Introduction: Component separation technique has become an extremely useful technique for management of abdominal wall defects. The procedure and its applications for managing of abdominal wall defects, in adults, have been very well described. Very little information exists however, about the use of the technique in the pediatric population. We will present our experience with 2 children with large abdominal wall defects who were successfully treated using the component separation technique. Materials and method: The first child was born with a large omphalocele and a left diaphragmatic hernia. The omphalocele was treated initially conservatively with local care and with a synthetic mesh at age 3 years. The mesh had to be removed few weeks later due to infection. The child was referred to us for definitive reconstruction at age 8 years, with a large residual ventral hernia and a fascial defect measuring approximately 15x10cm.The sac was removed, the abdominal wall was closed without tension using the component separation technique, and the undermined overlying skin, for coverage. The second child was also born with a large omphalocele. She underwent 2 unsuccessful procedures for closure and was referred at age 9 years with an abdominal defect measuring approximately 17x12cm. This patient was also successfully treated using the component separation technique. Results: Our follow up was two years for the first and eight years for the second patient. There were no short or long term complications of any kind. Wounds healed nicely; there was no recurrence of the hernia and no respiratory problems. Both patients remain with a stable and functional abdominal wall and without the need for further reconstructive surgery. Conclusions: The use of component separation techniques in adults is very well accepted.The application of the technique in the pediatric population however, is not well described. Based on our small experience we believe that this technique can be used equally well in children as in adults, with excellent lasting results, and without negative effect on growth. Extensive evaluation, planning, surgical technique and close follow-up are necessary for a successful outcome.
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