Tension-reduced closure of large abdominal wall defect caused by shotgun wound: A case report

Figure 1 The patient’s first preoperative, intraoperative, and postoperative conditions in our department. A: Length of the abdominal bulge when the patient was standing; B: Width of the abdominal bulge when the patient was standing; C: Grafted skin of the abdomen was carefully removed; D: Immediate primary closure was achieved, utilizing 7 Top Closure^® and 8 mm sets; E: Top Closure^® 1S 8 mm sets; F: Tension Relief System was removed 3 wk after installation.

Figure 2 The patient’s surgical procedure and the dynamic changes in biochemical indicators. A: The anterolateral thigh perforator (ALT) flap was designed preoperatively according to the size of the defect in the recipient area; B: The skin and subcutaneous tissue were incised and the ALT flap was separated from the surrounding tissue; C: The ALT flap was freed and the tip was broken; D: Mesh was used to reinforce the abdominal wall hernia; E: ALT flap was grafted to the abdomen and vascular anastomosis was performed; F: The abdominal wound was closed and the abdominal skin was sutured; G: The patient’s volume of urine changes over time; H: The patient’s creatinine values over time.

Figure 3 Timeline of treatment events. ALT: Anterolateral thigh perforator.

Figure 4 One year following surgery, the patient recovered well and reported significant improvement in quality of life without signs of hernial recurrence.