METHODS OF PREOPERATIVE FORECASTING OF THE RESULTS OF DIASTASE PLASTY OF THE STRAIGHT ABDOMINAL MUSCLES IN COMBINATION WITH ABDOMINOPLASTY

BACKGROUND: Despite the expansion of surgical techniques for correcting rectus abdominis diastasis (RAD), the selection of an optimal repair method remains debatable. Current approaches differ in the degree of tissue trauma, recurrence rates, and postoperative pain, while the prognostic role of preoperative ultrasound and electromyographic parameters has not been sufficiently studied. Establishing objective preoperative criteria could facilitate prediction of long-term outcomes and reduce the risk of complications following RAD repair combined with abdominoplasty.

AIM: To evaluate the effectiveness of different RAD repair techniques performed concurrently with abdominoplasty and to determine the prognostic value of preoperative ultrasound and electromyography for long-term surgical outcomes.

METHODS: This study included 86 female patients who underwent abdominoplasty with RAD repair between 2022 and 2024. Patients were assigned to three groups according to the repair technique: continuous suture, mesh placement with traditional fixation, and interaponeurotic mesh placement without fixation. All patients underwent preoperative and early postoperative ultrasound assessment (RAD size and aponeurosis thickness) and electromyographic evaluation of abdominal muscle bioelectric activity.

RESULTS: Interaponeurotic mesh placement demonstrated the most favorable indicators of bioelectric muscle activity and the lowest incidence of chronic pain. Recurrence of RAD (30%) was recorded exclusively in the continuous suture group. Early postoperative complications were comparable across groups. Preoperative ultrasound and electromyography parameters correlated with the likelihood of long-term complications and may serve as predictive markers for surgical outcomes.

CONCLUSION: Preoperative ultrasound and electromyographic assessment enables prediction of long-term outcomes of RAD repair combined with abdominoplasty and supports informed selection of the optimal surgical technique. Interaponeurotic mesh placement without fixation appears to be an effective alternative associated with fewer long-term complications, though further research is required to confirm its long-term safety.