الفهرس 
Embryology of the anteriorOnly 14 pages are availabe for public view
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Abstract
Burst abdomen is one of the most challenging obstacles that faces general and plastic surgeons with very high mortality rate.
The corner stone in management of that surgical problem and the best way in closing that defect is through studying the anatomy of the abdominal wall, its arterial and nerve supply.
No single cause being responsible, rather it is a multifactorial problem which is related to patients, operative and postoperative factors.
Preoperative evaluation of the patient, the defect, and history of the case, should be kept in mind to help in reaching the most appropriate way in reconstructing burst abdomen.
Methods of closure of burst abdomen are varying a lot from conservative method by repeated dressings and keeping it clean, resuturing the wound, or making retention sutures, all if the wound can be closed primarily.
If the defect cannot be closed primarily the management can be planned in a way that close the abdomen safely not under tension to avoid abdominal compartemental syndrome.
The VAC which can drain the fluid that oozes from the wound under vacuum method that helps in closing the wound, or using component separation technique which separate the layers of the abdomen then closing them separetly. Minimally invasive component separation with biological mesh can be also used.
The defect can be also closed by skin and fascial tissue through either grafting or flaps that may be local, distant, or free flaps.
If the defect is large, the local tissue around the defect can be used in its closure, that instead of using other tissue in form of grafts and flaps. That can be achieved by tissue expander.
The prosthetic materials can be used in covering the defect or as a support for the tissue that used in covering the abdominal wall defect by its inlamatory reaction.
A lot of meshes are used between them absorbable, non absorbable, and composite prosthesis as Marlex, Prolene, Vicryl, Vipro, and Ultrapro.
All that meshes represent a good supportive material for the abdominal wall, but may have some side effects.
Biological meshes have less side effects than synthetic. Acellular human dermis (AlloDerm), and porcine dermal collagen (Permacol) are the most common.
The chorioamniotic membrane can be used as a biological material when vacuum application is not possible or plastic cover might be harmful. The chorioamniotic membrane is obtained from elective cesarean section.
Reconstruction of the anterior abdominal wall defects may represent an important issue that has different causes and different modalities in management depending on the surgeon’s experience and disease condition.