medigraphic.com
ISSN 2007-8013 (Print)
Órgano oficial de la Universidad Autónoma de Sinaloa

2023, Number 1

<< Back Next >>

Rev Med UAS 2023; 13 (1)

Diastasis of rectus abdominis muscles. Literature review

Bolívar-Rodríguez MA, Gaxiola-López Cl, Servín-Uribe SD, Cázarez-Aguilar MA, Morgan-Ortiz F

Language: Spanish
References: 61
Page: 74-89
PDF size: 420.43 Kb.


ABSTRACT

The diastasis of the rectus abdominis muscles is commonly described as an abnormally wide separation of the rectus muscles, which although this distance has been indicated equal to or greater than 2 cm as pathological, even today there is no consensus to define it, there are several classifications that consider measurements at different levels of the midline of the abdomen. The diastasis of recti in addition to congenital can be conditioned by situations that increase intra-abdominal pressure, such as pregnancy, obesity, etc. The treatment to correct it, if required, is surgical and there are different techniques using open or laparoscopic surgery. The surgery can be performed in the same surgical time with hernioplasty procedures, even with plastic and reconstructive surgery. This article provides a literature review of the definition, classification, and treatment of diastasis recti.


REFERENCES

  1. Akram J, Matzen SH. Rectus abdominis diastasis.J Plast Surg Hand Surg. 2014;48(3):163-9.

  2. Rosen A, Hartman T. Repair of the midline fascialdefect in abdominoplasty with long-actingbarbed and smooth absorbable sutures. AesthetSurg J. 2011;31(6):668-73.

  3. Digilio MC, Capolino R, Dallapiccola B. Autosomaldominant transmission of nonsyndromic diastasisrecti and weakness of the linea alba. Am JMed Genet A. 2008;146A(2):254-6.

  4. Brauman D. Diastasis recti: clinical anatomy.Plast Reconstr Surg. 2008;122(5):1564-9.

  5. Beer GM, Schuster A, Seifert B, Manestar M, Mihic-Probst D, Weber SA. The normal width of thelinea alba in nulliparous women. Clin Anat.2009;22(6):706-11.

  6. Keshwani N, Mathur S, McLean L. RelationshipBetween Interrectus Distance and Symptom Severityin Women With Diastasis Recti Abdominisin the Early Postpartum Period. Phys Ther.2018;98(3):182-90.

  7. Axer H, Keyserlingk DG, Prescher A. Collagenfibers in linea alba and rectus sheaths. I. Generalscheme and morphological aspects. J Surg Res.2001;96(1):127-34.

  8. Mota P, Pascoal AG, Carita AI, Bř K. Normalwidth of the inter-recti distance in pregnant andpostpartum primiparous women. MusculoskeletSci Pract. 2018;35:34-7

  9. Rath AM, Attali P, Dumas JL, Goldlust D, ZhangJ, Chevrel JP. The abdominal linea alba: ananatomo-radiologic and biomechanical study.Surg Radiol Anat. 1996;18(4):281-8.

  10. Tung RC, Towfigh S. Diagnostic techniques fordiastasis recti. Hernia. 2021;25(4):915-9

  11. Ranney B. Diastasis recti and umbilical herniacauses, recognition and repair. S D J Med.1990;43(10):5-8.

  12. Nahas FX. An aesthetic classification of the abdomenbased on the myoaponeurotic layer.Plast Reconstr Surg. 2001;108(6):1787-95.

  13. Reinpold W, Köckerling F, Bittner R, Conze J,Fortelny R, Koch A,et al. Classification of RectusDiastasis-A Proposal by the German Hernia Society(DHG) and the International EndoherniaSociety (IEHS). Front Surg. 2019;6:1.

  14. Hernández-Granados P, Henriksen NA, BerrevoetF, Cuccurullo D, López-Cano M, NienhuijsS, et al. European Hernia Society guidelines onmanagement of rectus diastasis. Br J Surg.2021;108(10):1189-91.

  15. Nahas FX, Ferreira LM. Concepts on correctionof the musculoaponeurotic layer in abdominoplasty.Clin Plast Surg. 2010;37(3):527-38.

  16. Veríssimo P, Nahas FX, Barbosa MV, de CarvalhoGomes HF, Ferreira LM. Is it possible torepair diastasis recti and shorten the aponeurosisat the same time? Aesthetic Plast Surg.2014;38(2):379-86.

  17. McPhail I. Abdominal aortic aneurysm and diastasisrecti. Angiol. 2008;59(6):736-9.

  18. Lockwood T. Rectus muscle diastasis in males:primary indication for endoscopically assistedabdominoplasty. Plast Reconstr Surg. 1998;101(6):1685-91.

  19. Sperstad JB, Tennfjord MK, Hilde G, Ellström-Engh M, Bř K. Diastasis recti abdominis duringpregnancy and 12 months after childbirth: prevalence,risk factors and report of lumbopelvicpain. Br J Sports Med. 2016;50(17):1092-6.

