Abdominal wall closure in bladder exstrophy complex repair by rectus flap

Background and Objectives: The Exstrophy Complex (EC) is a serious malformation of midline abdominal wall. Wide pubis prevents approximating the lateralized rectus muscle and leads to dehiscence and fi stula formation. Our aim was to recommend an easier method for abdominal wall closure in the Bladder Exstrophy (BE) complex repair. Materials and Methods: From November 2007 to April 2010, we had three case of Cloacal Exstrophy (CE) and 10 BE, in which early bladder closure and coverage were performed by wide mobilization of bladder and rectus muscle fl ap closure in the midline without pubic closure. Results: Two cases of CE had only minor wound dehiscence and bladder prolapsed later. One of the 10 BE cases developed vesicocutaneous fi stula and the other two had minor wound dehiscence. Conclusions: Our Technique reconstructed the abdominal wall with less morbidity and hospitalization because of tensionless closure. Keywords: Abdominal wall closure, bladder exstrophy, rectus flap Contexte et objectifs: Exstrophy le complexe (EC) est une grave malformation de la paroi abdominale de la ligne mediane. Large pubienne empeche de se rapprocher du muscle rectus lateralisation et conduit a la formation de fistule et de dehiscence. Notre objectif etait de recommander une methode simplifi ee de fermeture de la paroi abdominale dans la reparation complexe de la vessie Exstrophy (BE). Methodes et materiaux: De novembre 2007 a avril 2010, nous avons eu trois cas de cloacaux Exstrophy (CE) et 10 BE, dont la couverture et la fermeture anticipee de la vessie ont ete effectuees par large mobilisation de la vessie et rectus fermeture de Rabat musculaires dans la ligne mediane sans poils pubiens fermeture. Resultats: Deux cas de CE avaient dehiscence plaies mineures et la vessie prolabees plus tard. L’un des 10 cas BE developpe vesicocutaneous fi stule et les deux autres avaient une blessure mineure dehiscence. Conclusions: Notre Technique reconstruit la paroi abdominale avec moins de morbidite et hospitalisation en raison de la fermeture de tensionless. Mots cles: Fermeture de la paroi abdominale, Exstrophy de la vessie, rectus flap