Surgical decision-making process and definitive abdominal wall reconstruction

With advances in both abdominal surgery and the management of abdominal catastrophes, major abdominal wall defects have become a significant surgical disease, and the number of complex abdominal wall reconstructions has increased dramatically. However, the management of these patients has brought up a new dilemma, which is the question of how to actually repair these major defects. Such cases require extensive surgical knowledge of the physiology and anatomy of the patient, as well as the overall disease process. While one’s surgical skills and expertise are crucial when dealing with major abdominal wall defects, there are still a number of issues that are difficult to address, and so appropriate surgical decisions are important to ensure optimal outcomes. Furthermore, there is a need for a structured and logical management approach that is well understood by the patient, their family, as well as the team caring for them. In this chapter, we will specifically address this decision-making process across the various stages of reconstruction for complex abdominal wall defects.