Ventilatory Function and Intra-abdominal Pressure in Patients Who Underwent Abdominoplasty with Plication of the External Oblique Aponeurosis

• Published in: Aesthetic plastic surgery 2013-10, Vol.37 (5), p.993-999
• Main Authors: Rodrigues, Maria Amélia, Nahas, Fábio Xerfan, Gomes, Heitor Carvalho, Ferreira, Lydia Masako
• Format: Article
• Language: English
• Subjects: Abdominal Muscles - surgery; Abdominoplasty - methods; Adult; Body Mass Index; Female; Humans; Lung - physiology; Medicine; Medicine & Public Health; Middle Aged; Original Article; Otorhinolaryngology; Plastic Surgery; Postoperative Period; Pressure; Prospective Studies; Respiratory Function Tests; Respiratory Mechanics - physiology; Spirometry; Young Adult
• ISSN: 0364-216X; 1432-5241
• DOI: 10.1007/s00266-013-0158-5

Background After correction of rectus diastasis there is a change in the values obtained by spirometry in the first few postoperative days. In specific cases, a plication of the external oblique aponeurosis in addition to plication of the anterior rectus sheath is indicated. Therefore, the aim of this study was to evaluate ventilatory function and intra-abdominal pressure (IAP) in patients who underwent abdominoplasty with the plication of the anterior rectus sheath, associated with an “L-shaped” plication of the external oblique aponeurosis. Methods Eighteen female patients, classified as Nahas type III or B, were selected. Spirometry was performed preoperatively and on the 2nd, 7th, and 15th days after surgery. Intraoperatively, the IAP was measured at five points in the surgical procedure: (1) before skin incision, (2) after the plication of the rectus abdominis muscle, (3) after the L-plication of the aponeurosis of the external oblique, (4) after skin closure, and (5) after the use of a compressive garment. Results There was a significant reduction in spirometry values after surgery. There was no correlation between body mass index (BMI), pain, the increase of IAP, and the width of diastasis and changes in spirometry ( p  ≤ 0.05) in any of the postoperative evaluations. Conclusion Spirometric parameters change on the 2nd and 7th postoperative days and tend to normalize on the 15th day. Postoperative pain, BMI, and increased IAP are not related to these changes. The use of compressive garments increases the IAP. Level of Evidence III 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 .