Long-term follow-up of scar quality and satisfaction after surgical closure of congenital abdominal wall defects: a single center perspective.

PURPOSE: Postoperative scarring remains a major concern for patients and parents following repair of congenital abdominal wall defects. This study evaluated perceptions of postoperative scars in children after omphalocele or gastroschisis repair, comparing self-assessments with parental evaluations. We hypothesized that parents perceive scarring more negatively than their children.

METHODS

A single-center study was conducted among patients treated for omphalocele or gastroschisis at the Department of Pediatric Surgery, University Hospital Erlangen (2001-2011). Between July 2022 and March 2023, patients and their parents completed the Patient and Observer Scar Assessment Scale (POSAS) 2.0, Patient Scar Assessment Questionnaire (PSAQ), and Short Form-36 (SF-36). Exclusion criteria were death or psychomotor impairment precluding reliable self-assessment.

RESULTS

Twenty-eight participants (61% gastroschisis, 39% omphalocele) were included. Parents rated scar appearance more negatively than their children (POSAS overall impression p = 0.040; appearance p = 0.002 in omphalocele). PSAQ revealed discrepancies regarding scar-related symptoms (p = 0.006) and satisfaction (p = 0.009 total; p = 0.038 omphalocele). Parents tended to underestimate children's physical complaints (p = 0.099). No differences were found between defect types. SF-36 indicated high overall quality of life (mean 79.9 ± 13.3).

CONCLUSION

Significant parent-child differences exist in scar perception. Parents emphasize cosmetic concerns, whereas children report physical symptoms. Larger studies are warranted to guide tailored postoperative support.