Summary: Reconstructive surgeons supporting military operations are required to definitively treat severe pediatric abdominal injuries in austere environments. The safety and efficacy of using a components separation technique to treat large ventral hernias in pediatric patients in this setting remains understudied. Components separation technique was required to achieve definitive closure in a 12-month-old pediatric patient in Kandahar, Afghanistan. Her course was complicated by an anastomotic leak after small bowel resection. Her abdominal was successfully reopened, the leak repaired, and closed primarily without incident on postinjury day 9. Abdominal trauma with a large ventral hernia requiring components separation is extremely rare. A pediatric patient treated with components separation demonstrated minimal complications, avoidance of abdominal compartment syndrome, and no mortality.
From the *Plastic and Reconstructive Surgery Service, Walter Reed National Military Medical Center, Bethesda, Md.; †The Department of Trauma and General Surgery, The Role 3 NATO Multinational Medical Unit, Kandahar, Afghanistan; ‡Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Md.; and §Department of Plastic and Reconstructive Surgery, The University of Pittsburgh Medical Center, Pittsburgh, Pa.
Received for publication February 18, 2014; accepted April 16, 2014.
Presented at the Plastic Surgery: The Meeting 2013, October 2013, San Diego, Calif.
Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Army, Department of Defense, or the United States Government.
Ian L. Valerio, MD, MS, MBA, FACS, Department of Plastic and Reconstructive Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD 20889, E-mail: firstname.lastname@example.org
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