Abstract
Rectus diastasis plication performed during abdominoplasty aims to narrow the widened linea alba and return the rectus muscle bellies to their anatomic position. It is unclear whether plication improves abdominal strength and function.This systematic review summarizes the effect of rectus plication on abdominal strength, function, and postoperative complications.A comprehensive search of CINAHL, Embase, Medline and Web of Science was performed. Screening and data extraction were performed in duplicate. Data were extracted from the included articles, and outcomes were analyzed categorically.A total of 497 patients from seven articles were included. Mean age was 44.5 years (range 20.5-72) and 94.4% were female. Three articles reported abdominal strength measurements, with two showing significant improvement. Four articles used the SF-36 survey, all demonstrating improvement in physical function subscale postoperatively. An additional six instruments were used to assess functional outcomes, of which four demonstrated significant improvement. The overall complication rate was 17.0%.Rectus plication is commonly performed during abdominoplasty to improve abdominal form and function. While the literature to date is encouraging with respect to functional outcomes, improvements in abdominal strength are less consistent. Heterogeneity in patient population, outcome measures, and comparison groups limit the strength of our conclusions. Future research should include a large comparative study as well as a protocol for standardizing outcomes in this population.
Highlights
BackgroundAbdominal rectus diastasis (ARD) is the separation of the rectus muscles due to thinning along the linea alba [1]
While the literature to date is encouraging with respect to functional outcomes, improvements in abdominal strength are less consistent
The most consistent result was an improvement in the physical function subscale of social role functioning (SF)-36 in all studies that used this instrument [6,10,21,23]
Summary
Abdominal rectus diastasis (ARD) is the separation of the rectus muscles due to thinning along the linea alba [1]. This separation may be caused by abdominal obesity, pregnancy, or congenital collagen abnormalities, and can lead to a permanent increase in the width of the aponeuroses from the patient's baseline by several centimetres [2]. ARD results in biomechanical compromise in the integrity of the abdominal wall, which has both aesthetic and physical consequences [3]. ARD may result in decreased core strength, which can impact physical function and quality of life [5,6]. Low back pain, decreased lung function, and urinary incontinence have been reported from ARD [2,7,8]
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