Successful Abdominal Wall Reconstruction Using a Reinforced Tissue Matrix After Severe Pancreatitis and Abdominal Compartment Syndrome: A Case Report

Abdominal wall reconstruction following severe abdominal pathology presents a significant surgical challenge. The management of an open abdomen, coupled with the need for delayed closure, often requires advanced techniques to restore abdominal wall integrity, minimize complications, and optimize patient outcomes. This case report describes the successful management of a complex abdominal wall defect following severe pancreatitis and abdominal compartment syndrome in a 48-year-old male patient with a history of alcohol use disorder. After initial decompressive laparotomy and lack of progress with temporary abdominal closure systems, the patient underwent a second procedure at eight weeks to replace the closure system with a reinforced tissue matrix (RTM; OviTex^®, TELA Bio, Malvern, PA) combined with negative pressure wound therapy (NPWT). Early histopathological analysis of the RTM revealed favorable tissue integration with early remodeling and minimal inflammation. Over the next eight weeks, progressive fascial closure was achieved. Epithelialization reached nearly 100% by 43 weeks post-RTM placement. The final abdominal wall reconstruction at 44 weeks was deemed successful, with satisfactory functional and cosmetic outcomes. This case highlights the effectiveness of combining an RTM and NPWT in the management of complex abdominal wall defects, providing a promising approach for restoring abdominal integrity in high-risk patients. Further studies are needed to assess the long-term outcomes and broader applicability of these techniques.