The Research Of Brad Composix Mesh Combined With Skin Flap Transfer Repair Large Abdominal Wall Defects

Objective To evaluate the methods，indications and efficacy of artificialantiadhesive mesh combined with local skin flap transfer repair full thickness largeabdominal wall defects associated with peritoneal defect.Methods Select from November2008to December2012, in our hospital,8cases of full-thickness abdominal wall and peritoneal defect after abdominal surgeryand the around skin can not be free to draw directly. Of the8cases,2males and6females; the average age was53years(range,32～76years). The mean course ofdisease was2.3years (range,1～4years).Only1case of abdominal wall scarcontracture; the others are abdominal tumor, postoperative pathological types:3casesof protuberans skin fibrosarcoma, squamous cell carcinoma in1case, epithelioidsarcoma in1case, sweat gland carcinoma in1case, colon cancer invading abdominalwall in1case, epithelioid sarcoma was recurrent three times. The primary lesion doesnot infringe the gastrointestinal tract, and no wound contamination, incisioncategories are class I，1patient with diabetes and hypertension, and1case ofpulmonary infection.8cases were used the Bard Composix mesh combined with localskin flap pimary repair.Result Diseased tissue resection of peritoneal defect area4cm×5cm~10cm×12cm; muscle defect area4cm×5cm~10cm×12cm；skin defect area6cm×10cm~12cm×15cm; the mesh area7cm×8cm~13cm×15cm.8cases of successfulcompletion of the surgery,6cases of rotation skin flap,2cases of advance skin flap,the mean operation time was110min(range,80~120min), the blood loss of80~200mL.The operation was successful in all the cases, skin flap survived. only1case foundsubcutaneous fluid, to consider poor drainage, caused by liquefaction of fat, cure afterdrainage and local pressure dressing;1case of abdominal wall pain symptoms after six months. Telephone follow-up of3months to4years, the death of patients withcolon cancer in tumor metastasis; remaining patients without evidence of recurrence,incisional hernia, abdominal distension, abdominal foreign body sensation, canengage in normal physical activity.Conclusions The method of Bard Composix antiadhesive mesh combinedwith local flap repair the large abdominal wall defects and peritoneum defect is simple,effective and reliable, and can prevent the occurrence of adhesions and incisionalhernia.