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Use of posterior component separation and transversus abdominis release in trauma and emergency general surgery patients: a case report and review of the literature
  1. John J Como1,
  2. Oliver L Gunter2,
  3. Jose J Diaz3,4,
  4. Vanessa P Ho1,
  5. Preston R Miller5
  1. 1 Surgery, MetroHealth Medical Center, Cleveland, Ohio, USA
  2. 2 Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
  3. 3 Acute Care Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
  4. 4 Program in Trauma, University of Maryland Medical System, Baltimore, Maryland, USA
  5. 5 Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
  1. Correspondence to Dr John J Como, Surgery, MetroHealth Medical Center, Cleveland, OH 44109, USA; jcomo{at}


Posterior component separation with transversus abdominis release and implantation of synthetic mesh in the retromuscular space is a durable type of repair for many large incisional hernias with recurrence rates consistently less than 10%. The purported advantage of biologic prostheses in contaminated fields has recently been challenged, and the concern for placing synthetic mesh in contaminated fields may be overstated. There are almost no data specifically addressing the use of this type of repair for chronic incisional hernias in trauma and emergency general surgery patients, so research is needed on this patient population. In this review, a case of a trauma patient receiving posterior component separation with transversus abdominis release and implantation of synthetic mesh for a chronic incisional hernia resulting from a gunshot wound to the abdomen is presented, the technique is explained, and relevant literature is reviewed.

  • incisional hernia
  • abdominal wall reconstruction

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  • Contributors JJC designed and wrote the article. OLG, JJD, VPH, and PRM were involved in critical revisions and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data sharing statement No original data are to be published in this article.

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