Use of Tissue Expanders for Reconstruction of an Extensive Abdominal Wall Defect -A Case Report and Literature Review

Abstract

Laparotomies are indicated for patients suffering pulmonary or renal failure related to abdominal compartment syndrome. Large defects of the abdominal wall usually follow laparotomies that are associated with increased intraabdominal pressure. Therefore, primary closure of a large abdominal wall defect can be quite difficult or virtually impossible. Surgeons are guided by the desire to return the patient's abdominal wall, as much as possible, to its preoperative contour, texture and color. A method of accelerated delayed primary closure has been developed which leads to gradual expansion of the skin and subcutaneous tissue by means of the application of external tissue expanders. We report a successful closure of a huge abdominal wall defect for a case of necrotizing pancreatitis following a 14-day period of abdominal wall skin expansion by an implanted device. We also review the literature pertaining to the use of tissue expanders for the reconstruction of abdominal wall defects.