Huge Abdominal Wall Reconstruction in a Complicated Inguinal Hernia
Abstract
Inguinal hernia repair is a common surgery that can result in incarceration in some cases. Catastrophic events may be encountered in specialized circumstances, such as Fournier’s gangrene, which is an emergent condition. Treatment of debrided skin of the abdominal wall is always challenging, particularly in large defects.
A 69-year-old man suffered from complications following inguinal hernia repair, which included laparoscopic mesh repair, subsequent right hemicolectomy with anastomosis, leading to ileostomy, Fournier’s gangrene, and eventually a large skin defect in the lower abdomen and perineal area. After multiple sessions of wound
therapy, he underwent abdominal wall reconstruction with two large pedicled anterolateral thigh flaps.
Anterolateral thigh flaps, with their robust blood supply, can easily reach the lower abdomen and cover extensive abdominal skin defects when transferred bilaterally. Level of Evidence: Level V, therapeutic study
[2] Marcolin P, Mazzola Poli de Figueiredo S, Moura Fé de Melo V, Walmir de Araújo S, Mota Constante M, Mao RD, et al. Mesh repair versus non-mesh repair for incarcerated and strangulated groin hernia: an updated systematic review and meta-analysis. Hernia. 2023 Dec;27(6):1397-1413. https://doi.org/10.1007/s10029-023-02874-0
[3] Lewis GD, Majeed M, Olang CA, Patel A, Gorantla VR, Davis N, et al. Fournier’s Gangrene Diagnosis and Treatment: A Systematic Review. Cureus. 2021 Oct 21;13(10):e18948. https://doi.org/10.7759/cureus.18948
[4] Ninkovic M, Ninkovic M, Öfner D, Ninkovic M. Reconstruction of Large Full-Thickness Abdominal Wall Defects Using a Free Functional Latissimus Dorsi Muscle. Front Surg. 2022 Mar 17;9:853639. https://doi.org/10.3389/fsurg.2022.853639
[5] Leppäniemi A, Tukiainen E. Planned hernia repair and late abdominal wall reconstruction. World J Surg. 2012
Mar;36(3):511-5. https://doi.org/10.1007/s00268-011-1177-5
[6] Viswanathan S, Manjunath S, Ramesh BA, Jagannathan M. Large Abdominal Wall Defect Reconstruction: Revoking
and Modifying the Old Technique. Niger J Surg. 2019 JulDec;25(2):220-222. https://doi.org/10.4103/njs.njs_29_18
[7] Matsukubo M, Muto M, Yamada K, Nishida N, Kedoin C, Matsui M, et al. Abdominal wall defect repair with component separation technique for giant omphalocele with previous relaxing incisions on the abdominal skin. Surg Case Rep. 2023 Jun 7;9(1):99. https://doi.org/10.1186/s40792-023-01679-8
[8] Rongviriyapanich A. Reconstruction of a large abdominal wall defect without using mesh: A case report. Int J Surg Case Rep. 2020;75:517-520. https://doi.org/10.1016/j.ijscr.2020.09.125
Files | ||
Issue | Vol 9 No 5 (2024): September -October | |
Section | Case Report(s) | |
Keywords | ||
Anterolateral thigh flap (ALT) Abdominal wall reconstruction Fournier`s gangrene Inguinal hernia Incarceration |
Rights and permissions | |
![]() |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |