Summary
Background
Correction of rectus diastasis during abdominoplasty is controversial. Few published
studies have investigated the long-term value of plication. This prospective study
aims to assess the long-term durability of plication of the rectus sheath in abdominoplasty
using ultrasound.
Methods
A total of 28 consecutive abdominoplasty patients underwent rectus plication by the
senior author (FSF) since 2006, using a 0/0 looped nylon suture. Rectus diastasis
was measured preoperatively and postoperatively at 3, 6 and 12 month’s intervals using
a standardised ultrasound (7.5 MHz) probe, by the single senior radiologist (GJD).
Diastasis of the recti was assessed at three fixed points: at the umbilicus, 6 cm
above and 6 cm below the umbilicus. Diastasis was categorised using the Beer classification.
Results
All patients were female with a mean age of 36 years and average of body mass index
(BMI) 26 kg m−2. The majority of subjects had previous abdominal surgery including caesarean sections
(82%, n = 23) and had at least one previous pregnancy (87%), with only two patients (8.7%)
in the study being nulliparous. Correction of diastasis was maintained in all patients
despite previous pregnancies and abdominal surgery.
Postoperative follow-up time averaged 28 months (range 12–43 months). According to
the Beer classification, there was no recurrence of rectus diastasis at the 12-month
postoperative ultrasound measurements. A significant reduction in the mean distance
between rectus muscles before surgery and 12 months postoperatively was noted. Previous
surgery did not have a statistically significant affect on preoperative rectus distance.
Conclusions
Vertical rectus plication with a non-absorbable suture demonstrates long-term durable
results without any suture-related complications. Patient factors such as extent of
preoperative rectus diastases and previous abdominal surgery did not appear to have
a significant effect on the durability of the corrected diastasis.
Keywords
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Article info
Publication history
Published online: October 20, 2011
Accepted:
September 15,
2011
Received:
May 12,
2011
Footnotes
☆Presentation: International Confederation of Plastic, Reconstructive and Aesthetic Surgery (IPRAS), meeting 2011; International Society of Aesthetic Plastic Surgery scientific meeting (ISAPS), 2010; British Association of Aesthetic Plastic Surgery annual meeting (BAAPS), 2010; British Association of Plastic, Reconstructive and Aesthetic Plastic Surgery (BAPRAS), Winter meeting – December 2010.
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
