Value of using the anterior rectus abdominis sheath turnover flap for fascial repair of gapping ventral midline incisional hernia

Background: Complex abdominal wall defects are a dangerous situation to the patient and challenging to the surgeon. The defects can occur after trauma, oncologic resection, infection or any other reason. Those patients are frequently left with retracted abdominal musculature. Patients and Methods: During a period from June 2012 to November 2015, thirty six patients with complex ventral abdominal wall defect were repaired by autologous fascial reconstruction using bilateral anterior rectus abdominis sheath turn over flaps that were sutured in the medline, then the repair was completed byprolene mesh enforcement. Results: All the 36 patients passed without recurrence. The complication rate was 25%, including mild skin infection, seroma, partial superficial skin necrosis, and hematoma. Factors associated with increased rate of overall complications included chronic obstructive pulmonary disease, diabetes mellitus, obesity and factors related to the indication for the primary surgery. Conclusions: Ventral incisional hernia and burst abdomen are a frustrating event to the patients. In this study the repair using anterior rectus abdominis sheath turn over flap, was feasible, successful, reliable and effective method for repair of ventral incisional hernia.