背景:脐膨出(OM)是一种先天性腹壁缺损。手术管理的主要目标是新生儿的生存。然而,手术后残留的疤痕可能极其繁重,并对这些患者的生活质量(QoL)产生负面影响.这项研究的目的是评估手术治疗的美容效果,患者和外科医生的满意度,以及瘢痕对患者QoL的影响。
方法:我们进行了一项观察性回顾性横断面研究,收集了所有与OM出生患者有关的数据,1998年至2021年在我们的中心运营。使用经过验证的患者和观察者疤痕评估量表(POSAS)评估手术修复的美容结果。使用PedQL4.0对由疤痕的存在确定的生活质量进行评估。最后,两名儿科外科医生和一名医学生看望了患者,然后对疤痕的美容结果进行评分。统计学分析采用Spearman线性相关和Mann-Whitney检验。低于0.05的P值被认为是统计学上显著的。
结果:在我们的研究中,我们总共纳入了19名患者,评估时平均年龄为12岁。对患者对疤痕的一般看法有主要影响的参数是僵硬度,厚度,和不规则。我们发现巨大OM组和非巨大OM组之间所有得分的中值存在显着差异,赞成后者。最后,我们发现父母和患者填写的PedsQL之间的一致性等级较低.
结论:POSAS量表是有效的,可行,和评估外科手术美学效果的可靠工具。缺陷的原始大小是影响结果的最重要因素。然而,至关重要的是,任何关于整形手术以改善疤痕外观的决定都必须推迟到患者的成年年龄。
方法:本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266.
BACKGROUND: Omphalocele (OM) is a congenital defect of the abdominal wall. The main goal of the surgical management is the survival of the neonate. However, the residual scar following the surgery can be extremely burdensome and negatively impact the quality of life (QoL) of these patients. The aim of this study is to assess the cosmetic results of the surgical treatment, the level of satisfaction of patients and surgeons, and the influence of the scar on the QoL of the patient.
METHODS: We conducted an observational retrospective cross-sectional study collecting all data regarding patients born with OM, operated at our Centre between 1998 and 2021. The cosmetic results of the surgical repair were evaluated using the validated Patient and Observer Scar Assessment Scale (POSAS). The assessment of the quality of life determined by the presence of the scar was conducted using PedQL 4.0. At last, the patients were visited by two paediatric surgeons and a medical student, which then scored the cosmetic result of the scar. Statistical analysis was conducted with Spearman linear correlation and Mann-Whitney test. A P-value below 0.05 was considered statistically significant.
RESULTS: In our study, we included a total of 19 patients, with a mean of 12 years of age at the time of the evaluation. The parameters with the major influence on the patient\'s general opinion of the scar were stiffness, thickness, and irregularity. We discovered significant differences in median values of all scores between the giant OM group and the nongiant OM group, in favour of the latter. Finally, we found a low grade of concordance between PedsQL filled by parents and patients.
CONCLUSIONS: The POSAS scale is a valid, feasible, and reliable tool for the assessment of the aesthetic outcome of surgical procedures. The original size of the defect is the most important factor acting on the result. However, it is crucial that any decision on plastic surgery to improve the looks of the scar must be postponed to the adult age of the patient.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .