Abdominal Wall Reconstruction Using De-Epithelialized Dermal Flap: A New Technique

ABSTRACT

Background: Although autogenous materials have been used in abdominal wall hernioplasty for a long time; the introduction of prosthetic materials diminished their popularity. However; these materials may be expensive; inappropriate or unavailable. The aim of this study is to determine the place of de-epithelialized dermal flap in the reconstruction of abdominal wall hernias. Materials and Methods: A five-year prospective; descriptive analysis of eligible patients with difficult abdominal wall hernias closed with de-epithelialized dermal flap in a Nigerian Tertiary Health Institution; from January 2001 to December 2005. Results: Over the five-year period; 37 patients were recruited into the study. There were 11 males and 26 females; giving a male female ratio of 1 2.4. The ages ranged from 8 months to 47 years (mean = 12.6 years). The defects consisted of 15 incisional hernias; 12 intermuscular/inferior lumbar hernias; nine healed exomphalos major and two giant umbilical hernias. The size of the hernia defects ranged from 4.5 cm to13cm (mean = 6.4 cm). Three patients had bowel resection and end-to-end anastomosis; in addition to the flap reconstruction. Morbidity was minimal and included skin dimpling in 11 patients; seroma in three; and wound infection in two patients. Neither recurrence of herniation nor mortality was recorded during the period of follow-up; which ranged from three months to 4.5 years (mean = nine months). Conclusion: The results suggest that this is a useful technique that can easily be applied in many centers with minimal resources. It is cheap; effective and associated with minimal morbidity