Elfiah Ulfa, Saputra Antonius Dwi
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Jember, Jember, Indonesia.
J Surg Case Rep. 2023 Aug 14;2023(8):rjad463. doi: 10.1093/jscr/rjad463. eCollection 2023 Aug.
An incisional hernia (IH) is a common complication after a cesarean section (CS). Large IH mesh repair is problematic when initial fascial closure cannot be accomplished. We report the case of a large IH for 20 months after a CS with a midline vertical incision that was treated with a combination of modified peritoneal flap hernioplasty and abdominoplasty. There was a large fascia defect (15 × 21 cm) and adhesions of the omentum and the ileum to the anterior abdominal wall. CS with midline vertical incision, history of surgical site infections and obesity are risk factors that increase IH. In conclusion, this combination successfully repairs a large IH, reduces obesity, prevents recurrence and complications after hernia repair, improves the abdominal shape and patient quality of life. Abdominoplasty is also performed to create new umbilical and vascular preservation.
切口疝（IH）是剖宫产（CS）术后常见的并发症。当初次筋膜闭合无法完成时，大型切口疝修补术存在问题。我们报告了1例剖宫产术后20个月的大型切口疝病例，该患者采用中线垂直切口，采用改良腹膜瓣疝修补术和腹壁成形术联合治疗。存在一个大的筋膜缺损（15×21厘米），大网膜和回肠与前腹壁粘连。中线垂直切口剖宫产、手术部位感染史和肥胖是增加切口疝的危险因素。总之，这种联合方法成功修复了大型切口疝，减轻了肥胖，预防了疝修补术后的复发和并发症，改善了腹部外形和患者生活质量。还进行了腹壁成形术以重建新的脐部并保留血管。
