Post-Caesarean and Post-Laparotomy Abdominal Wall Reconstruction (Tummy Tuck) For Aesthetic and Functional Restoration in A Low Resource Setting: A Case Report.

Abstract

Background: Complex abdominal wall reconstruction following multiple surgical interventions remains challenging in resource-limited settings. We report the first successful case of combined post-caesarean and post-laparotomy total abdominal wall reconstruction with mesh reinforcement in a low-to-middle-income country setting.

Case presentation: A 27-year-old multipara Nigerian woman presented with severe abdominal wall laxity and aesthetic deformity following caesarean delivery complicated by cryptogenic ascites requiring exploratory laparotomy. Clinical examination revealed extensive abdominal wall weakness with positive diastasis recti (Diver's test). She underwent comprehensive abdominal wall reconstruction, including total abdominoplasty with polypropylene mesh reinforcement. Intraoperative findings demonstrated diffuse muscle attenuation without discrete hernial defects. The procedure was completed without complications, with 0.8kg of excess tissue excised. The patient achieved complete wound healing by postoperative day 15 with excellent functional and aesthetic outcomes maintained at 15-month follow-up. No postoperative complications, mesh-related adverse events, or recurrence of abdominal wall laxity were observed.

Conclusion: This case demonstrates the feasibility and safety of complex abdominal wall reconstruction in resource-constrained environments when appropriate patient selection, surgical technique, and perioperative management are employed. The successful outcome challenges conventional assumptions about the technical requirements for such procedures and supports the expansion of reconstructive surgical services in low-resource settings.