Separation of Thoracoomphalopagus Conjoined Twins. Use of Tissue Expanders and Abdominoplasty According to the San Martín Technique

We present a set of female thoracoomphalopagus conjoined twins who were separated at ten months of age. Tissue expanders were used to expand the available soft tissue to cover the defect. The abdominal wall was closed by making a release incision on the outer aspect of the anterior sheath of the rectus muscle, detaching the anterior sheath of the muscle fibers, and flipping it over towards the midline. Meshes of decellularized collagen matrix were used to close the thorax. They had no major complications and were discharged from the hospital 60 days later. The girls are currently 5 years old and lead a normal life according to their age. We believe that the use of tissue expanders combined with the mobilization of aponeurotic flaps through discharge incisions adds a useful tool for the treatment of these patients.