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Chirurgia 2005 October;18(5):367-72

language: Italian

Anatomical reconstruction of the abdominal wall

Del Frari C., Annacontini L., Piza-Katzer H.


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Abdominal wall reconstruction for the treatment of post-laparotomic hernia is still today a challenge both for general and plastic and reconstructive surgeons. The aim of the reconstruction is to recover the normal anatomy ­ rectus abdominis muscles approximation to reduce muscles diastasis, linea alba reconstruction, restoring of the abdominal wall muscle-aponeurotic ring - in order to avoid some important functions (like posture, walking, breathing, coughing in which we assist to an increase of the intra-abdominal pressure) compromising. At the Plastic and Reconstructive Surgery Department of Innsbruck (Austria), in the past 9 years, 21 anatomical reconstruction of the abdominal wall were performed. We present two cases: the first is about a patient 11 years old born with a gastroschisis immediately repaired with a Goretex mesh. In the 2000 she underwent a new operation for rectus abdominis muscles diastasis: the mesh was removed and the diastasis recovered. The second case is about a patient 58 years old with a postlaparotomic hernia and an important - 15 cm - rectus abdominis muscles diastasis. This patient too, underwent anatomical reconstruction of the abdominal wall. Follow-up is satisfactory for both cases. This surgical technique allows abdominal wall constituent elements repositioning in their natural seat without using skin grafts or muscle or fasciocutaneous flaps, with very good aesthetic results

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