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December 1983

Total Abdominal Wall Reconstruction

Author Affiliations

From the Divisions of Plastic Surgery (Drs Luce, Gottlieb, and Romm) and General Surgery (Dr Hyde), University of Kentucky Medical Center, Lexington.

Arch Surg. 1983;118(12):1446-1448. doi:10.1001/archsurg.1983.01390120066017

• A patient had full-thickness loss of abdominal wall from clostridial myonecrosis. Initial care consisted of resuscitation, débridement, and transfer to a hyperbaric chamber facility. After control of sepsis, multiple enteric fistulas were managed by enterotomies, gastric and duodenal defunctionalization with closed-loop gastrojejunostomy, gastrostomy, and end jejunostomy. Good nutritional status was maintained with total parenteral nutrition over a three-month period. Total abdominal wall reconstruction was accomplished by rotation of bilateral tensor fascia lata musculocutaneous flaps. Reconstruction was successful as the patient was able to return to an active life.

(Arch Surg 1983;118:1446-1448)