Post-traumatic massive abdominal wall defect — A challenge

Abstract

Blast trauma due to fragmentation devices can be devastating. The management of complex and multiple injuries, particularly when associated with intra-abdominal injuries and complicated by abdominal wall defect is a test of endurance for both patient and the surgeon. The reconstructive goals for the abdominal wall defect in such cases are to preserve life by providing a speedy cover to exposed abdominal viscera, protect the abdominal contents and provide functional support. Full thickness abdominal wall defects exceeding 6 cm in transverse diameter have been categorized as massive [1]. Their closure requires import of autogenous tissue in the form of vascularised flaps. Reconstruction by local or regional flaps may not be feasible in the acute stage on account of involvement of donor areas and the resultant defect at the donor site. We report a case of staged reconstruction of a massive abdominal wall defect following blast trauma from a land mine explosion by tissue expansion and prosthetic mesh.