Tackling Abdominal Wall Contour Deformities in Patients with Complex Ventral Hernias in Plastic Surgeon's Perspective

Abstract

Acquired abdominal wall defects or contour disturbances may develop due to traumas, soft tissue infections, previous surgical interventions, ablative tumor resections, burns, or radiation damages. Improvements in drug technology and surgical intensive care techniques have increased the rate of encountering patients with abdominal wall defects. One should consider that features of the defect such as size, depth, position, and associated medical problems undertake a guidance role while selecting the repair method of abdominal wall defect or contour disturbances. Distorted abdominal appearance due to abdominal wall defects or abdominal wall scarring can be repaired with local abdominal flaps, tissue expansion, panniculectomy, or abdominoplasty. A series of 25 patients with distorted abdominal appearance due to abdominal wall defects or abdominal scarring were treated by using tissue expansion, panniculectomy, abdominoplasty, or local abdominal flaps and, in some patients, concurrent ventral hernia repair. Age, gender, BMI scores, previous operations, surgical procedures, complications, outcomes, and patient/physician satisfactions were analyzed during the follow-up period. The average lady BMI score was higher than the average gentleman BMI score. Concurrent hernia repair was significantly higher in ladies (n: 20) than gentlemen (n: 3). In our patients, no recurrence of ventral hernia was detected in the follow-up period. The mean follow-up period was 37.08 months (range: 12-96). The resultant abdominal contour was satisfactory for both the patients and us. To improve the results, individualized approach should be preferred.