title: Components separation technique with limited subcutaneous undermining: a cadaver study.
abstract: The purpose of this study is to evaluate the influence of the undermining of the subcutaneous tissue on the tension of the abdominal wall, after the components separation of the abdominal muscles. Twenty adult cadavers were studied. The resistance of the medial advancement of both anterior and posterior recti sheaths was represented by the traction index and measured in 2 levels-3 cm above and 2 cm below the umbilicus. Traction indices were compared in the following 3 consecutive dissection situations: (1) after the subcutaneous tissue undermining laterally to the semilunaris line; (2) after the dissection of the rectus muscle from its posterior sheath associated with the release of the external oblique muscle; (3) after the subcutaneous tissue undermining laterally to the anterior axillary line. Friedman and Spearman tests were used to compare the results. There was no statistical significant difference between the subcutaneous tissue undermining laterally to the semilunaris line and that laterally to the anterior axillary line, when associated with the musculoaponeurotic dissections. In conclusion, limited subcutaneous undermining does not influence the tension of closure of the musculoaponeurotic layer after the components separation technique in cadavers.
authors.affiliation: Division of Plastic Surgery, Federal University of São Paulo/EPM, São Paulo, Brazil. fabionahas@uol.com.br
authors.forename: Fabio Xerfan
authors.initials: FX
authors.lastname: Nahas
authors.forename: Alexandro Kenji
authors.initials: AK
authors.lastname: Kimura
authors.forename: Marcus Vinícius Jardini
authors.initials: MV
authors.lastname: Barbosa
authors.forename: Yara
authors.initials: Y
authors.lastname: Juliano
authors.forename: Lydia Masako
authors.initials: LM
authors.lastname: Ferreira
mesh_terms: D000009:Abdominal Muscles / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery*; D034861:Abdominal Wall / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery*; D058107:Abdominal Wound Closure Techniques; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004210:Dissection / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D040521:Subcutaneous Tissue / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery*; D014143:Traction