Anterior component separation technique for abdominal wall closure among patients undergoing colorectal surgery: Short-term outcomes and initial experience

Abstract

Introduction

The anterior component separation (ACS) is a technique used for abdominal wall closure performed by dissecting and medially advancing the musculature to achieve tension-free closure.

Methods

and Materials:

This study reviewed our experience with this procedure as used for complex abdominal wall defects encountered during colorectal surgery in a 7-year period.

Results

Sixteen patients were included, with 12 having malignancies and the rest for infectious or inflammatory conditions. Defects ranged from 16–400 cm² and were mostly located at the midline (56%, n = 9). Five cases required additional flaps for closure, attributed either to the size or area of abdominal involvement where benefits of component separation is more limited. Complications include surgical site infection (n = 4), hematoma (n = 2), seroma (n = 1), and wound dehiscence (n = 2). None required ICU admission or assisted ventilation post-operatively. One patient died who had a preexisting cardiac pathology, and the rest were discharged improved.

Conclusion

This study demonstrates use of this modality for autologous reconstruction of complex appropriately sized abdominal wall defects from multiple etiologies. Adjunct flaps may be used to achieve reconstruction particularly in areas wherein the effectiveness of ACS is limited. While the study is able to describe immediate outcomes, long-term follow-up is recommended.