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Background <p>Previous laparotomy frequently leads to long-term abdominal wall dysfunction, including rectus diastasis, incisional hernia, contour deformity, and musculoaponeurotic weakness. These alterations may compromise trunk stability and are often associated with lumbar pain and functional limitation. Delayed functional abdominoplasty has emerged as a reconstructive option to restore abdominal wall integrity while improving functional outcomes. We aimed to evaluate functional outcomes and identify predictors of postoperative complications in patients undergoing delayed functional abdominoplasty after previous laparotomy.</p> Methods <p>A retrospective observational study was conducted including 83 patients who underwent delayed functional abdominoplasty between January 2021 and January 2024. Demographic variables, abdominal wall findings, operative characteristics, and postoperative outcomes were analyzed. Functional improvement was assessed using lumbar pain visual analog scale and abdominal wall strength. Multivariate logistic regression analysis was performed to identify independent predictors of postoperative complications.</p> Results <p>Mean age was 41.8 ± 8.7 years and mean body mass index was 29.6 ± 3.8&#xa0;kg/m². Rectus diastasis was present in 85.5% of patients and incisional hernia in 34.9%. The overall complication rate was 25.3%, with seroma being the most frequent event (15.7%). Lumbar pain significantly decreased from 5.8 ± 1.9 preoperatively to 2.1 ± 1.5 postoperatively (<i>p</i> &lt; 0.001). Abdominal wall weakness decreased from 73.5% to 21.7% (<i>p</i> &lt; 0.001). Multivariate logistic regression identified body mass index ≥ 30&#xa0;kg/m² (OR 2.94; 95% CI 1.02–8.46; <i>p</i> = 0.045), smoking (OR 4.38; 95% CI 1.18–16.21; <i>p</i> = 0.028), and previous surgical site infection (OR 3.52; 95% CI 1.09–11.34; <i>p</i> = 0.035) as independent predictors of postoperative complications.</p> Conclusions <p>Delayed functional abdominoplasty significantly improves abdominal wall function following laparotomy with acceptable complication rates. Obesity and smoking independently increase postoperative risk. Level of Evidence: Level III, risk / prognostic study.</p>

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Delayed functional abdominoplasty for abdominal wall reconstruction in patients with previous laparotomy: functional outcomes and predictors of postoperative complications

  • 期刊论文

  • 发表日期：

    2026年5月14日

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  • Alexis Uriel Martinez Montes,
  • Izcalli Yamili Zavaleta Martinez

摘要

Background

Previous laparotomy frequently leads to long-term abdominal wall dysfunction, including rectus diastasis, incisional hernia, contour deformity, and musculoaponeurotic weakness. These alterations may compromise trunk stability and are often associated with lumbar pain and functional limitation. Delayed functional abdominoplasty has emerged as a reconstructive option to restore abdominal wall integrity while improving functional outcomes. We aimed to evaluate functional outcomes and identify predictors of postoperative complications in patients undergoing delayed functional abdominoplasty after previous laparotomy.

Methods

A retrospective observational study was conducted including 83 patients who underwent delayed functional abdominoplasty between January 2021 and January 2024. Demographic variables, abdominal wall findings, operative characteristics, and postoperative outcomes were analyzed. Functional improvement was assessed using lumbar pain visual analog scale and abdominal wall strength. Multivariate logistic regression analysis was performed to identify independent predictors of postoperative complications.

Results

Mean age was 41.8 ± 8.7 years and mean body mass index was 29.6 ± 3.8 kg/m². Rectus diastasis was present in 85.5% of patients and incisional hernia in 34.9%. The overall complication rate was 25.3%, with seroma being the most frequent event (15.7%). Lumbar pain significantly decreased from 5.8 ± 1.9 preoperatively to 2.1 ± 1.5 postoperatively (p < 0.001). Abdominal wall weakness decreased from 73.5% to 21.7% (p < 0.001). Multivariate logistic regression identified body mass index ≥ 30 kg/m² (OR 2.94; 95% CI 1.02–8.46; p = 0.045), smoking (OR 4.38; 95% CI 1.18–16.21; p = 0.028), and previous surgical site infection (OR 3.52; 95% CI 1.09–11.34; p = 0.035) as independent predictors of postoperative complications.

Conclusions

Delayed functional abdominoplasty significantly improves abdominal wall function following laparotomy with acceptable complication rates. Obesity and smoking independently increase postoperative risk. Level of Evidence: Level III, risk / prognostic study.