Determinations of a safe musculofascial plication in abdominoplasty

This study was conducted to determine a safe vertical musculo-fascial plication distance in abdominoplasty operation in order to avoid the risk of developing respiratory distress during the post operative period. Abdominoplasty is a surgical procedure that removes excess abdominal skin and fat (panneculectomy), and tightens lax anterior abdominal wall muscle; in which musculo-fascial plication is a major component of abdominoplasty in patient with significant divaricating of the recti muscles. Respiratory decompensation may occur as a result of undue plication which reduces the intra abdominal volume with diaphragmatic excursion leading to abdominal compartmental syndrome. Fifty six patients for abdominoplasty were selected prospectively, during the period from June 1998 to February 2004, male to female ratio 1:13, mean age 39.5, mean weight 95.2 kilogram. To determine a safe plication distance (PD). The difference between two pre-operative measurements of the abdominal circumference was measured, before (BB) and after (AB) application of abdominal binder. The safe plication distance (PD) in centimeters = (BB) - (AB). The mean plication distance is 13.5cm. The changes in the pulmonary functions test before and after surgery were clinically insignificant. Pre-operative determination of safe plication distance is simple and convenient method which reduces the risk of developing respiratory distress in patients undergoing abdominoplasty in the post-operative period.