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Case Reports
. 2014 Jan 20;2014(1):rjt133.
doi: 10.1093/jscr/rjt133.

Component separation in abdominal trauma

Edward Rawstorne  1 , Christopher J Smart  2 , Simon A Fallis  2 , Nigel Suggett  2
Affiliations
Case Reports

Component separation in abdominal trauma

Edward Rawstorne et al. J Surg Case Rep. .

Abstract

Component separation is established for complex hernia repairs. This case presents early component separation and release of the anterior and posterior sheath to facilitate closure of the abdominal wall following emergency laparotomy, reinforcing the repair with a biological mesh. On Day 11 following an emergency laparotomy for penetrating trauma, this patient underwent component separation and release of the anterior and posterior sheath. An intra-abdominal biological mesh was secured, and the fascia and skin closed successfully. Primary abdominal closure can be achieved in patients with penetrating abdominal trauma with the use of component separation and insertion of intra-abdominal biological mesh, where standard closure is not possible.

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Figures

Figure 1:
Figure 1:
Defect following removal of topical negative pressure dressing.
Figure 2:
Figure 2:
Component separation showing the released anterior sheath [(A) incised external oblique aponeurosis; (B) internal oblique; (C) released edge of external oblique aponeurosis].
Figure 3:
Figure 3:
Posterior sheath released from rectus.
Figure 4:
Figure 4:
The mesh is sutured to the abdominal wall.
Figure 5:
Figure 5:
The rectus muscle has been closed, and a drain is placed prior to closing the skin.
Figure 6:
Figure 6:
The wound at discharge from hospital.
See this image and copyright information in PMC

References

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