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Semin Plast Surg 2012; 26(01): 25-28
DOI: 10.1055/s-0032-1302462
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Component Separations

Lior Heller
1   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
,
Colton H. McNichols
1   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
,
Oscar M. Ramirez
2   Elite Surgical Center, Weston, Florida
› Author Affiliations
Further Information

Publication History

Publication Date:
23 February 2012 (online)

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Abstract

Component separation is a technique used to provide adequate coverage for midline abdominal wall defects such as a large ventral hernia. This surgical technique is based on subcutaneous lateral dissection, fasciotomy lateral to the rectus abdominis muscle, and dissection on the plane between external and internal oblique muscles with medial advancement of the block that includes the rectus muscle and its fascia. This release allows for medial advancement of the fascia and closure of up to 20-cm wide defects in the midline area. Since its original description, components separation technique underwent multiple modifications with the ultimate goal to decrease the morbidity associated with the traditional procedure. The extensive subcutaneous lateral dissection had been associated with ischemia of the midline skin edges, wound dehiscence, infection, and seroma. Although the current trend is to proceed with minimally invasive component separation and to reinforce the fascia with mesh, the basic principles of the techniques as described by Ramirez et al in 1990 have not changed over the years. Surgeons who deal with the management of abdominal wall defects are highly encouraged to include this technique in their collection of treatment options.

Keywords

component separation - abdominoplasty - abdominal wall hernia - abdominal wall defects - abdominal wall closure
 

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