PMC3599755_01
Soft tissue gas of the right abdominal wall.
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F1
Computed tomography identified massive right torso soft tissue gas extending from the costal margin to inguinal canal (midline to the back) (Figure  1).
Intact transversus abdominus layer following resection of the external and internal oblique aponeuroses, rectus muscles, and a portion of the pectoralis muscle.
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F2
Immediate antimicrobial support and operative intervention led to resection of the entire external oblique and transversus abdominus aponeuroses, rectus muscles, and a portion of the pectoralis muscle of the patient's right torso (Figure  2).
Large triangular skin flaps.
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F3
The internal oblique aponeurosis and two large triangular skin flaps were left intact (Figure  3).
Reconstruction of the abdominal wall with 2 large pieces of biologic graft.
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F4
The final closure utilized two large pieces of biologic material (Strattice , LifeCell Inc., New Jersey, USA) to prevent subsequent hernia formation (Figure  4).
Closure of skin flaps over the abdominal wall reconstruction.
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F5
The two large skin and soft tissue flaps were then closed (Figure  5).
Abdominal wall 12 months after the reconstruction.
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F6
His 12-month out-patient follow-up continues to show no obvious hernia or attenuation in his abdominal wall (Figure  6).