Mapping traction strength of the anterior rectus sheath in cadaver

Abstract

Purpose: The tension at the aponeurotic edges of abdominal wall defects is an important factor of dehiscence and incisional hernia formation. The purpose of this study is to map and compare the traction force necessary for medial mobilization in various levels of the anterior rectus sheath in cadavers. Methods: Twenty four adult male cadavers, raging from 22 to 59 years old, with the abdominal wall intact and without prior preservation techniques, were dissected. A complete excision of the linea alba was performed. Traction loops of 10 mm in diameter were made in the anterior rectus sheath and were placed: 2, 4, 6 and 8 cm below the lower edge of the umbilicus and 3, 6 and 9 cm above the upper edge of the umbilicus. Each loop was mobilized 10 mm in the medial direction, using an analog dynamometer. The values obtained in each level were compared using Friedman's analysis of Variance for p ≤ 0.05. Results: The average traction values obtained at the various levels were compared and there was no statistical significant difference. Conclusion: There is no variation in tension along the whole extension of the anterior rectus sheath.