Reconstructive Options of Abdominal Wounds in the Setting of Abdominal Wall Defects and Hernias

Abstract

The abdominal wall is an integral, yet often ignored, functional unit that, while performing an important aesthetic role, is required to protect vital internal organs and allow for physical activity. Thus, the goals of abdominal wall reconstruction (AWR) are to restore these crucial functions. Understanding and appreciating the abdominal wall anatomy is critical for successful reconstruction. When surgical intervention is required, preoperative nutrition optimization and glucose control are imperative to permit desired wound healing. From a reconstructive standpoint, repair can be done via an open or closed approach. However, most defects that a plastic surgeon encounters are large, requiring an open approach, likely with mesh utilization. Numerous strategies for mesh placement are addressed in this chapter, and options for soft tissue coverage are addressed by location. Abdominal wall defects require a logical, multidisciplinary, individualized approach to permit successful reconstruction. However, with a solid foundation of anatomy and familiarity with options for soft tissue coverage, successful reconstruction can be achieved.