An Obturation Technique for Closure of Body Wall Defects.
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Date
2015
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Abstract
Aims: In the vast majority of instances, closure of abdominal wall defects relies on the tensile
strength of transposed native tissue and/or prosthetic material. The purpose of this report is to alert
clinicians to a different strategy for closure that we have used successfully on several occasions.
Presentation of Case: A 72 year old man had a bulky inguinal nodal metastasis from cutaneous
squamous cell carcinoma. He had an extended radical groin dissection including full thickness
abdominal wall resection, with primary closure, followed by external beam radiotherapy. After 30
months, he developed an abdominal wall hernia and enterocutaneous fistula at the surgical site.
Direct closure and local vascularized flaps were not feasible. Obturation of the defect by omentum
was employed, taking advantage of its relative incompressibility rather than its minimal tensile
strength. The wound was subsequently covered by a skin graft. The patient survived 10 years with
an intact hernia repair and died of unrelated causes.
Discussion: The technique has yielded good results. Conclusions: This surgical option is valuable for situations in which the abdominal wall defect to
be closed is fibrotic, has been radiated, is infected, or is otherwise not suitable for conventional
techniques.
Description
Keywords
Hernia, surgery, omentum, obturation, abdominal wall defect
Citation
Johnson David Y, Franke Mark A, Phillips Nancy J, Johnson Frank E. An Obturation Technique for Closure of Body Wall Defects. British Journal of Medicine and Medical Research. 2015; 7(12): 1039-1043.