s / International Journal of Surgery 10 (2012) S1–S52 S46 ABSTRACTS 0354: COMPONENTS SEPARATION WITH ONLAY MESH: A SAFE AND EFFECTIVE REPAIR FOR COMPLEX ABDOMINAL WALL HERNIAS. EXPERIENCE WITH 50 CASES AND THE DEVELOPMENT OF A TRIPLE MESH TECHNIQUE Steve Hornby, James Boorer, Neil Patel, Andrew Kingsnorth. Derriford Hospital, Plymout, UK Introduction: Closuring complex major abdominal hernias risks abdominal compartment syndrome. Components separation (CS) allows midline closure in most cases. This poster outlines our experience including postoperative quality of life (QoL) and the evolution of a triple mesh technique. Method: Retrospective case notes review and structured telephone interview of patients undergoing CS between October 2005 and May 2010 at Derriford Hospital. Results: 50 patients underwent CS; 41 underwent telephone follow-up (82%). Median follow-up was 29 months (range 3.2 57.6). 29 Patients were men;medianagewas60andBMI33.8 (range20-48.1).Woundcomplications affected16(38%); themajority settlingwithconservativemanagement. There was 1 recurrence of original hernia and 2 subsequent parastomal hernias. One patient developed a hernia related to the lateral release. Since developing the triple onlay technique there have been no recurrences. The series has one death related to small bowel ischaemia. 36(88%) of patients reported improved QoL; (95%) were happy to recommend the procedure to a friend. Conclusion: CS is associated with low mortality (2%); minimal long term morbidity and improved QoL. Triple mesh technique results in a low recurrence rate. We recommend CS with a triple onlay mesh for repairing complex major abdominal wall defects. 0357: THE ROLE OF PLAIN ABDOMINAL X-RAY IN ACUTE SURGICAL SETTING: A RETROSPECTIVE ANALYSIS Luke Stroman, Mohamed Ismat Abdulmajed, Cassandra McDonald, Palanichamy Chandran. Wrexham Maelor Hospital, Wrexham,