Autologous dermis reinforcement in severe rectus diastasis with cutaneous excess: A case report

Severe rectus diastasis with ventral hernia is typically reinforced with synthetic mesh, although prosthetic materials carry risks of infection and other complications. Autologous dermis harvested during abdominoplasty offers a biologic alternative. We report the case of a 36-year-old multiparous woman with giant rectus diastasis (15 cm intraoperatively; 19 cm on computed tomography) and an umbilical hernia associated with marked skin excess. She underwent abdominoplasty with placement of an autologous dermal graft in a sublay position to reinforce fascial repair. One week postoperatively, umbilical necrosis required debridement and local-flap reconstruction; subsequent recovery was uneventful. At one year, no recurrence was detected clinically or by ultrasound, and the patient reported high functional and aesthetic satisfaction. This case demonstrates that autologous dermal reinforcement can provide durable abdominal wall support even in very large defects while avoiding prosthetic material. The absence of mesh was advantageous in the setting of umbilical necrosis, reducing the risk of mesh infection. Autologous dermis during abdominoplasty is therefore an efficient and cost-effective option for selected patients with severe rectus diastasis.