Gama Luiz José Muaccad, Barbosa Marcus Vinicius Jardini, Czapkowski Adriano, Ajzen Sergio, Ferreira Lydia Masako, Nahas Fábio Xerfan
Translational Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
Affiliate Professor and Coordinator of the Morphology Laboratory, University of Franca Medical School, São Paulo, Brazil.
Aesthet Surg J. 2017 Jun 1;37(6):698-705. doi: 10.1093/asj/sjw263.
Plication of the anterior rectus sheath is the most commonly used technique for repair of diastasis recti, but is also a time-consuming procedure.
The aim of this study was to compare the efficacy and time required to repair diastasis recti using different plication techniques.
Thirty women with similar abdominal deformities, who had had at least one pregnancy, were randomized into three groups to undergo abdominoplasty. Plication of the anterior rectus sheath was performed in two layers with 2-0 monofilament nylon suture (control group) or in a single layer with either a continuous 2-0 monofilament nylon suture (group I) or using a continuous barbed suture (group II). Operative time was recorded. All patients underwent ultrasound examination preoperatively and at 3 weeks and 6 months postoperatively to monitor for diastasis recurrence. The force required to bring the anterior rectus sheath to the midline was measured at the supraumbilical and infraumbilical levels.
Patient age ranged from 26 to 50 years and body mass index from 20.56 to 29.17 kg/m2. A significant difference in mean operative time was found between the control and study groups (control group, 35 min:22 s; group I, 14 min:22 s; group II, 15 min:23 s; P < 0.001). Three patients in group II had recurrence of diastasis. There were no significant within- and between-group differences in tensile force on the aponeurosis.
Plication of the anterior rectus sheath in a single-layer with a continuous suture showed to be an efficient and rapid technique for repair of diastasis recti.
腹直肌前鞘折叠术是修复腹直肌分离最常用的技术，但也是一个耗时的手术。
本研究的目的是比较使用不同折叠技术修复腹直肌分离的疗效和所需时间。
30名有相似腹部畸形且至少经历过一次妊娠的女性被随机分为三组接受腹部整形手术。腹直肌前鞘折叠术采用2-0单丝尼龙缝线分两层进行（对照组），或采用连续2-0单丝尼龙缝线单层进行（I组），或使用连续倒刺缝线（II组）。记录手术时间。所有患者在术前、术后3周和6个月接受超声检查，以监测腹直肌分离复发情况。在脐上和脐下水平测量将腹直肌前鞘拉至中线所需的力量。
患者年龄在26至50岁之间，体重指数在20.56至29.17kg/m²之间。对照组和研究组之间的平均手术时间存在显著差异（对照组，35分钟22秒；I组，14分钟22秒；II组，15分钟23秒；P<0.001）。II组有3例患者腹直肌分离复发。在腱膜张力方面，组内和组间均无显著差异。
采用连续缝线单层折叠腹直肌前鞘是一种修复腹直肌分离的有效且快速的技术。
