Firriolo Joseph M, Truong Ashley K, Charvet Heath J
Division of Plastic and Reconstructive Surgery, University of California Davis, Sacramento, CA, USA.
private practice in New Orleans, LA, USA.
Aesthet Surg J Open Forum. 2023 Feb 2;5:ojad009. doi: 10.1093/asjof/ojad009. eCollection 2023.
Abdominoplasty is widely available; however, patients with abdominal stomas appear to be relatively undertreated. Apprehension to offer abdominoplasty in the presence of a stoma may be secondary to the fear of surgical site infection and stoma compromise.
To demonstrate the feasibility and safety of abdominoplasty in the presence of an abdominal stoma for both functional and aesthetic indications and to define perioperative protocols to reduce the risk of surgical site infection in this patient population.
The authors present 2 patients with stomas who underwent abdominoplasty. Patient 1 was a 62-year-old female with a history of urostomy formation and weight loss. She had a fold of skin overhanging her ostomy site, making it difficult to maintain a seal on her urostomy bag. She underwent fleur-de-lis abdominoplasty and urostomy revision. Patient 2 was a 43-year-old female with a history of end ileostomy formation, who requested cosmetic abdominoplasty to address postpartum abdominal changes; she had no functional stoma-related complaints. Abdominoplasty, flank liposuction, and ileostomy revision were performed.
Both patients were satisfied with their aesthetic and functional outcomes. There were no complications and no instances of stoma compromise. At follow-up, Patient 1 reported a complete amelioration of her urosotomy appliance issues.
Abdominoplasty may confer both functional and aesthetic benefits to patients with abdominal stomas. The authors present peri- and intraoperative protocols, both to prevent stoma compromise and to reduce the risk of surgical site infection. The presence of a stoma does not appear to be an absolute contraindication to cosmetic abdominoplasty.
腹壁成形术应用广泛；然而，有腹部造口的患者似乎相对治疗不足。在存在造口的情况下不愿进行腹壁成形术可能是由于担心手术部位感染和造口受损。
证明对于有腹部造口的患者，出于功能和美观的指征进行腹壁成形术的可行性和安全性，并确定围手术期方案以降低该患者群体手术部位感染的风险。
作者介绍了2例接受腹壁成形术的有造口患者。患者1是一名62岁女性，有输尿管造口形成和体重减轻史。她造口部位有一圈皮肤下垂，导致输尿管造口袋难以保持密封。她接受了百合花形腹壁成形术和输尿管造口修复术。患者2是一名43岁女性，有回肠造口形成史，要求进行美容性腹壁成形术以解决产后腹部变化；她没有与造口功能相关的主诉。进行了腹壁成形术、侧腹吸脂术和回肠造口修复术。
两名患者对其美观和功能结果均满意。没有并发症，也没有造口受损的情况。随访时，患者1报告其输尿管造口器具问题完全改善。
腹壁成形术可能给有腹部造口的患者带来功能和美观上的益处。作者介绍了围手术期和术中方案，以防止造口受损并降低手术部位感染的风险。造口的存在似乎并非美容性腹壁成形术的绝对禁忌证。
