GS07 ABDOMINAL WALL COMPONENTS SEPARATION TECHNIQUE FOR CLOSURE OF VENTRAL DEFECTS – INITIAL EXPERIENCE AND LESSONS LEARNT

Abstract

Purpose The Abdominal Wall Components Separation Technique (AWCST), allows closure of ventral defects by transposition of the abdominal wall muscle(1). The aim of this audit of our initial experience was to evaluate the technique for repairing defects after removal of infected mesh or for uncomplicated incisional hernia.Methodology A prospective audit was conducted on the initial experience of 9 consecutive patients under the care of one surgeon (BPW) from August to December 2006.Results Of the 9 patients, 5 had infected mesh and 4 had large incisional hernias. The median follow up was 62 days range 7–125 days. Significant wound infections occurred in 4 patients requiring re‐operation. In all 4 abdominal wall repair remained in tact. 1 patient has developed a recurrent incisional hernia.Conclusion AWCST is an useful procedure for the closure of large defects, particularly for incisional hernia and may avoid the use of mesh. We recommend avoiding primary skin closure after removing infected mesh and follow the principle of delayed primary closure. No specific conclusions can be made from this small series with a short follow up, but the technique has merit and requires further evaluation.