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A systematic review on the outcomes of correction of diastasis of the recti

Hernia volume 15, pages 607–614 (2011)Cite this article

Abstract

Purpose

Diastasis or divarication of the rectus abdominus muscles describes the separation of the recti, usually as a result of the linea alba thinning and stretching. This review examines whether divaricated recti should be repaired and tries to establish if the inherent co-morbidity associated with surgical correction outweighs the benefits derived.

Methods

EMBASE, MEDLINE and the Cochrane library were searched for (‘divarication’ OR ‘diastasis’) AND (‘recti’ OR ‘rectus’). A standard data extraction form was used to extract data from each text. Due to the lack of randomised control trials, meta-analysis was not possible.

Results

Seven studies report that patient satisfaction was high following surgery. The most common complication seen was the development of a seroma. Other common complications included haematomas, minor skin necrosis, wound infections, dehiscence, post-operative pain, nerve damage and recurrence, the rate of which may be as high as 40%.

Conclusions

Further studies are required to compare laparoscopic and open abdominoplasty techniques. Patients and physicians should be advised that correction is largely cosmetic, and although divarications may be unsightly they do not carry the same risks of actual herniation. Progressive techniques have resulted in risk reduction with no associated surgical mortality. However, the outcomes may be imperfect, with unsightly scarring, local sepsis and the possibility of recurrence.

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Fig. 1

References

  1. Moore KL, Dalley AF (eds) (2006) Clinically orientated anatomy, 5th edn. Lippincott Williams and Wilkins, Baltimore

  2. Hsia M, Jones S (2000) Natural resolution of rectus abdominis diastasis. Two single case studies. Aust J Physiother 46(4):301–307

    PubMed  Google Scholar 

  3. Palanivelu C, Rangarajan M, Jategaonkar PA, Amar V, Gokul KS, Srikanth B (2009) Laparoscopic repair of diastasis recti using the ‘Venetian blinds’ technique of plication with prosthetic reinforcement: a retrospective study. Hernia 13(3):287–292

    Article  PubMed  CAS  Google Scholar 

  4. Macpherson G (ed) (1999) Black’s medical dictionary, 39th edn. Black, London

  5. Nahas FX, Ferreira LM, De Arimateia Mendes J (2004) An efficient way to correct recurrent rectus diastasis. Aesthetic Plast Surg 28(4):189–196

    Article  PubMed  Google Scholar 

  6. Pollock H, Pollock T (2000) Progressive tension sutures: a technique to reduce local complications in abdominoplasty. Plast Reconstr Surg 105(7):2583–2586

    Article  PubMed  CAS  Google Scholar 

  7. Van Uchelen JH, Werker PM, Kon M (2001) Complications of abdominoplasty in 86 patients. Plast Reconstr Surg 107(7):1869–1873

    Article  PubMed  Google Scholar 

  8. Huang GJ, Bajaj AK, Gupta S, Petersen F, Miles DA (2007) Increased intraabdominal pressure in abdominoplasty: delineation of risk factors. Plast Reconstr Surg 119(4):1319–1325

    Article  PubMed  CAS  Google Scholar 

  9. Van Uchelen JH, Kon M, Werker PMN (2001) The long-term durability of plication of the anterior rectus sheath assessed by ultrasonography. Plast Reconstr Surg 107(6):1578–1584

    Article  PubMed  Google Scholar 

  10. Nahas FX, Augusto SM, Ghelfond C (2001) Nylon versus polydioxanone in the correction of rectus diastasis. Plast Reconstr Surg 107(3):700–706

    Google Scholar 

  11. Bhanot A (2009) Laparoscopic abdominoplasty for divarication of recti. J Chinese Clinical Med 4(12):703–705

    Google Scholar 

  12. Zukowski ML, Ash K, Spencer D, Malanoski M, Moore G (1998) Endoscopic intracorporal abdominoplasty: a review of 85 cases. Plast Reconstr Surg 102(2):516–527

    Article  PubMed  CAS  Google Scholar 

  13. Lockwood T (1998) Rectus muscle diastasis in males: primary indication for endoscopically assisted abdominoplasty. Plast Reconstr Surg 101(6):1685–1694

    Article  PubMed  CAS  Google Scholar 

  14. Williams TC, Hardaway M, Altuna B (2005) Ambulatory abdominoplasty tailored to patients with an appropriate body mass index. Aesthet Surg J 25(2):132–137

    Article  PubMed  CAS  Google Scholar 

  15. Ferreira LM, Castilho HT, Hochberg J, Ardenghy M, Toledo SR, Cruz R (2001) Triangular mattress suture in abdominal diastasis to prevent epigastric bulging. Ann Plast Surg 46(2):130–134

    Article  PubMed  CAS  Google Scholar 

  16. Nahas FX, Augusto SM, Ghelfond C (1997) Should diastasis recti be corrected? Aesthetic Plast Surg 21(4):285–289

    Article  PubMed  CAS  Google Scholar 

  17. Asaadi M, Haramis HT (1994) A simple technique for repair of rectus sheath defects. Ann Plast Surg 32(1):107–109

    Article  PubMed  CAS  Google Scholar 

  18. Brauman D, Capocci J (2009) Liposuction abdominoplasty: an advanced body contouring technique. Plast Reconstr Surg 124(5):1685–1695

    Article  PubMed  CAS  Google Scholar 

  19. Nahas FX, Ferreira LM, Augusto SM, Ghelfond C (2005) Long-term follow-up of correction of rectus diastasis. Plast Reconstr Surg 115(6):1736–1741

    Article  PubMed  CAS  Google Scholar 

  20. Dabb RW, Hall WW, Baroody M, Saba AA (2004) Circumferential suction lipectomy of the trunk with anterior rectus fascia plication through a periumbilical incision: an alternative to conventional abdominoplasty. Plast Reconstr Surg 113(2):727–732

    Article  PubMed  Google Scholar 

  21. Ramirez OM (2000) Abdominoplasty and abdominal wall rehabilitation: a comprehensive approach. Plast Reconstr Surg 105(1):425–435

    Article  PubMed  CAS  Google Scholar 

  22. Hsia M, Jones S (2000) Natural resolution of rectus abdominis diastasis. Two single case studies. Aust J Physiother 46(4):301–307

    PubMed  Google Scholar 

  23. Nahas FX, Ferreira LM (2010) Concepts on correction of the musculoaponeurotic layer in abdominoplasty. Clin Plast Surg 37(3):527–538

    Article  PubMed  Google Scholar 

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Conflict of interest

None of the three authors have any financial interest in this work nor have they received any funds supporting the work. Further, the authors have no commercial associations or financial disclosures that might pose any conflict of interest with any information presented in the submitted document.

Author information

Authors and Affiliations

  1. Department of Surgery, Northampton General Hospital NHS Trust, Cliftonville, Northampton, NN1 5BD, UK

    F. Hickey, J. G. Finch & A. Khanna

  2. 8 Shanklin Avenue, Leicester, LE2 3RE, UK

    A. Khanna

Authors
  1. F. Hickey
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  2. J. G. Finch
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  3. A. Khanna
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Corresponding author

Correspondence to A. Khanna.

Appendix

Appendix

Data extraction form

Reference

Objective

Study design

Population

Intervention

Control

Outcome

Statistical analysis (type, P value)

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Hickey, F., Finch, J.G. & Khanna, A. A systematic review on the outcomes of correction of diastasis of the recti. Hernia 15, 607–614 (2011). https://doi.org/10.1007/s10029-011-0839-4

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  • DOI: https://doi.org/10.1007/s10029-011-0839-4

Keywords

  • Divarication
  • Recti
  • Review
  • Outcome