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Abdominal Wall Reconstruction
24 July 2018 (online)
Approaches to reconstruction of the abdominal wall is an evolving debate that is fueled by innovations in surgical technique, advances in materials science, bioprosthetic device development, and evidence-based medicine. The repair and reconstruction of abdominal wall defects is a complex clinical problem, dependent on factors that are unique to each patient, defect, and clinical scenario. As such, the ideal approach to abdominal wall reconstruction involves a thoughtful, integrated approach that allows the surgeon to create an evidence-based, multidisciplinary, and patient-centric operative plan.
Although the indications for surgical repair of abdominal wall defects are well established and often self-evident, there have remained some durable controversies in the surgical community about techniques, the need for reinforcement of surgical repairs, mesh choice and placement, the necessity and approach to component separation, and management of the overlying soft tissue. Within each of these subjects is its own universe of data, controversy, and subject matter. There is too much to cover in a single issue, so in this compilation, specific topics are discussed by experts in the field. The following is not meant to be a comprehensive review of abdominal wall reconstruction, but rather a close examination of select topics and controversies which are intended to shine light on them and provide insights.
Abdominal wall reconstruction continues to be a fascinating field in a very difficult patient population. This is not a glamorous subject, and good outcomes require experience, judgment, a detailed understanding of anatomy, and meticulous surgical technique. For this reason, plastic surgeons have historically had a great impact on this field even though the vast majority of abdominal wall reconstruction is performed by general surgeons. I hope that the rich history of plastic and reconstructive surgeons' contribution to this subject remains vibrant and healthy in the future of plastic surgery. I hope this volume helps furthers that effort and maintains the interest of our specialty, for the sake of the patients who need our services.