PMC3913436_01
Defect following removal of topical negative pressure dressing.
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The topical negative pressure dressing was removed leaving the defect shown with the anterior sheath retracted away from the midline (see Fig. 1) .
Component separation showing the released anterior sheath [(A) incised external oblique aponeurosis; (B) internal oblique; (C) released edge of external oblique aponeurosis].
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The internal oblique is then exposed (Point B), and the released edge is visible at Point C (see Fig. 2).  
Posterior sheath released from rectus.
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A posterior sheath release was then performed to provide medial movement of the sheath, so that it could be closed in the midline (see Fig. 3).
The mesh is sutured to the abdominal wall.
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Tissue Matrix,-LifeCell Corp.) was rotated to a diamond shape and secured in the pre-peritoneal space, to the lateral fascia (see Fig. 4). The rectus muscle was closed, and the component separation allowed for the anterior sheath to be closed in the midline (see Fig. 5).
The rectus muscle has been closed, and a drain is placed prior to closing the skin.
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Tissue Matrix,-LifeCell Corp.) was rotated to a diamond shape and secured in the pre-peritoneal space, to the lateral fascia (see Fig. 4). The rectus muscle was closed, and the component separation allowed for the anterior sheath to be closed in the midline (see Fig. 5).
The wound at discharge from hospital.
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He returned to the ward and was discharged on the 49th postoperative day, following implant of a cardiac defibrillator, with an intact wound (see Fig. 6).