Single-Layer Plication for Repair of Diastasis Recti: The Most Rapid and Efficient Technique.
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.
Translational Surgery,  Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
Luiz José Muaccad
LJM
Gama
Affiliate Professor and Coordinator of the Morphology Laboratory, University of Franca Medical School, São Paulo, Brazil.
Marcus Vinicius Jardini
MVJ
Barbosa
Clinical Radiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
Adriano
A
Czapkowski
Department of Diagnostic Imaging, UNIFESP, São Paulo, Brazil.
Sergio
S
Ajzen
Division of Plastic Surgery, Department of Surgery, UNIFESP, São Paulo, Brazil.
Lydia Masako
LM
Ferreira
Division of Plastic Surgery, Department of Surgery, UNIFESP, São Paulo, Brazil.
Fábio Xerfan
FX
Nahas
D061645:Abdominoplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D000328:Adult; D001938:Brazil; D004867:Equipment Design; D005260:Female; D006801:Humans; D008875:Middle Aged; D009119:Muscle Contraction; D053580:Muscle Strength; D061646:Operative Time; D020127:Recovery of Function; D017568:Rectus Abdominis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D013536:Suture Techniques / Q000009:adverse effects / Q000295:instrumentation; D013537:Sutures; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D057188:Workflow