Novel Techniques for the Surgical Management of Abdominopelvic Constriction Rings in Amniotic Band Syndrome

Abstract

Constriction rings are associated with amniotic band syndrome and most often present in the extremities. Constriction bands of the trunk are rare, and a standard of surgical care remains elusive. Traditional methods of constriction ring excision rely on soft-tissue rearrangement with multiple Z-plasties, but renewed interest in linear closure and limited Z-plasty has emerged. The authors review contemporary literature and report two cases of abdominopelvic constriction ring reconstruction with long-term follow-up. Novel techniques including anterior sheath Y-V plasty, pteruges release of the Scarpa fascia, and limited Z-plasty closure may minimize the need for serrated scar patterns.

Amniotic Band Syndrome: Head-to-Toe Manifestations and Clinical Management Guidelines

“…47 These bands occur at various depths, most commonly only to the level of the Scarpa fascia, but they can extend down to the external or internal oblique muscles. 2 Although constriction can give the abdomen an hourglass deformity, abdominal constriction syndrome rarely causes mechanical obstruction. 47 In cases of mild constriction, abdominal grooving may become more shallow as the child grows, obviating the need for surgical correction.…”

“…[13][14][15] ABS has been found to occur in association with several other systemic conditions including facial clefts, micrognathia, syndactyly, clubfeet, limb absence, renal cysts, gastroschisis, imperforate anus, and gastrointestinal obstruction. 2,[16][17][18] In addition, reduced quality of life associated with the consequences of ABS has been linked to depressive disorders, which can show improvement following surgical treatment. 17…”

“…1 The current reported incidence is one in 1200 to one in 15,000 live births, and 1.8% of stillbirths. [2][3][4] Patients with ABS are frequently referred to plastic surgeons for definitive management. The purpose of this CME article is to provide background information on the condition and supply updated recommendations for reconstructive management of this condition when presenting throughout the body.…”

“…1 The current reported incidence is one in 1200 to one in 15,000 live births, and 1.8% of stillbirths. 2–4…”

La reprise de cicatrice chez l’enfant : situations cliniques et solutions

“…Parfois rencontrées sur les membres et le tronc, elles se présentent alors sous la forme d'un anneau de striction constitué de fibrose adhérente sensiblement identique à un tissu cicatriciel. La correction est possible classiquement en supprimant le tissu fibreux et en traitant la brièveté cutanée par des plasties en Z [19] (Fig. 4).…”