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Since the distance gained with the single layer component separation was not sufficient for primary closure, mesh was interposed in the remaining defect. The first layer was polyester with a non-adherent backing.
The final closure is shown. The deepest layer of mesh (dark blue) was polyester with non-adherent coating on the deep side, attached to the edge of the posterior rectus sheath. The middle layer was polyester extending between posterior rectus sheath and the posterior side of the rectus muscles out to their lateral border. This was fixed in position with through-and-through non-absorbable sutures. The outer layer was dermal matrix sutured to the edge of the anterior rectus sheath.
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