Mohamed, H., Lashin, R., Omran, H., Al-Shaffai, M. (2019). The Relation between the Distance of Recto-Fascial Plication and the Intra-Abdominal Pressure Changes before and Immediately after Abdominoplasty. The Egyptian Journal of Plastic and Reconstructive Surgery, 43(1), 143-151. doi: 10.21608/ejprs.2019.247330
Helen Kamel Mohamed; Riham Lashin; Hisham Mohamed Omran; Mahmoud Ahmed Al-Shaffai. "The Relation between the Distance of Recto-Fascial Plication and the Intra-Abdominal Pressure Changes before and Immediately after Abdominoplasty". The Egyptian Journal of Plastic and Reconstructive Surgery, 43, 1, 2019, 143-151. doi: 10.21608/ejprs.2019.247330
Mohamed, H., Lashin, R., Omran, H., Al-Shaffai, M. (2019). 'The Relation between the Distance of Recto-Fascial Plication and the Intra-Abdominal Pressure Changes before and Immediately after Abdominoplasty', The Egyptian Journal of Plastic and Reconstructive Surgery, 43(1), pp. 143-151. doi: 10.21608/ejprs.2019.247330
Mohamed, H., Lashin, R., Omran, H., Al-Shaffai, M. The Relation between the Distance of Recto-Fascial Plication and the Intra-Abdominal Pressure Changes before and Immediately after Abdominoplasty. The Egyptian Journal of Plastic and Reconstructive Surgery, 2019; 43(1): 143-151. doi: 10.21608/ejprs.2019.247330
The Relation between the Distance of Recto-Fascial Plication and the Intra-Abdominal Pressure Changes before and Immediately after Abdominoplasty
1The Department of General Surgery, Faculty of Medicine, Ain Shams University
2The Department of Plastic Surgery a, Faculty of Medicine, Ain Shams University
3The Department of General Surgery, Faculty of Medicine, Ain Shams University
Abstract
Background: Abdominoplasty surgery involves excision of redundant abdominal skin flap and, in most cases, involves restoring weakened anterior abdominal wall muscles creating an abdominal profile that is smoother and firmer. Diastasis recti caused by anterior abdominal wall weakness. It happens because the space between left and right recti muscles has been widened. Surgical correction for diastasis during the abdominoplasty can be considered as a definitive way for correction of diastasis by performing a plication or folding of the linea alba, this results in a tighter abdominal wall. Aim of Work: Is to evaluate the relationship between the distance of recto-fascial plication and intra-abdominal pressure (IAP) changes before and immediately after abdominoplasty. Patient and Methods: This study included 75 female patients, ageing between 24-57 years old, with mean age of 43.3 years. Patients complained of abdominal redundancy after childbirth, or post massive weight loss, with weak anterior abdominal wall muscles. The diastasis width was measured intraoperatively at three levels (3cm above the umbilicus, at the umbilicus, and 3cm below the umbilicus) before performing recto-fascia plication. Recto-fascial plication have been performed for all patients during their abdominoplasty procedure in two layers. Intra-abdominal pressure (IAP) variation, before and immediately after rectus sheath plication were measured using U-tube technique. Statistical analysis of all measurements were done. Results: Statistical analysis showed that the mean value of diastasis above and at the umbilicus didn't differ significantly, however it was significantly lower below the umbilicus compared with the other two levels. Comparing the pre and postoperative IAP showed non-statistically significant increase of IAP postoperative. Most importantly, statistics showed that there is a statistically significant positive correlation between the IAP immediately after surgery and the distance of rectofascial plication especially above the umbilicus. Complication rate in the current study was 2.6%. Conclusion: As a result of our current study, rectus diastasis width is significantly correlated with the IAP immediately after abdominoplasty, therefore the larger the width of the rectus diastasis, the more increase of IAP that would happen immediately after abdominoplasty.
