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Case Reports in Medicine
Volume 2014, Article ID 235930, 4 pages
Case Report

Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect

1University of Milan, School of Plastic Surgery, Plastic Surgery Department, Multimedica Holding S.p.A, Via Milanese 300, Sesto San Giovanni, 20099 Milan, Italy
2University of Milan, School of Plastic Surgery, Department of Translational Medicine (BIOMETRA), Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano, 20089 Milan, Italy
3Università degli Studi di Milano, Dipartimento di Biotecnologie Mediche e Medicina Traslazionale (BIOMETRA), IRCCS Istituto Clinico Humanitas, U.O. Chirurgia Plastica, Via Manzoni 56, Rozzano, 20090 Milan, Italy

Received 9 December 2013; Revised 4 February 2014; Accepted 18 February 2014; Published 19 March 2014

Academic Editor: Tobias Keck

Copyright © 2014 Fabio Caviggioli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Reconstruction of open abdominal defects is a clinical problem which general and plastic surgeons have to address in cooperation. We report the case of a 66-year-old man who presented an abdominal dehiscence after multiple laparotomies for a sigmoid-rectal adenocarcinoma that infiltrated into the abdominal wall, subsequently complicated by peritonitis and enteric fistula. A cutaneous dehiscence and an incontinent abdominal wall resulted after the last surgery. The abdominal wall was reconstructed using a biological porcine cross-linked mesh Permacol (Covidien Inc., Norwalk, CT). Negative Pressure Wound Therapy (NPWT), instead, was used on the mesh in order to reduce wound dimensions, promote granulation tissue formation, and obtain secondary closure of cutaneous dehiscence which was finally achieved with a split-thickness skin graft. Biological mesh behaved like a scaffold for the granulation tissue that was stimulated by the negative pressure. The biological mesh was rapidly integrated in the abdominal wall restoring abdominal wall continence, while the small dehiscence, still present in the central area, was subsequently covered with a split-thickness skin graft. The combination of these different procedures led us to solve this complicated case obtaining complete wound closure after less than 2 months.