Reconstruction of large abdominal wall defects

Reconstruction of a large abdominal defect is a technically demanding procedure. A single flap is sometimes insufficient for cover. Compound procedures play an important role in solving this problem. The case of a 35-year-old man with a large abdominal hernia as a result of a traumatic defect on the right abdomen, previously covered by a skin graft, is presented. The reconstructive method was initially expansion of posterior and upper parts of the defect and also of the tenser fascia lats in situ and then deepithelization of the previous skin graft over the intestinal serosa. The defect was covered by Prolene mesh, the upper and dorsal expanded skin was approximated, and an expanded tenser fascia lata flap was transposed to complete the cover. During follow-up examinations, there were no complications such as infection or recurrence of the hernia.