Post-Oncologic Abdominal Wall Reconstruction: Mesh Versus Autologous Tissue

Purpose of Review The aim of this review is to summarize and sum up the recent evidence on the topic of abdominal wall reconstruction post oncologic resection, comparing the use of mesh versus autologous reconstruction. Recent Findings Recent findings show a more accepting approach towards more complex reconstructions that aim at a dynamic and robust abdominal wall reconstruction. Musculocutaneous free flaps using the anterolateral thigh flap, with a vastus lateralis, or the latissimus dorsi flap are being used more for replacing musculo-fascial and full-thickness defects to restore abdominal domain. Those autologous reconstructions are best combined with a mesh for robust musculo-fascial layer closure. Different mesh options are available for different cases depending on defect and the contamination status of the wound. Post-oncologic abdominal wall reconstruction is a complex procedure that should be well planned in multidisciplinary teams. The surgical options should be set up on a case-by-case basis weighing the different benefits and risks of autologous, mesh, or combined reconstruction. The more robust the reconstruction, the less complications encountered, especially with hernia formation rates.