Improved quality of life after combined plastic and general surgical retromuscular mesh repair for abdominal wall hernia with concurrent rectus diastasis: a retrospective cohort study of 59 post-partum woman.

PURPOSE: To evaluate hernia recurrence, postoperative complications, and patient reported outcomes after combined open ventral hernia repair (OVHR) and rectus diast asis (RD) reconstruction with abdominal wall contour correction in postpartum women.

METHODS

This retrospective study included women (BMI < 30 kg/m2) with symptomatic ventral hernia ≥ 1 cm and concomitant RD ≥ 3 cm who underwent elective combined repair between 2018 and 2024. All patients had completed childbearing, experienced functional complaints, and maximized physiotherapy benefit. Primary outcomes were hernia recurrence and postoperative complications, classified as surgical site occurrences (SSO) and SSO requiring procedural intervention. Secondary outcomes included functional, physical, and cosmetic patient-reported outcomes.

RESULTS

Fifty-nine patients were included. Wound-related complications occurred in 38.9%, mainly wound dehiscence (18.6%) and umbilical necrosis (13.6%). Wound infection occurred in 5.1%, with 3.4% requiring radiologic drainage and 1.7% reoperation. Significant postoperative improvements were observed in abdominal pain (93.2% to 15.3%, p < 0.001), back pain (64.4% to 3.4%, p < 0.001) abdominal swelling (59.3% to 5.1%, p < 0.001), abdominal wall dysfunction (100% to 8.5%, p < 0.001), and physical limitations (61.0% to 0%, p < 0.001). Dissatisfaction with abdominal aesthetics decreased from 100% preoperatively to 18.6% postoperatively (p < 0.001). No hernia recurrence occured.

CONCLUSION

Combined OVHR and RD reconstruction in postpartum women results in substantial improvements in pain, function, and abdominal wall aesthetics without hernia recurrence. Despite notable wound-related complications, outcomes support the functional and quality-of-life benefits of a multidisciplinary surgical approach. Prospective studies are needed to confirm these findings and optimize perioperative strategies.