Tissue Expanders in Skin Deficient Ventral Hernias Utilizing Component Separation.

Complicated hernias usually include those in patients with obesity, diabetes, smokers, and other comorbidities or in the presence of enterocutaneous fistulas (ECFs), multiple recurrent hernias, mesh infection, and hernias after trauma or tumor resection.1–3 One of the most significant challenges in abdominal wall reconstruction are patients with a large abdominal wall defect in conjunction with an ECF or stoma.4 An extensive literature review performed by the authors up to January 2015 revealed only 6 publications on the use of tissue expanders to reconstruct ventral hernias, none of which discussed the importance of specific anatomic placement of tissue expanders during simultaneous repair of the hernia with underlying ECF or stomas.1,5–9 We report 2 patients with skin deficient incisional ventral hernias with these underlying conditions.