Open Anterior Component Separation Reconstruction Technique for Large Ventral Incisional Abdominal Wall Hernias

Abstract

Background: Eleven percent of all abdominal laparotomies are complicated with ventral abdominal wall hernias, which is an increasing problem.

Aim: To assess complication rates as well as outcomes of the open anterior component separation (ACS) technique for large ventral and incisional abdominal wall repair.

Patients and Methods: This prospective research was conducted on twenty cases who underwent open ACS procedure for large  incisional hernia. Clinical and routine studies including investigations of blood and radiological investigations, as abdominal US, were  performed for all cases.

Results: Regarding operative data, the duration of the operation varied from 123 to 167 min with a mean of 142.6 ± 14.5 min, and blood  loss varied from 318 to 712 ml with a mean of 495.7 ± 130.41 ml. Regarding prevalence of 30-day readmission, 4 (20%) individuals were  readmitted to the hospital within a month after operation. Regarding wound complications, 5 (25%) patients had infection, 3 (15%)  patients had seroma, 2 (10%) patients had hematoma, and 1 (5%) patient had skin necrosis. Regarding GIT complications, 3 (15%)  patients had paralytic ileus and 1 (5%) patient had fistula. No cases had systemic complications.

Conclusions: The open anterior  components separation technique still a good option for detecting primary fascial closure in treating giant ventral hernias. Preserving  perforator vessels and retromuscular mesh placement are to be installed to original method to reduce wound problems and rather high  recurrence rate.