A Case of Abdominal Wall Reconstruction After Gunshot Wound in the Setting of Abdominal Compartment Syndrome and Loss of Domain

A critical issue in trauma and reconstructive surgery is managing abdominal compartment syndrome (ACS) and loss of domain following major abdominal trauma. ACS is a life-threatening complication that often necessitates damage control surgery, including an open abdomen. However, this approach increases the risk of further complications, such as significant loss of domain, which complicates subsequent abdominal closure. Our case highlights the successful use of a porcine dermal matrix as a biologic mesh in a patient with significant loss of domain following a traumatic injury. This innovative approach facilitated complete mesh granulation prior to autografting. By providing temporary support for the patient's loss of domain, our technique allowed for stabilization and resolution of operative edema, creating the opportunity for a more definitive myofascial approximation once the patient has achieved full optimization in recovery and rehabilitation.