Abstract
We are grateful for the comments of Nathan and Nathan, which will allow us to better clarify our article. Diastasis of recti muscles differs from a regular inci- sional hernia.
A hernia is defined as the protrusion of an organ or part of an organ through a defect in the wall of the cavity.1 Incisional hernia arises from dif- ferent causes, such as surgical-site infection, excessive tension on the suture, or use of inappropriate sutur- ing material. Diastasis of recti muscles, on the other hand, is a result of spread in the area of the linea alba without any organ protrusion.
The complex but flex- ible structural composition of the linea alba makes it prone to fatigue in cases of long-lasting increased intra- abdominal pressure, such as that resulting from preg- nancy. Consequently, the recti abdominis muscles will separate, leading to diastasis with a widened linea alba.2 The articles cited by Nathan and Nathan evaluat- ing outcomes of hernia correction are excellent level 1 articles evaluating methods of abdominal fascia clo- sure and incisional hernia therapy.
However, in our opinion, these findings cannot be interpolated to the treatment of diastasis recti abdominis muscles for the reasons stated above. Level 1 or 2 studies evaluating approaches to the therapy of diastasis recti muscles are lacking.
We think that use of absorbable suture for this repair has advantages that are described in our article, and we believe our study provides the best scientific data in this field to date. Abdominal musculature plays a crucial role in postural muscle balance.
There are studies suggesting that back pain, pelvic floor dysfunction, and other comor- bidities are related to diastasis recti abdominis mus- cles.3,4 As far as we know, there are no scientific data evaluating the impact of surgical correction of diastasis recti muscles on these comorbidities.