Treatment of rectus diastasis: should the midline always be reinforced with mesh? A systematic review

Kerckhoven, Liza Van; Nevens, Thomas; Winkel, Nele Van De; Miserez, Marc; Vranckx, Jan; Segers, Katarina

doi:10.1016/j.bjps.2021.01.004

Cited by 9 publications

(13 citation statements)

References 43 publications

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“…Authors describe recurrences after open plication or laxity of the abdominal wall with protrusion of linea alba, what should be interpret as recurrent DRA [3]. Kerckhoven et al [31] distinguish two kinds of recurrences. First is recurrence of DRA examined by ultrasound, while the second is abdominal wall protrusion assessed by clinical examination However the recurrences that require a reoperation are rare [31].…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…Kerckhoven et al [31] distinguish two kinds of recurrences. First is recurrence of DRA examined by ultrasound, while the second is abdominal wall protrusion assessed by clinical examination However the recurrences that require a reoperation are rare [31].…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…Access to linea alba in a particular patient depends on body figure, surplus of excessive skin and anatomical conditions, and involve midline incision, low transverse incision and abdominoplasty including resection of excessive skin [6]. The complications are associated predominantly with abdominoplasty [31]. The most frequent complication was seroma (7%), followed by abdominal hypoesthesia (6%), chronic pain (4%), surgical site infection (2%).…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…The most frequent complication was seroma (7%), followed by abdominal hypoesthesia (6%), chronic pain (4%), surgical site infection (2%). Mesh reinforcement may increase chronic postoperative pain [31]. Studies using a hernia repair technique reported no recurrences [3].…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…The impact of surgery of quality of life has not yet been established [41]. Surgical reconstruction of DRA is safe, durable and effective, improves function and could possibly provide increased quality of life [30,31,41]. Although Kerckhoven et al [31] showed a high rate of patient satisfaction after surgical correction of DRA, they did not favour any treatment method.…”

Section: Surgical Treatmentmentioning

confidence: 99%

See 4 more Smart Citations

Diastasis recti abdominis (DRA): review of risk factors, diagnostic methods, conservative and surgical treatment

Sułkowski¹,

Matyja²,

Osuch³

et al. 2022

Clin. Exp. Obstet. Gynecol.

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Diastasis recti abdominis (DRA) is an acquired condition defined as a thinning, widening and protruding of the linea alba following an increase in intra-abdominal pressure. The aim of this review is to provide insight in the pathophysiology, risk factors, diagnostic methods and treatment modalities of DRA. DRA occurs in both women and in men, however, it is extraordinarily common and even expected condition affecting over half of women during pregnancy and one third 12 months after childbirth. There is no consensus of risk factors for DRA. Proposed risk factors include multiparity, maternal age and high age, caesarean section, macrosomia, multiple pregnancy, ethnicity, heavy lifting, body mass index (BMI) and diabetes. To diagnose the presence of DRA and its severity the interrecti distance (IRD) is measured. Palpation, caliper, ultrasound, computed tomography (CT) and magnetic resonance (MR) are applied to measure IRD and exclude concurrent hernias. DRA is mostly treated conservatively by physiotherapists. However, physiotherapy is unlikely to prevent or completely treat DRA. Over four fifth of patients are unsatisfied with the results of training programmes and opted for surgical intervention. Thereby the main purpose of physical training is to restore function, not to reduce the DRA. Physiotherapy may be an alternative for those who cannot undergo surgery. In case if severe cosmetic and functional impairment patients are referred for surgery. Patients with severe symptoms benefit more from surgery. Surgery is challenging since guidelines almost do not exist. Plication and mesh reinforcement are recommended by most authors, however whether it should be open or laparoscopic remains debatable.

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Section: Surgical Treatmentmentioning

confidence: 99%

Section: Surgical Treatmentmentioning

confidence: 99%