  20. Hsia M, Jones S. Natural resolution of rectus abdominisdiastasis. Two single case studies. AustJ Physiother. 2000;46(4):301-7

  21. Fernandes da Mota PG, Pascoal AG, Carita AI,Bř K. Prevalence and risk factors of diastasisrecti abdominis from late pregnancy to 6 monthspostpartum, and relationship with lumbo-pelvicpain. Man Ther. 2015;20(1):200-5.

  22. Beamish N, Green N, Nieuwold E, McLean L.Differences in Linea Alba Stiffness and LineaAlba Distortion Between Women With and WithoutDiastasis Recti Abdominis: The Impact ofMeasurement Site and Task. J Orthop SportsPhys Ther. 2019;49(9):656-665.

  23. Spitznagle TM, Leong FC, Van Dillen LR. Prevalenceof diastasis recti abdominis in a urogynecologicalpatient population. Int UrogynecolJ Pelvic Floor Dysfunct. 2007;18(3):321-8.

  24. Boissonnault JS, Blaschak MJ. Incidence of diastasisrecti abdominis during the childbearingyear. Phys Ther. 1988;68(7):1082-6.

  25. Theodorsen NM, Strand LI, Bř K. Effect of pelvicfloor and transversus abdominis muscle contractionon inter-rectus distance in postpartumwomen: a cross-sectional experimental study.Physiotherapy. 2019;105(3):315-20.

  26. Benjamin DR, van de Water AT, Peiris CL. Effectsof exercise on diastasis of the rectus abdominismuscle in the antenatal and postnatalperiods: a systematic review. Physiotherapy.2014;100(1):1-8.

  27. Moesbergen T, Law A, Roake J, Lewis DR. Diastasisrecti and abdominal aortic aneurysm. Vascular.2009;17(6):325-9.

  28. Benjamin DR, Frawley HC, Shields N, van deWater ATM, Taylor NF. Relationship between diastasisof the rectus abdominis muscle (DRAM)and musculoskeletal dysfunctions, pain andquality of life: a systematic review. Physiotherapy.2019;105(1):24-34.

  29. Michalska A, Rokita W, Wolder D, PogorzelskaJ, Kaczmarczyk K. Diastasis recti abdominis - areview of treatment methods. Ginekol Pol.2018;89(2):97-101.

  30. Chiarello CM, McAuley JA. Concurrent validity ofcalipers and ultrasound imaging to measure interrectidistance. J Orthop Sports Phys Ther.2013;43(7):495-503.

  31. Bursch SG. Interrater reliability of diastasis rectiabdominis measurement. Phys Ther.1987;67(7):1077-9.

  32. Mota P, Pascoal AG, Sancho F, Bř K. Test-retestand intrarater reliability of 2-dimensional ultrasoundmeasurements of distance betweenrectus abdominis in women. J Orthop SportsPhys Ther. 2012;42(11):940-6.

  33. Nahas FX, Augusto SM, Ghelfond C. Nylon versuspolydioxanone in the correction of rectus diastasis.Plast Reconstr Surg. 2001;107(3):700-6.

  34. Emanuelsson P, Gunnarsson U, Strigĺrd K,Stark B. Early complications, pain, and quality oflife after reconstructive surgery for abdominalrectus muscle diastasis: a 3-month follow-up. JPlast Reconstr Aesthet Surg. 2014;67(8):1082-8.

  35. Hickey F, Finch JG, Khanna A. A systematic reviewon the outcomes of correction of diastasisof the recti. Hernia. 2011;15(6):607-14.

  36. Mommers EHH, Ponten JEH, Al Omar AK, deVries Reilingh TS, Bouvy ND, Nienhuijs SW. Thegeneral surgeon's perspective of rectus diastasis.A systematic review of treatment options.Surg Endosc. 2017;31(12):4934-49.

  37. Gluppe SL, Hilde G, Tennfjord MK, Engh ME, BřK. Effect of a Postpartum Training Program onthe Prevalence of Diastasis Recti Abdominis inPostpartum Primiparous Women: A RandomizedControlled Trial. Phys Ther. 2018;98(4):260-8.

  38. Nahas FX, Augusto SM, Ghelfond C. Should diastasisrecti be corrected? Aesthetic Plast Surg.1997;21(4):285-9.

  39. Williams TC, Hardaway M, Altuna B. Ambulatoryabdominoplasty tailored to patients with an appropriatebody mass index. Aesthet Surg J.2005;25(2):132-7.

  40. Palanivelu C, Rangarajan M, Jategaonkar PA,Amar V, Gokul KS, Srikanth B. Laparoscopic repairof diastasis recti using the 'Venetian blinds'technique of plication with prosthetic reinforcement:a retrospective study. Hernia.2009;13(3):287-92.

