title: Effects of Abdominoplasty on Intra-Abdominal Pressure and Pulmonary Function.
abstract: BACKGROUND
  Abdominal wall weakness is a consequence of rectus abdominis diastasis and flaccidity of the myofascial component. A degree of plicature of the rectus abdominis generates an increase of intra-abdominal pressure (IAP), which may result in an increase of intrathoracic pressure, thus affecting thoracic hemodynamics and leading to inadequate ventilation.
  
  
  OBJECTIVE
  To assess changes generated by plicature of the rectus abdominis on IAP and pulmonary function in patients undergoing abdominoplasty.
  
  
  METHODS
  A total of 10 female patients with abdominal ptosis were included. Chronic smokers and patients with respiratory co-morbidities were excluded. The IAP was measured using a modified Kron's trans-bladder technique. Pulmonary function was assessed by pulmonary compliance (P-Comp) and was calculated with parameters provided by the mechanical ventilator. Both were calculated before and after plicature.
  
  
  RESULTS
  The mean values for IAP before and after plicature were 6.6 and 9.3 mmHg respectively. Before plicature, the mean P-Comp value was 38.97 mL/cm of water, and after it was 36.54 mL/cm. Both differences were statistically significant.
  
  
  CONCLUSIONS
  Based on the results obtained, it is possible to conclude that plicature of the rectus abdominis generates significant physiological changes, such as an increase in IAP and a decrease of P-Comp, which do not have a clinically relevant impact on healthy individuals. Measuring IAP with the modified technique and the assessment of pulmonary function using P-Comp are both reliable and provide a more accurate correlation with such physiologic changes. LEVEL OF EVIDENCE 3: Therapeutic.
authors.affiliation: Dr Pereira is a Plastic Surgeon, Plastic Surgery and Burns Department, Hospital del Trabajador; Plastic Surgery Department, Clínica Las Condes, Santiago, Chile; and Clínica Universidad de Chile, Santiago, Chile. Dr Sciaraffia is a Plastic Surgeon, Clínica Universidad de Chile, Santiago, Chile; and Subdirector, Oficina de Apoyo a la Investigación Clínica (OAIC), Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Danilla is a Plastic Surgeon, Department of Surgery, Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Parada is a Plastic Surgeon, Clínica Universidad de Chile, Santiago, Chile. Ms Asfora is an Operating Room Midwife, Department of Obstetrics and Gynecology, Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Moral is an Anesthesiologist, Department of Anesthesiology, Hospital Clínico Universidad de Chile, Santiago, Chile.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Pereira
authors.affiliation: Dr Pereira is a Plastic Surgeon, Plastic Surgery and Burns Department, Hospital del Trabajador; Plastic Surgery Department, Clínica Las Condes, Santiago, Chile; and Clínica Universidad de Chile, Santiago, Chile. Dr Sciaraffia is a Plastic Surgeon, Clínica Universidad de Chile, Santiago, Chile; and Subdirector, Oficina de Apoyo a la Investigación Clínica (OAIC), Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Danilla is a Plastic Surgeon, Department of Surgery, Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Parada is a Plastic Surgeon, Clínica Universidad de Chile, Santiago, Chile. Ms Asfora is an Operating Room Midwife, Department of Obstetrics and Gynecology, Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Moral is an Anesthesiologist, Department of Anesthesiology, Hospital Clínico Universidad de Chile, Santiago, Chile.
authors.forename: Carlos
authors.initials: C
authors.lastname: Sciaraffia
authors.affiliation: Dr Pereira is a Plastic Surgeon, Plastic Surgery and Burns Department, Hospital del Trabajador; Plastic Surgery Department, Clínica Las Condes, Santiago, Chile; and Clínica Universidad de Chile, Santiago, Chile. Dr Sciaraffia is a Plastic Surgeon, Clínica Universidad de Chile, Santiago, Chile; and Subdirector, Oficina de Apoyo a la Investigación Clínica (OAIC), Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Danilla is a Plastic Surgeon, Department of Surgery, Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Parada is a Plastic Surgeon, Clínica Universidad de Chile, Santiago, Chile. Ms Asfora is an Operating Room Midwife, Department of Obstetrics and Gynecology, Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Moral is an Anesthesiologist, Department of Anesthesiology, Hospital Clínico Universidad de Chile, Santiago, Chile.
authors.forename: Stefan
authors.initials: S
authors.lastname: Danilla
authors.affiliation: Dr Pereira is a Plastic Surgeon, Plastic Surgery and Burns Department, Hospital del Trabajador; Plastic Surgery Department, Clínica Las Condes, Santiago, Chile; and Clínica Universidad de Chile, Santiago, Chile. Dr Sciaraffia is a Plastic Surgeon, Clínica Universidad de Chile, Santiago, Chile; and Subdirector, Oficina de Apoyo a la Investigación Clínica (OAIC), Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Danilla is a Plastic Surgeon, Department of Surgery, Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Parada is a Plastic Surgeon, Clínica Universidad de Chile, Santiago, Chile. Ms Asfora is an Operating Room Midwife, Department of Obstetrics and Gynecology, Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Moral is an Anesthesiologist, Department of Anesthesiology, Hospital Clínico Universidad de Chile, Santiago, Chile.
authors.forename: Francisco
authors.initials: F
authors.lastname: Parada
authors.affiliation: Dr Pereira is a Plastic Surgeon, Plastic Surgery and Burns Department, Hospital del Trabajador; Plastic Surgery Department, Clínica Las Condes, Santiago, Chile; and Clínica Universidad de Chile, Santiago, Chile. Dr Sciaraffia is a Plastic Surgeon, Clínica Universidad de Chile, Santiago, Chile; and Subdirector, Oficina de Apoyo a la Investigación Clínica (OAIC), Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Danilla is a Plastic Surgeon, Department of Surgery, Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Parada is a Plastic Surgeon, Clínica Universidad de Chile, Santiago, Chile. Ms Asfora is an Operating Room Midwife, Department of Obstetrics and Gynecology, Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Moral is an Anesthesiologist, Department of Anesthesiology, Hospital Clínico Universidad de Chile, Santiago, Chile.
authors.forename: Constanza
authors.initials: C
authors.lastname: Asfora
authors.affiliation: Dr Pereira is a Plastic Surgeon, Plastic Surgery and Burns Department, Hospital del Trabajador; Plastic Surgery Department, Clínica Las Condes, Santiago, Chile; and Clínica Universidad de Chile, Santiago, Chile. Dr Sciaraffia is a Plastic Surgeon, Clínica Universidad de Chile, Santiago, Chile; and Subdirector, Oficina de Apoyo a la Investigación Clínica (OAIC), Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Danilla is a Plastic Surgeon, Department of Surgery, Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Parada is a Plastic Surgeon, Clínica Universidad de Chile, Santiago, Chile. Ms Asfora is an Operating Room Midwife, Department of Obstetrics and Gynecology, Hospital Clínico Universidad de Chile, Santiago, Chile. Dr Moral is an Anesthesiologist, Department of Anesthesiology, Hospital Clínico Universidad de Chile, Santiago, Chile.
authors.forename: César
authors.initials: C
authors.lastname: Moral
mesh_terms: D034861:Abdominal Wall / Q000473:pathology*; D061645:Abdominoplasty / Q000379:methods*; D000328:Adult; D005260:Female; D006801:Humans; D059325:Intra-Abdominal Hypertension / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012129:Respiratory Function Tests