Abdominal Wall Reconstruction Using De-epithelializedDermal Flap: A New Technique

Background: although autogenous materials have beenused in abdominal wall hernioplasty for a long time,the introduction of prosthetic materials diminished theirpopularity. however, these materials may be expensive,inappropriate or unavailable. the aim of this study is todetermine the place of de-epithelialized dermal flap in thereconstruction of abdominal wall hernias. materials andmethods: a five-year prospective, descriptive analysis ofeligible patients with difficult abdominal wall hernias closedwith de-epithelialized dermal flap in a nigerian tertiary healthinstitution, from january 2001 to december 2005. results:over the five-year period, 37 patients were recruited into thestudy. there were 11 males and 26 females, giving a male:female ratio of 1: 2.4. the ages ranged from 8 months to47 years (mean = 12.6 years). the defects consisted of 15incisional hernias, 12 intermuscular/inferior lumbar hernias,nine healed exomphalos major and two giant umbilicalhernias. the size of the hernia defects ranged from 4.5cm to13cm (mean = 6.4 cm). three patients had bowelresection and end-to-end anastomosis, in addition to theflap reconstruction. morbidity was minimal and includedskin dimpling in 11 patients, seroma in three, and woundinfection in two patients. neither recurrence of herniationnor mortality was recorded during the period of follow-up,which ranged from three months to 4.5 years (mean = ninemonths). conclusion: the results suggest that this is auseful technique that can easily be applied in many centerswith minimal resources. it is cheap, effective and associatedwith minimal morbidity.