The Long-Term Durability of Plication of the Anterior Rectus Sheath Assessed by Ultrasonography

University Medical Center Utrecht, Utrecht, Utrecht, Netherlands
Plastic &amp Reconstructive Surgery (Impact Factor: 2.99). 06/2001; 107(6):1578-84. DOI: 10.1097/00006534-200105000-00046
Source: PubMed


The purpose of this study was to assess the long-term durability of a standard vertical plication of the anterior rectus sheath. For this purpose, 70 women who had undergone this procedure as part of an abdominoplasty were sent a questionnaire, their records were studied, and they were invited back to the clinic for an examination using ultrasound. A total of 63 patients returned the questionnaire, and 40 were willing to attend a follow-up consultation and ultrasound investigation. The presence of rectus diastasis was assessed by ultrasound (a real time scanner with a 7.5-MHz linear probe). The study showed that after a follow-up of 32 to 109 months (mean, 64 months), standard plication of the abdominal wall with absorbable material led to residual or recurrent diastasis in 40 percent of the patients. It also confirmed that vertical plication only is not enough to improve the waistline and may eventually lead to epigastric bulging.

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    • "L'intervention est courte et bien codifiée ; de ce fait, les deux équipes peuvent travailler ensemble harmonieusement et efficacement sans perte de temps. Bien entendu, le recul est encore insuffisant [7] pour en tirer des conclusions définitives et nous prévoyons de faire un nouveau bilan dans trois ans avec scanner de contrôle systématique pour toutes les patientes. "
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    Annales de Chirurgie Plastique Esthétique 08/2012; 57(4). DOI:10.1016/j.anplas.2011.08.011 · 0.31 Impact Factor
    • "The durability of diastasis repair has been well-documented.[15] The effect of intra-abdominal fat content resulting in the protruded appearance after the surgery has been highlighted by only few authors.[14] "
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    Indian Journal of Plastic Surgery 03/2012; 45(1):77-88. DOI:10.4103/0970-0358.96592
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    ABSTRACT: Liposuction abdominoplasty-liposuction of abdominal subcutaneous tissue deep and superficial to Scarpa's fascia, with excision of excess abdominal skin and, when indicated, plication of the anterior rectus sheath without undermining-is an effective, low-risk approach to minimizing abdominal flap undermining. The technique allows aggressive thinning and "sculpting" of full-thickness abdominal subcutaneous tissue and achieves a natural (not featureless) abdominal contour. It minimizes the creation of "dead space," which often leads to postoperative complications, as well as preserves sensory nerve and blood supply to the abdominal skin. The operation may be performed with the patient under local anesthesia, which probably diminishes the risk for deep vein thrombosis. Moreover, additional procedures can be conducted safely and the postoperative course is short, uneventful, and without restrictions; patients return to normal activity within a week or so. New evaluation criteria for abdominoplasty are discussed in this article, the most important of which is the assessment of intraabdominal fat content and its impact on surgical outcome and the decision to perform anterior rectus sheath plication. The concept of a sliding, mobile, sensate abdominal flap, created by liposuction and sustained by multiple neurovascular mesenteries, is also offered.
    Plastic &amp Reconstructive Surgery 08/2003; 112(1):288-98; discussion 299-301. DOI:10.1097/01.PRS.0000066371.34978.F0 · 2.99 Impact Factor
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