title: Simultaneous prosthetic mesh abdominal wall reconstruction with abdominoplasty for ventral hernia and severe rectus diastasis repairs.
abstract: BACKGROUND
  Standard abdominoplasty rectus plication techniques may not suffice for severe cases of rectus diastasis. In the authors' experience, prosthetic mesh facilitates the repair of severe rectus diastasis with or without concomitant ventral hernias.
  
  
  METHODS
  A retrospective review of all abdominal wall surgery patients treated in the past 8 years by the senior author (G.A.D.) was performed. Patients with abdominoplasty and either rectus diastasis repair with mesh or a combined ventral hernia repair were analyzed.
  
  
  RESULTS
  Thirty-two patients, 29 women and three men, underwent mesh-reinforced midline repair with horizontal or vertical abdominoplasty. Patient characteristics included the following: mean age, 53 years; mean body mass index, 26 kg/m; average width of diastasis or hernia, 6.7 cm; and average surgery time, 151 minutes. There were no surgical-site infections and two surgical-site occurrences-two seromas treated with drainage in the office. After an average of 471 days' follow-up, none of the patients had recurrence of a bulge or a hernia.
  
  
  CONCLUSIONS
  For patients with significant rectus diastasis, with or without concomitant hernias, the described mesh repair is both safe and durable. Although this operation requires additional dissection and placement of prosthetic mesh in the retrorectus plane, it may be safely combined with standard horizontal or vertical abdominoplasty skin excision techniques to provide an aesthetically pleasing overall result.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Chicago, Ill. From Northwestern University, Feinberg School of Medicine.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Cheesborough
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Dumanian
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D061645:Abdominoplasty / Q000379:methods*; D000328:Adult; D000368:Aged; D005260:Female; D006555:Hernia, Ventral / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000150:complications / Q000601:surgery*; D017568:Rectus Abdominis / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013526:Surgical Mesh; D013997:Time Factors