  41. Zukowski ML, Ash K, Spencer D, Malanoski M,Moore G. Endoscopic intracorporal abdominoplasty:a review of 85 cases. Plast ReconstrSurg. 1998;102(2):516-27.

  42. Fiori F, Ferrara F, Gobatti D, Gentile D, Stella M.Surgical treatment of diastasis recti: the importanceof an overall view of the problem. Hernia.2021;25(4):871-82.

  43. Nahas FX, Ferreira LM, Mendes Jde A. An efficientway to correct recurrent rectus diastasis.Aesthetic Plast Surg. 2004;28(4):189-96.

  44. Yousif NJ, Lifchez SD, Nguyen HH. Transverserectus sheath plication in abdominoplasty. PlastReconstr Surg. 2004;114(3):778-84.

  45. Brauman D, Capocci J. Liposuction abdominoplasty:an advanced body contouring technique.Plast Reconstr Surg. 2009;124(5):1685-95.

  46. Batchvarova Z, Leymarie N, Lepage C, LeyderP. Use of a submuscular resorbable mesh forcorrection of severe postpregnancy musculoaponeuroticlaxity: an 11-year retrospective study.Plast Reconstr Surg. 2008;121(4):1240-8.

  47. Kanjoor JR, Singh AK. Lipoabdominoplasty: Anexponential advantage for a consistently safeand aesthetic outcome. Indian J Plast Surg.2012;45(1):77-88.

  48. Bezama J. Técnica quirúrgica para reparar ladiástasis de rectos asociada a hernia umbilical.Diez ańos de experiencia. Rev Hispanoam Hernia.2017;5(2):52-6.

  49. Nahas FX, Ferreira LM, Augusto SM, GhelfondC. Long-term follow-up of correction of rectus diastasis.Plast Reconstr Surg. 2005;115(6):1736-41.

  50. Gama LJM, Barbosa MVJ, Czapkowski A, AjzenS, Ferreira LM, Nahas FX. Single-Layer Plicationfor Repair of Diastasis Recti: The Most Rapidand Efficient Technique. Aesthet Surg J.2017;37(6):698-705.

  51. Nahas FX, Faustino LD, Ferreira LM. AbdominalWall Plication and Correction of Deformities ofthe Myoaponeurotic Layer: Focusing on Materialsand Techniques Used for Synthesis. AesthetSurg J. 2019;39(Suppl_2):S78-S84.

  52. Cheesborough JE, Dumanian GA. Simultaneousprosthetic mesh abdominal wall reconstructionwith abdominoplasty for ventral hernia and severerectus diastasis repairs. Plast ReconstrSurg. 2015;135(1):268-76

  53. Emanuelsson P, Gunnarsson U, Dahlstrand U,Strigĺrd K, Stark B. Operative correction of abdominalrectus diastasis (ARD) reduces pain andimproves abdominal wall muscle strength: A randomized,prospective trial comparing retromuscularmesh repair to double-row, self-retainingsutures. Surgery. 2016;160(5):1367-75.

  54. Nahabedian MY. Diastasis recti repair with onlaymesh. Hernia. 2021;25(4):855-62.

  55. Pollock H, Pollock T. Progressive tension sutures:a technique to reduce local complicationsin abdominoplasty. Plast Reconstr Surg.2000;105(7):2583-6.

  56. van Uchelen JH, Werker PM, Kon M. Complicationsof abdominoplasty in 86 patients. Plast ReconstrSurg. 2001;107(7):1869-73.

  57. Tadiparthi S, Shokrollahi K, Doyle GS, FahmyFS. Rectus sheath plication in abdominoplasty:assessment of its longevity and a review of theliterature. J Plast Reconstr Aesthet Surg.2012;65(3):328-32.

  58. Mestak O, Kullac R, Mestak J, Nosek A,Krajcova A, Sukop A. Evaluation of the long-termstability of sheath plication using absorbable suturesin 51 patients with diastasis of the rectimuscles: an ultrasonographic study. Plast ReconstrSurg. 2012;130(5):714e-719e.

  59. de Castro EJP, Radwanski HN, Pitanguy I, NahasF. Long-term ultrasonographic evaluation ofmidline aponeurotic plication during abdominoplasty.Plast Reconstr Surg. 2013;132(2):333-8.

  60. Elkhatib H, Buddhavarapu SR, Henna H,Kassem W. Abdominal musculoaponeuretic system:magnetic resonance imaging evaluation beforeand after vertical plication of rectus musclediastasis in conjunction with lipoabdominoplasty.Plast Reconstr Surg. 2011;128(6):733e-740e.

  61. Kaufmann RL, Reiner CS, Dietz UA, Clavien PA,Vonlanthen R, Käser SA. Normal width of thelinea alba, prevalence, and risk factors for diastasisrecti abdominis in adults, a cross-sectionalstudy. Hernia. 2022;26(2):609-18.




2020     |     www.medigraphic.com