title: Dynamic abdominoplasty for the treatment of prune belly syndrome.
abstract: BACKGROUND
  The deficient abdominal wall musculature associated with prune belly syndrome often results in numerous functional disabilities, including diminished cough, impaired bladder and bowel function, and poor posture and balance. Traditional abdominoplasties focus on static fascial excisions or plications. The authors sought to assess their preliminary experience with a new abdominoplasty technique that incorporates standard fascial tightening with bilateral pedicled rectus femoris muscle transfers.
  
  
  METHODS
  This case series review included all patients treated with prune belly syndrome at the authors' center. Physical presentation, operative procedures, hospitalization, complications, and postoperative functional status were assessed, and a systematic analysis of published surgical series was performed.
  
  
  RESULTS
  Over a 16-year period, the authors treated 13 patients with prune belly syndrome. All underwent standard "vest over pants" fascial plications, with 11 of 13 undergoing additional rectus femoris muscle transpositions at a mean age of 4 years (range, 12 months to 13 years). Hospitalization averaged 9.3 days, and the average follow-up was over 1.5 years. The authors identified three minor complications (chylous leak, fungal urinary tract infection, and partial umbilical necrosis), yielding a complication rate similar to those identified in our systematic analysis of published standard abdominoplasties. Postoperatively, all transposed muscles were palpably functional, one patient was successfully weaned off a ventilator, and all demonstrated improvements with balance and ambulation.
  
  
  CONCLUSIONS
  The authors' preliminary review suggests that this new procedure, which supplements the standard prune belly abdominoplasty with bilateral rectus femoris transposition flaps, is not associated with substantially higher complication rates yet does appear to have the potential to provide functional improvements.
authors.affiliation: Dallas, Texas From The Craniofacial Center.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Fearon
authors.forename: George
authors.initials: G
authors.lastname: Varkarakis
mesh_terms: D034861:Abdominal Wall / Q000601:surgery; D061645:Abdominoplasty / Q000009:adverse effects / Q000379:methods*; D000293:Adolescent; D057868:Anastomotic Leak / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009181:Mycoses / Q000209:etiology; D009336:Necrosis / Q000209:etiology; D011535:Prune Belly Syndrome / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014472:Umbilicus / Q000473:pathology; D014552:Urinary Tract Infections / Q000209:etiology