Bridging Acellular Dermal Matrix in Abdominal Wall Repair following Radical Resection of Recurrent Endometrioma

Paige N. Hackenberger, Stephen J. Poteet, Jeffrey E. Janis
In: Plastic and Reconstructive Surgery - Global Open · 2020 · vol. 8(1) , pp. e2603 · doi:10.1097/gox.0000000000002603 · W3001329143
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Abstract

Summary: The patient is a 31-year-old woman with a history of prior resection of a presumed keloid scar around her Pfannenstiel incision found to be endometrial tissue on final pathology. She presented 5 years later with recurrence of pain and a mass associated with menses despite maximal medical therapy for endometriosis. Computed tomography of her abdomen and pelvis demonstrated an infiltrative soft tissue mass measuring 8.8 cm × 4.0 cm. Surgical oncology conducted an en bloc resection of the mass and obstetrics and gynecology performed a concomitant total abdominal hysterectomy and bilateral salpingo-oophorectomy. Plastic and reconstructive surgery completed the repair of the final 23 cm × 10 cm full-thickness abdominal wall defect with bridging biologic mesh, complex layered closure, and incisional negative-pressure wound therapy. Final pathology confirmed a diagnosis of endometriosis. Patient’s hospital course was uncomplicated, and follow-up at 6 months does not demonstrate clinical or radiographic evidence of bulge or hernia recurrence. Abdominal wall endometrioma is a well-documented occurrence in prior cesarean scars; plastic surgeons can contribute to a multidisciplinary approach in reconstruction when resection compromises abdominal wall integrity, necessitating expertise in complex repairs.

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endometriosisendometrioma

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