A Prospective Multicentre Study Evaluating the Outcomes of the Abdominal Wall Dehiscence Repair Using Posterior Component Separation With Transversus Abdominis Muscle Release Reinforced by a Retro-muscular Mesh - Filling a Step

This study determined the incidence of burst abdomen recurrent (BAR), incisional hernia(IH), and surgical site occurrence (SSO) following burst abdomen surgical treatment after abdominal midline incisions using a posterior component separation(CS) technique with transversus abdominis muscle release (TAR) reinforced by retro-muscular mesh technique.

Methods: Between June 2014 and April 2018, 202 patients with grade IA BA (Björck's first classification) were treated in a prospective multiple-center cohort study.

Inclusion criteria

• BA Grade IA according to Björck's initial classification following midline laparotomy from various departments,
• ≥ 18 years
• both sex
• emergency or elective surgery

Exclusion criteria

• BA grade 1B,2,3, and 4 according to Björck's initial classification,
• < 18 years,
• primary laparotomy performed through a non-midline incision, open abdomen,
• if another laparotomy had been performed between the surgery for BA and the end of the follow-up period,
• concomitant intra-abdominal surgery, abdominal complications during BA surgery,
• adherent bowel to the defect edge that cannot be separated,
• patients lost during follow up,
• presence of intra-abdominal contamination that cannot be controlled radiologically,
• history of previous BA repair,
• stoma exteriorized from the midline primary wound,
• temporarily wound closure techniques,
• prior abdominal surgeries other than operation resulted in BA,
• prior abdominal wall hernia repair with or without mesh,
• history of collagen diseases