Autologous Dermal Mesh in Severe Postpregnancy Recti Muscles Diastasis

The severe postpregnancy diastasis of recti muscles causes a biomechanical alteration of the statics of the trunk and an unaesthetic bulging of the abdominal wall. This is always combined with cutaneous and subcutaneous excess, which is different on a case-by-case basis. There is not a consensus on the best way to treat it. The anterior sheath plication is the mostly used surgical technique, and many surgeons believe that the use of mesh is necessary in the cases of severe diastasis. The authors here report the outcomes of the use of dermal automesh in the retromuscular layer.

Between January 2015 and December 2019, a retrospective study on 101 patients was conducted. All patients underwent the repairment of the diastasis recti with transversalis sheath plication and dermal automesh reinforcement in the sublay fashion. In addition, all the patients had an abdominal wall ultrasound before the operation and an ultrasound after 1 month, 3 months, 6 months, 1 year and every year afterward. The median follow-up was 32.5 months RESULTS: No major complications, such as infections, extrusions, respiratory diseases or thrombosis, were reported. The follow-up abdominal wall ultrasound reported the absence of muscle recti diastasis in all patients. All patients were completely satisfied with the final result.

In postpregnancy women, the severe recti muscles diastasis dermal automesh repair is safe and effective. The dermal graft is easy to handle, has demonstrated comparable tensile strength to alloplastic mesh and is available in abdominoplasty or miniabdominoplasty from the excised skin.

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