Direct Closure, Tissue Expansion, and Grafting of the Abdominal Wall

The flat muscles of the abdominal wall (external and internal oblique and transversus abdominis) and the recti muscles are arranged to form a contractile, elastic layer around the abdominal cavity and its contents. They protect the abdominal contents and function as a constricting ring mechanism, while the pressure they exert helps maintain the viscera in their respective proper positions. They also work in concert with the visceral peristaltic mechanisms to assist in voiding and defecation (I). Defects in this ring mechanism therefore have direct functional and social imfJlications.