Abdominal Wall Defect
Large midline abdominal wall hernia consisting of myofascial defect with overlying skin.
The rectus abdominis muscles have migrated laterally.
There is no evidence of visceral incarceration.
Etiology of defect: Congenital, previous surgery, trauma, resection.
Duration of defect, management thus far.
History of smoking.
Steroids or immunosuppressive medications.
Body mass index (BMI): weight (kg)/[height (m)]2.
Abdominal wall defect description
Midline or lateral.
Upper, middle, or lower abdomen.
Skin and subcutaneous tissue.
Size of defect.
Condition of surrounding tissues.
Pertinent comorbid conditions (diabetes, autoimmune diseases, coronary artery disease, etc).
Pertinent imaging or diagnostic studies
Computed tomography of the abdomen with contrast may be helpful to delineate the extent of the defect, the related anatomy, and other issues (e.g., bowel adhesions, abscesses).
Pulmonary function testing should be performed if there is preexisting respiratory compromise or suspicion for loss of domain from a large hernia.