腹壁缺损是临床常见且处理难度较高的外科问题，其修复重建不仅需要关闭创面，更需重建腹壁的解剖结构与力学功能。腹壁缺损分为Ⅰ型（皮肤和皮下组织缺失）、Ⅱ型（肌肉筋膜组织缺损但皮肤完整）、Ⅲ型（全层腹壁缺失）。缺损面积较大或伴感染、放疗及多次手术史时，单纯依赖补片或组织分离技术往往难以获得长期稳定效果，需整形外科皮瓣移植技术参与修复重建。腹壁缺损修复应以承压结构重建为核心，结合覆盖条件与感染风险进行个体化决策。整形外科皮瓣技术、自体筋膜及补片并非相互替代，而应协同应用。多学科协作和充分的术前评估是获得良好疗效的关键。

Abdominal wall defect is a common and clinically challenging problem, whose repair and reconstruction require not only wound closure but also restoration of the abdominal wall’s anatomical structure and mechanical function. Abdominal wall defects were classified into three types: type Ⅰ, involving loss of skin and subcutaneous tissue; type Ⅱ, characterized by muscular and fascial defects with intact skin coverage; and type Ⅲ, representing full-thickness abdominal wall defects. In cases with large defect size or those complicated by infection, prior radiotherapy, or multiple previous surgeries, satisfactory long-term outcomes are often difficult to achieve with mesh repair or component separation techniques alone. In such situations, reconstructive procedures incorporating plastic surgical flap techniques are frequently required. Reconstruction of abdominal wall defects should be centered on restoration of load-bearing structures, with individualized decision-making based on soft tissue coverage conditions and infection risk. Plastic surgical flap techniques, autologous fascia, and prosthetic mesh are not mutually exclusive but should be used in a complementary manner. Multidisciplinary collaboration and thorough preoperative evaluation are essential to achieve optimal clinical outcomes.