The Relation between the Distance of Recto-Fascial Plication and the Intra-Abdominal Pressure Changes before and Immediately after Abdominoplasty

Mohamed, Helen Kamel; Lashin, Riham; Omran, Hisham Mohamed; Al-Shaffai, Mahmoud Ahmed

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

Document Type : Research article

Authors

¹ The Department of General Surgery, Faculty of Medicine, Ain Shams University

² The Department of Plastic Surgery a, Faculty of Medicine, Ain Shams University

10.21608/ejprs.2019.247330

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.

Keywords

Main Subjects

Aesthetics

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