The authors report a new technique for secondary abdominal closure after burst abdomen as illustrated by the case of a patient who developed a perforated sigmoid diverticulitis following septic polyarthritis. Sigmoid resection was followed on the sixth day postoperative by a burst abdomen. Upon abdominal revision the burst abdomen was found to be caused by necrotic destruction of the linea alba. Abdominal wall closure was achieved using the novel technique of inverting bilateral interrupted figure-of-eight suture of the anterior and posterior rectus sheaths in combination with relieving lateral incisions and mesh implantation in the sublay technique. It remains for future studies to show whether this technique can reduce the high incisional hernia rate following secondary abdominal wall closure.
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Published online: January 22, 2007
Accepted: November 19, 2005
Received: June 7, 2005
© 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.