Long-Term Assessment of Aesthetic Results in Omphalocele Repair with POSAS Scale

Introduction: Omphalocele (OM) is a congenital defect of the abdominal wall. The main goal of thesurgical management is the survival of the neonate. However, the residual scarfollowing the surgery can be extremely burdensome and negatively impact the qualityof life (QoL) of these patients. The aim of this study is to assess the cosmetic results ofthe surgical treatment, the level of satisfaction of patients and surgeons, and theinfluence of the scar on the QoL of the patient. Materials and methods: We conducted an observational retrospective cross-sectional study collecting all dataregarding patients born with OM, operated at our Centre between 1998 and 2021. Thecosmetic results of the surgical repair were evaluated using the validated Patient and Observer Scar Assessment Scale (POSAS). The assessment of the quality of lifedetermined by the presence of the scar was conducted using PedQL 4.0. At last, thepatients were visited by two paediatric surgeons and a medical student, which thenscored the cosmetic result of the scar. Statistical analysis was conducted withSpearman 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 thetime of the evaluation. The parameters with the major influence on the patient’s generalopinion of the scar were stiffness, thickness, and irregularity. We discovered significantdifferences in median values of all scores between the giant OM group and the nongiantOM group, in favour of the latter. Finally, we found a low grade of concordancebetween PedsQL filled by parents and patients. Conclusion: 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. Level of Evidence IV: 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.