Abstract
Component separation is a technique used to provide adequate coverage for midline
abdominal wall defects such as a large ventral hernia. This surgical technique is
based on subcutaneous lateral dissection, fasciotomy lateral to the rectus abdominis
muscle, and dissection on the plane between external and internal oblique muscles
with medial advancement of the block that includes the rectus muscle and its fascia.
This release allows for medial advancement of the fascia and closure of up to 20-cm
wide defects in the midline area. Since its original description, components separation
technique underwent multiple modifications with the ultimate goal to decrease the
morbidity associated with the traditional procedure. The extensive subcutaneous lateral
dissection had been associated with ischemia of the midline skin edges, wound dehiscence,
infection, and seroma. Although the current trend is to proceed with minimally invasive
component separation and to reinforce the fascia with mesh, the basic principles of
the techniques as described by Ramirez et al in 1990 have not changed over the years.
Surgeons who deal with the management of abdominal wall defects are highly encouraged
to include this technique in their collection of treatment options.
Keywords
component separation - abdominoplasty - abdominal wall hernia - abdominal wall defects
- abdominal wall closure
