Gormley Jessica, Copeland Andrea, Augustine Haley, Axelrod Charlotte, McRae Mark
Plastic Surgery, Michael G. DeGroote School of Medicine, Hamilton, CAN.
Plastic Surgery, McMaster University, Hamilton, CAN.
Cureus. 2020 Dec 29;12(12):e12358. doi: 10.7759/cureus.12358.
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.
腹壁成形术中进行的腹直肌分离折叠术旨在缩小增宽的白线，并使腹直肌肌腹恢复到解剖位置。目前尚不清楚折叠术是否能改善腹部力量和功能。本系统评价总结了腹直肌折叠术对腹部力量、功能及术后并发症的影响。对CINAHL、Embase、Medline和Web of Science进行了全面检索。筛选和数据提取重复进行。从纳入的文章中提取数据，并对结果进行分类分析。共纳入7篇文章中的497例患者。平均年龄44.5岁（范围20.5 - 72岁），94.4%为女性。3篇文章报告了腹部力量测量结果，其中2篇显示有显著改善。4篇文章使用了SF - 36调查问卷，均表明术后身体功能子量表有所改善。另外使用了6种工具来评估功能结果，其中4种显示有显著改善。总体并发症发生率为17.0%。腹直肌折叠术常用于腹壁成形术中以改善腹部形态和功能。虽然迄今为止的文献在功能结果方面令人鼓舞，但腹部力量的改善并不一致。患者人群、结果测量和比较组的异质性限制了我们结论的力度。未来的研究应包括大型比较研究以及该人群结果标准化方案。
