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"Wide-rectus Abdominus Fascia Advancement(wrafa): A Method For Treatment Of Global Abdominal Wall Distention"
Vitali Azouz, M.D,, Oscar Ramírez, M.D., Munir Patel, MD.
Cleveland Clinic Florida, Weston, FL, USA.

PURPOSE:
Fascial plication is a common treatment of diastasis recti at the time of abdominoplasty. However, some patients present with significant fascial laxity that is not fully explained or corrected by traditional repair. These patients suffer from global abdominal fascial distention and require treatment using a novel approach. We sought to evaluate the use of Wide Rectus Abdominus Fascia Advancement (WRAFA) in these patients.
METHODS: Wide-rectus abdominus fascia advancement (WRAFA) is performed by incising the anterior rectus sheath above the rectus muscle at the lateral 1/3 of the rectus width parallel to the linea semilunaris. The lateral borders of the fascial flaps are then medialized and sutured together with permanent suture to create a new linea alba. This dramatically reduces the surface area of the abdominal wall and redefines the waistline. We reviewed 250 patients over a 20 year period for cosmetic improvement, diastasis recurrence, and other complications.
RESULTS: 250 patients with global wall distension were treated with the WRAFA technique. One patient (1%) developed a hernia at the site of fascial incision. Patient aesthetic results and correction of laxity were good in 175 patients (70%), moderate in 63 patients (25%), and minimal in 22 patients (5%).
CONCLUSION: The WRAFA technique is a safe and effective treatment for patients who present with global abdominal wall distension that is not corrected by traditional diastasis repair.


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