Introduction:

Abdominal wall repair, presents complex scenarios, as the bellies open with ostomy or intestinal fistulas, that treatment the surgeon should seek surgical tactics and ideal management for each case.

Objective:

To describe the results in repair of complex defects of the abdominal wall and return of intestinal transit in a single time.

Patients and methods:

observational, descriptive, prospective and longitudinal study, a series of 30 patients, both sexes, over 18 years, carriers of complex defects of the abdominal wall (open abdomen healed by second intention and paraestomales herniations) and ostomy admitted for elective surgery at the surgical clinic of the Hospital de Clínicas of March 2011 to2015 December II. All patients were evaluated with axial computed tomography, according to the case subject to progressive pneumoperitoneum progressive pre operative and managed by a multidisciplinary team.

Results:

Were included 30 patients, 9 women and 21 men with an average age of 51.5 years (20-83 years), diameters trasverso parietal defect with an average 18, 5cm (12 to 25 cm). Parietal defects were: incisional hernia planned 27 patients (open abdomen scarred by second intention) and paraestomales hernias 3 patients. In 25 patients and separation of components in the remaining technique was used only anatomical closure of the defect; in all cases reinforcement polypropylene in position onlay prosthesis. Intestinal anastomoses were manual in 11 cases and with mechanical suture in 19 cases. The hospital stay was average of 35 days, complications in 16,6% (2 infections of surgical wound, 2 dehiscence of intestinal anastomosis et 1 hemoperitoneo ), died a patient, follow-up at 24 months without recurrence.

Conclusion:

The use of this technique, in well selected patients and a group of experts and multidisciplinary management could be a good choice.

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