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

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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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.

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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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Keywords

  • Divarication
  • Recti
  • Review
  • Outcome