Massive ventral hernia with loss of domain and skin necrosis presenting as a large mass

Abstract

A ventral hernia with loss of domain is a challenging clinical scenario. We present a case of a 55-year-old female with a massive ventral hernia exhibiting loss of domain and significant skin necrosis. Surgical management involved extensive debridement, the components separation technique for tension-free reduction of herniated contents, and the placement of a synthetic mesh for abdominal wall reconstruction. Postoperatively, split-thickness skin grafts and negative pressure wound therapy were utilized. Intensive postoperative care included monitoring, targeted antibiotic therapy, and strict glycemic control. Despite a complicated recovery with an initial wound infection, the patient achieved satisfactory healing at a 1-year follow-up. This case underscores the efficacy of a multidisciplinary approach in complex hernia management.