title: Early complications, pain, and quality of life after reconstructive surgery for abdominal rectus muscle diastasis: a 3-month follow-up.
abstract: OBJECTIVE
  The aim of this study was to evaluate early complications following retromuscular mesh repair with those after dual layer suture of the anterior rectus sheath in a randomised controlled clinical trial for abdominal rectus muscle diastasis (ARD).
  
  
  METHODS
  Patients with an ARD wider than 3 cm and clinical symptoms related to the ARD were included in a prospective randomised study. They were assigned to either retromuscular inset of a lightweight polypropylene mesh or to dual closure of the anterior rectus fascia using Quill self-locking technology. All patients completed a validated questionnaire for pain assessment (Ventral Hernia Pain Questionnaire, VHPQ) and for quality of life (SF36) prior to and 3 months after surgery.
  
  
  RESULTS
  The most frequently seen adverse event was minor wound infection. Of the patients, 14/57 had a superficial wound infection; five related to Quill and nine to mesh repair. No deep wound infections were reported. Patient rating for subjective muscular improvement postoperatively was better in the mesh technique group with a mean of 6.9 (range 0-10) compared to a mean of 4.8 (range 0-10) in the Quill group (p=0.01). The pre- and post-operative SF36 scores improved in both groups.
  
  
  CONCLUSIONS
  There was no significant difference between the two surgical techniques in terms of early complications and perceived pain at the 3-month follow-up. Both techniques may be considered equally reliable for ARD repair in terms of adverse outcomes during the early postoperative phase, even though patients operated with a mesh experienced better improvement in muscular strength. ClinicalTrial.gov: 2009/227-31/3/PE/96.
authors.affiliation: Department for Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Emanuelsson
authors.affiliation: Department of Surgical and Perioperative Sciences, Umeå University, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Gunnarsson
authors.affiliation: Department of Surgical and Perioperative Sciences, Umeå University, Sweden. Electronic address: karin.strigard@umu.se.
authors.forename: K
authors.initials: K
authors.lastname: Strigård
authors.affiliation: Department for Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Stark
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D017568:Rectus Abdominis / Q000601:surgery*; D013526:Surgical Mesh; D053441:Suture Anchors; D013537:Sutures; D064232:Visual Analog Scale
keywords: Early complications; Quill suture; Rectus diastasis; Retromuscular mesh