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活体肝移植供者术后切口瘢痕和美容满意度。

Postoperative incision scars and cosmetic satisfaction of living liver donors.

机构信息

Nurse Practitioner of liver transplantation, Department of Nursing, Changhua Christian Hospital, Changhua.

Department of Nursing, Hung Kung University, Taichung.

出版信息

Medicine (Baltimore). 2021 Jun 11;100(23):e26187. doi: 10.1097/MD.0000000000026187.

Abstract

Cosmetic appearance is a major concern for living donors. However, little is known about the impact of a surgical scar on body image changes in living liver donors. The aim of this study was to identify potential factors that cause displeasing upper midline incision scar, and to evaluate the overall satisfaction regarding body image and scarring after living donor hepatectomy.Donors who underwent right lobe hepatectomy were recruited. Exclusion criteria included reoperation, refusal to participate, and lost follow-up. All donors were invited to complete the Vancouver Scar Scale (VSS) and the body image questionnaire. According to the VSS results of upper midline incision scar, donors were divided into 2 groups: good scarring group (VSS ≤4) and bad scarring group (VSS >4). we compared the clinical outcomes, including the demographics, preoperation, intraoperation, and postoperation variables. The study also analyzed the results of the body image questionnaire.The proportion of male donors was 48.9%. The bad scarring group consisted of 63% of the donors. On multivariate analysis, being a male donor was found to be an independent predictor of a cosmetically displeasing upper midline incision scar with statistical significance. The results of body image questionnaires, there were significant differences in cosmetic score and confidence score among the 2 groups.The upper midline incision and male donors have higher rates of scarring in comparison with the transverse incision and female donors. Donors who reported having a higher satisfaction with their scar appearance usually had more self-confidence. However, the body image won't be affected. Medical staff should encourage donors to take active participation in wound care and continuously observe the impact of surgical scars on psychological changes in living liver donors.

摘要

美容外观是活体供者的主要关注点。然而,对于活体肝供者手术瘢痕对体像变化的影响知之甚少。本研究旨在确定导致上中线切口瘢痕不满意的潜在因素,并评估活体肝切除术后体像和瘢痕的总体满意度。

招募接受右半肝切除术的供者。排除标准包括再次手术、拒绝参与和随访丢失。所有供者均被邀请完成温哥华瘢痕量表(VSS)和体像问卷。根据上中线切口瘢痕的 VSS 结果,将供者分为 2 组:良好瘢痕组(VSS≤4)和不良瘢痕组(VSS>4)。我们比较了临床结果,包括人口统计学、术前、术中、术后变量。研究还分析了体像问卷的结果。

男性供者的比例为 48.9%。不良瘢痕组占供者的 63%。多变量分析显示,男性供者是美容上不满意的上中线切口瘢痕的独立预测因素,具有统计学意义。体像问卷的结果显示,2 组在美容评分和信心评分方面存在显著差异。

与横向切口和女性供者相比,上中线切口和男性供者的瘢痕发生率更高。报告对瘢痕外观满意度较高的供者通常更有自信。然而,体像不会受到影响。医务人员应鼓励供者积极参与伤口护理,并持续观察手术瘢痕对活体肝供者心理变化的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18bd/8202607/a64ca47e212a/medi-100-e26187-g001.jpg

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