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Previous issue date: 2013 === A deformidade musculo-aponeurotica da parede abdominal decorrente da gestacao e multidirecional. A tecnica mais utilizada para sua correcao e a plicatura da aponeurose anterior. Seria desejavel obter ao mesmo tempo uma correcao transversal e longitudinal. O objetivo deste estudo e avaliar o eixo vertical do plano musculo-aponeurotico apos o uso da sutura triangular na correcao da diastase de retos. Metodos: Foram selecionadas 31 pacientes com deformidade abdominal tipo III/A de Nahas, divididas em dois grupos (GST- grupo sutura triangular e GSC u grupo sutura continua). Estas foram submetidas a abdominoplastia e correcao da diastase dos musculos retos com plicatura longitudinal mediana, feita entre dois clipes metalicos implantados. Os dois tipos de sutura foram realizados em todas as pacientes. No GST, apos a realizacao da sutura continua, foi realizada e mantida a sutura triangular e o oposto ocorreu no GSC. Apos cada sutura a distancia entre os clipes foi medida. Foram realizadas radiografias de abdome tres semanas e seis meses apos a cirurgia quando foi medida a distancia entre os clipes. Os dados foram comparados utilizando-se Analise de Variancia de Friedman e teste de Wilcoxon. Resultados: A sutura triangular promoveu reducao significante do eixo vertical da aponeurose quando comparada a sutura continua e a situacao sem sutura no periodo intraoperatorio (Wilcoxon p<0,001). Esta diferenca manteve-se nas radiografias de seis meses (Wilcoxon p<0,001). Conclusao: A sutura triangular produziu encurtamento do eixo vertical do plano musculo-aponeurotico da parede abdominal em longo prazo === Background: Diastasis recti secondary to pregnancy is multidirectional. Plication of the anterior rectus sheath is the most widely used technique for correction of this condition. However, it would be desirable to simultaneously perform the transverse and longitudinal repair of the defect. The aim of this study was to assess changes in the length of the musculoaponeurotic layer after diastasis recti repair using triangular sutures. Methods: Thirty-one women with Nahas’ type III/A deformity
were divided into two groups: the triangular suture (TS) group and the
continuous suture (CS) group. All patients underwent conventional
abdominoplasty and diastasis recti repair with medial longitudinal plication
performed between two metal clips. The two types of suture were used in
both groups. In the TS group, after a continuous suture was performed and
removed, triangular sutures were used and maintained in place. In the CS
group, the order of suture placement was reversed. The distance between
clips was measured before and immediately after suturing, and at 3 weeks
and 6 months postoperatively using plain abdominal radiographs. Statistical
analysis was conducted with the Friedman analysis of variance and
Wilcoxon test. Results: The use of triangular sutures significantly reduced
the length of the aponeurosis compared with both the intraoperative
Abstract | 87
situation without suture (P < 0.001) and the use of continuous suture
(intraoperatively and 6 months after surgery; P < 0.001). Conclusion: The repair of diastasis recti using triangular sutures resulted in vertical
shortening of musculoaponeurotic layer immediately after the procedure
and in the long term. === BV UNIFESP: Teses e dissertações
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