Plastic and Reconstructive Surgery Department, The London Clinic, 20 Devonshire Place, London, W1G 6BW, England.
Hernia. 2021 Aug;25(4):939-950. doi: 10.1007/s10029-021-02470-0. Epub 2021 Jul 26.
The postpartum abdomen presents significant challenges to the surgeon. It is anatomically complex, with often substantial symptomatic divarication of the rectus abdominis, affecting all anterior abdominal wall layers. This may lead to profound functional sequelae, and often, of more importance to patients, a significant physical deformity. The complex interplay of functional/physical symptoms can result in reduced quality of life (QoL) as well as negative body image/self-esteem. Postpartum women may seek abdominoplasty to address the whole scope of these concerns. Whilst techniques have evolved achieving such goals operatively, the impact of such surgery on QoL/mental health has yet to be established.
We perform a comprehensive review of potential options of validated patient-reported outcome measures (PROMs) for consideration of use in postpartum women seeking abdominoplasty; in addition to discussing current driving factors for seeking surgery and associated ethics.
Pressure on postpartum women to return their abdominal wall contour to a pre-pregnant state is high. This poses important ethical considerations for surgeons. There are several well-established/validated PROMs used in body contouring in massive weight loss/bariatric population groups, including Body-Q and Body-QoL scales, but none yet specific to postpartum women.
PROMs use to enable establishment of the true value of abdominoplasty in postpartum women, not just in terms of functional/physical restoration, but also in terms of delivering a positive impact on patients' mental health and QoL, are important. Further research is needed to determine if those already developed are appropriate or whether a postpartum-specific PROM would be beneficial.
产后腹部对外科医生来说是一个巨大的挑战。它在解剖上非常复杂，往往存在严重的腹直肌症状性分离，影响所有前腹壁层。这可能导致严重的功能后遗症，而且对患者来说，通常更重要的是，明显的身体畸形。功能/身体症状的复杂相互作用会导致生活质量（QoL）下降，以及身体形象/自尊心下降。产后女性可能会寻求腹部整形术来解决这些问题。虽然技术已经发展到可以实现这些目标，但这种手术对 QoL/心理健康的影响尚未确定。
我们对产后女性寻求腹部整形术时可能使用的经过验证的患者报告结局测量（PROM）的潜在选择进行全面审查；此外，还讨论了目前寻求手术的驱动因素和相关伦理问题。
对产后女性的压力很大，要求她们将腹部轮廓恢复到怀孕前的状态。这对外科医生提出了重要的伦理考虑。有几种经过充分验证/验证的 PROM 用于巨量体重减轻/减重人群的身体轮廓塑造，包括 Body-Q 和 Body-QoL 量表，但没有一种是专门针对产后女性的。
使用 PROM 来确定腹部整形术在产后女性中的真正价值非常重要，不仅要考虑到功能/身体恢复，还要考虑到对患者心理健康和 QoL 的积极影响。需要进一步研究以确定已经开发的 PROM 是否合适，或者是否需要开发一种专门针对产后女性的 PROM。
