5%). Skin necrosis occurred in 1 patient (5%). No single case of reburst occurred Only one patient showed few symptoms of abdominal compartment syndrome. The mean hospital stay was 18.5 days. Long term follow up showed only one case ofincisional hernia (5.5%) in a patient with biliary fistula. Conclusion: The component separation technique is a suitable, straightforward and tension free method with a comparable mortality and morbidity to other conventional methods for closure of burst abdomen.