Emergency full thickness abdominal wall defects constitute a challenging problem for surgeons. The aim of reconstruction is prevention of evisceration and hernia formation. Staged surgery is recommended in such cases. The first stage consists of wound healing with skin grafts and creation of "planned hernia". Ultimate reconstruction is delayed until good general health state of the patient. In presented case final skin and subcutaneous tissue reconstruction was achieved with island fasciocutaneous antero-lateral thigh flap. Reconstruction of musculo-aponeurotic layer was completed with compartment separation technique and synthetic mesh. During follow-up no recurrence of deformity was observed.