Partition technique in management of difficult abdominal fascia closure

Abstract

The partition technique is a type of method to repair abdominal fascia defects with autologous tissue. We present hereby our experience in 11 cases and report the relationship between some parameters and complication rates. From January 2006 to March 2010, 11 patients with complex abdominal fascia defects underwent reconstruction using the partition technique. The related data including sex, age, size of defect, duration of follow-up, comorbidities, mean fascia defect width/abdominal circumference ratio, body weight, body mass index (BMI), serum albumin level, and complications were collected. With regard to immediate postoperative outcome, patients were divided into two groups: patients with and without complications. The nonparametric Mann-Whitney U test was used to evaluate the differences between the groups; the receiver operating characteristic curve was used to assess the area under the curve (AUC), cutoff value, sensitivity, and specificity of each parameter. The relationships between comorbidities and postoperative complications were analyzed by Chi-square analysis. The mean fascia defect size was 11.85 cm, the mean follow-up was 18.64 months, and the mean fascia defect width/abdominal circumference ratio was 13.98%. Postoperative complications occurred in four patients. Compared with patients without complications, the group of patients with complications had a significantly larger fascia defect and greater fascia defect size/abdominal circumference ratio. The AUC for fascia defect size/abdominal circumference ratio (1.00) and fascia defect size (0.928) indicated that these two factors were good predictors. At 1-year follow-up, no patients developed any abdominal wall complications. The partition technique may be a single-stage solution to complex abdominal fascia defects, and the fascia defect width/abdominal circumference ratio is the most reliable parameter to predict the probability of complications.