An emotional impact of postoperative scars at pediatric patients and their parents after surgical correction of the chest funnel deformity

Introduction. Funnel-shaped deformity of the chest (CFD) is the most common anomaly, which accounts for about 90% of all congenital malformations of the chest. At the same time, complaints about the cosmetic defect of postoperative scars are characteristic of children of all age groups, but at the age of over 14 years they become prevalent, causing psychological discomfort in patients.

Purpose. To assess a psychological reaction of children with the CFD at postoperative scars after surgical correction of their deformity with an open approach and with the minimally invasive technique by Nuss.

Material and methods. A questionnaire survey was conducted in two groups (Group 1, n = 29; Group 2, n = 108) of children with CFD and their parents so as to assess cosmetic results of postoperative scars after open surgery and after the minimally invasive technique by Nuss. The enrolled patients were treated in the department of thoracic surgery in Filatov City Children’s Hospital No 13 (Moscow).

Results. It was found out that patients with CFD, who were operated on with an open access (55%), would like to have a smaller scar; 13% of them told about a feeling of complexion when communicating with peers; 7% assumed that they would expect difficulties in choosing a profession because of an ugly scar. Children from Group 2, operated on by the minimally invasive Nuss technique, had the following results: 100 (92.59%) respondents would also like to have a “better scar” on the skin surface – they meant barely noticeable scars and their smaller number. 8 (7.41%) patients would like to have an additional surgical correction of their scars because of problems with peer communication. None of the respondents from this group was preoccupied with possible difficulties in profession selection because their scars were not as rough as in patients from Group 1.

Conclusion. The minimally invasive Nuss technique for surgical treatment of CFD caused much less negative reactions in operated children due to barely noticeable scars on their chest.