1- Dixit V.V. and Wagh M.S.: Unfavorable Outcomes of Liposuction and Their Management. Indian J. of Plast. Surg., 46 (2): 377, 2013. 2- Rohrich R.J.: The American Society of Plastic Surgeons' Procedural Statistics: What They Really Mean. Plast. and Reconst. Surg., 112 (5): 1389, 2003. 3- Veríssimo P., Nahas F.X., Barbosa M.V., Gomes H.F. and Ferreira L.M.: Is it Possible to Repair Diastasis Recti and Shorten the Aponeurosis at the Same Time? Aesthet. Plast. Surg., 382: 379, 2014. 4- Boissonnault J.S. and Blaschak M.J.: Incidence of Diastasis Recti Abdominis during the Childbearing Year. Physical Therapy, 68 (7): 1082, 2015. 5- Benjamin D.R., Van de Water A.T. and Peiris C.L.: Effects of Exercise on Diastasis of The Rectus Abdominis Muscle in The Antenatal and Postnatal Periods: A Systematic Review. Physiotherapy, 100 (1): 1, 2014. 6- Thorek M.: Plastic Reconstruction of the Female Breasts and Abdomen. The American Journal of Surgery, 43 (2): 268, 1999. 7- Psillakis J.M.: Abdominoplasty: Some Ideas to Improve Results. Aesthetic Plastic Surgery, 2 (1): 205, 1978. 8- Rodrigues M.A., Nahas F.X., Reis R.P. and Ferreira L.M.: Diastasis Width Influence the Variation of the Intra- Abdominal Pressure After Correction of Rectus Diastasis? Aesthet. Surg. J., 355: 583, 2015. 9- Talisman R., Kaplan B., Haik J., et al.: Measuring Alterations in Intra-Abdominal Pressure during Abdominoplasty As a Predictive Value For Possible Postoperative Complications. Aesthet. Plast. Surg., 263: 189, 2002. 10- Al-Basti H.B., El-Khatib H.A., Taha A., Sattar H.A. and Bener A.: Intra-abdominal Pressure after Full Abdominoplasty in Obese Multiparous Patients. Plast. Reconstr. Surg., 113: 2145, 2004. 11- Pereira N., Sciaraffia C., Danilla S., Parada F., Asfora C. and Moral C. Effects of Abdominoplasty on Intra- Abdominal Pressure and Pulmonary Function. Aesthetic Surgery Journal, 36 (6): 697, 2016. 12- Huang G.J., Bajaj A.K., Gupta S., et al.: Increased Intraabdominal Pressure in Abdominoplasty: Delineation of Risk Factors. Plast. Reconstr. Surg., 119: 1319, 2007. 13- Milanesi R. and Caregnato R.C.A.: Intra-Abdominal Pressure: An Integrative Review. einstein. 14 (3): 423, 2016. 14- Lee R.K.: Intra-Abdominal Hypertension and Abdominal Compartment Syndrome. Critical Care Nurse, 32 (1): 19, 2012. 15- Gradinger G.P., Rosenfieldn L.K. and Nahai F.R.: The Art of Aesthetic Surgery: Principles and Techniques. Abdominoplasty, Chapter 83 (3): 2nd edition: 2935, 2010. 16- Campbell M.J., Julious S.A. and Altman D.G.: Estimating Sample Sizes for Binary, Ordered Categorical, and Continuous Outcomes in Two Group Comparisons. BMJ, 311 (7013): 1145, 1995. 17- Baroudi R., Keppke E.M. and Netto F.T.: Abdominoplasty. Plast. Reconstr. Surg., 54: 161, 1974. Egypt, J. Plast. Reconstr. Surg., January 2019 151 18- Floros C. and Davis P.K.B.: Complications and Long- Term Results Following Abdominoplasty: A Retrospective Study. Brit. J. Plast. Surg., 44: 190, 1991. 19- Hester T.R., Baird W., Bostwick III J., Nahai F. and Cukic J.: Abdominoplasty Combined with Other Major Surgical Procedures: Safe Or Sorry? Plast. Reconst. Surg., 86: 997, 1989. 20- Al-Qattan M.M.: Abdominoplasty in Multiparous Women with Severe Musculoaponeurotic Laxity. Brit. J. Plast. Surg., 50: 450, 1997. 21- Saggi B.H., Sugerman H.J., Ivatury R.R. and Bloomfield G.L.: Abdominal Compartment Syndrome. J. Trauma, 45: 597, 1998. 22- Pierri A., Munegato G., Carraro L., Zaccaria F., Tiso E. and Zotti E.F.: Hemodynamic Alterations during Massive Incisional Hernioplasty. J. Am. Coll. Surg., 181: 299, 1995. 23- Zhou J.C., Xu Q.P., Pan K.H., Mao C. and Jin C.W.: Effect of Increased Intra-Abdominal Pressure and Descompressive Laparotomy on Aerated Lung Volume Distribution. J. Zhejiang Univ. Sci. B., 115: 378, 2010. 24- Graça Neto L., Araújo L.R., Rudy M.R., Auersvald L.A. and Graf R.: Intra-Abdominal Pressure In Abdominoplasty Patients. Aesthet Plast. Surg., 30: 655, 2006. 25- Helene A., Saad R. and Stirbulov R.: Respiratory Evaluation In Patients Submitted To Abdominoplasty. Rev. Col. Bras Cir., 331: 45, 2006. 26- Brauman D.: Diastasis Recti: Clinical Anatomy. Plast. Reconstr. Surg., 1225: 1564, 2008. 27- Marín J.A., Saucedo J.A., Fuentes C., et al.: Variación De La Presión Intra-abdominal Causada Por Abdominoplastía En Mujeres Sanas. Rev. Gastroenterol. Mex., 69: 156, 2004. 28- Rodrigues M.A., Nahas F.X., Gomes H.C. and Ferreira L.M.: Ventilatory Function and Intra-Abdominal Pressure In Patients Who Underwent Abdominoplasty With Plication of the External Oblique Aponeurosis. Aesthetic Plast Surg., 37: 993, 2013. 29- Kron I.L., Harman P.K. and Nolan S.P.: The Measurement of Intra-abdominal Pressure as a Criterion for Abdominal Exploration. Ann. Surg., 199: 28, 1984. 30- Malbrain M.L., Cheatham M.L., Kirkpatrick A., et al.: Results From the International Conference of Experts on Intra-Abdominal Hypertension and Abdominal Compartment Syndrome. I. Definitions. Intensive Care Med., 32: 1722, 2006.
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