Abdominoplasty and Patient Safety: The Impact of Body Mass Index and Bariatric Surgery on Complications Profile

Brito, Íris M; Meireles, Rita; Baltazar, João; Brandão, Carla Figueiredo; Sanches, Fernanda Vassoler; Freire-Santos, Mário J

doi:10.1007/s00266-020-01725-y

Cited by 24 publications

(26 citation statements)

References 30 publications

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“…As reported separately by Chetta and Pajula, there were no difference in complication rate after abdominal contouring procedures in patients with different methods of weight loss (diet/exercise versus bariatric surgery), suggesting that bariatric surgery itself did not increase complication risk [ 51 , 52 ]. Several other studies report varying complication rates among post-bariatric patients [ 46 , 53 , 54 , 55 ].…”

Section: Complications In Abdominoplastymentioning

confidence: 99%

Post-Bariatric Plastic Surgery: Abdominoplasty, the State of the Art in Body Contouring

Sadeghi

Duarte-Bateman

et al. 2022

JCM

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Due to the increased prevalence of obesity in the last decades, bariatric surgery has been on the rise in recent years. Bariatric surgery is a compelling option for weight loss in obese patients with severe obesity-related comorbidities or for whom lifestyle modifications have proven ineffective. Redundant skin following significant weight loss is a common occurrence affecting up to 96% of patients who undergo bariatric surgery, negatively impacting physical and psychosocial health and detracting from activities of daily living. Statistics of the American Society of Plastic Surgeons show that 46,577 body contouring procedures were performed after massive weight loss in the USA in a 2020 report. Abdominoplasty, a well-established cosmetic surgery procedure for improving body contour, is performed by removing excess skin and fat from the abdominal wall and thereby restoring musculofascial integrity and skin elasticity, resulting in a more ideal body shape and increasing quality of life. Although abdominoplasty is a safe procedure, it has been associated with a higher complication rate compared with other body-contouring procedures. Technologic advances over the past decade have been developed as non-invasive alternatives or adjunctive tools to surgery to enhance cosmetic results and minimize complications. New energy-based technologies may supplant invasive surgery for mild to moderate skin laxity and/or diminish the extent of surgery and resulting scars. Plastic surgeons play a significant role in improving the quality of life of patients who suffer from obesity and underwent bariatric surgery. We are deeply convinced, however, that the advancement of knowledge and research in this field will determine the introduction of new technologies and custom-made techniques. This advancement will reduce the complication rate with a rapid reintegration of the patient into the world of work and resumption of daily activities.

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Section: Complications In Abdominoplastymentioning

confidence: 99%

Post-Bariatric Plastic Surgery: Abdominoplasty, the State of the Art in Body Contouring

Sadeghi

Duarte-Bateman

et al. 2022

JCM

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“…Interestingly though, while bariatric patients commonly seek out an abdominoplasty after their massive weight loss, bariatric surgery itself has not been identified as a risk factor for complications. A longer time interval between the bariatric procedure and an abdominoplasty has been cited though as a predictor of complications 4 . A higher BMI has been theorized to lead to poor wound healing due to excess abdominal wall stress and hypoperfusion of adipose tissue 7 .…”

Section: Discussionmentioning

confidence: 99%

Optimizing Abdominoplasty Surgical Site Morbidity Profiling Through an Effective and Nationally Validated Risk Scoring System

et al. 2022

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BackgroundAbdominoplasty complication rates are among the highest for cosmetic surgery. We sought to create a validated scoring system to predict the likelihood of wound complications after abdominoplasty using a national multi-institutional database.MethodsPatients who underwent abdominoplasty in the American College of Surgeons National Surgical Quality Improvement Program 2007–2019 database were analyzed for surgical site complications, a composite outcome of wound disruption, and surgical site infections. The cohort was randomly divided into a 60% testing and a 40% validation sample. Multivariable logistic regression analysis was performed to identify independent predictors of complications using the testing sample (n = 11,294). The predictors were weighted according to β coefficients to develop an integer-based clinical risk score. This system was validated using receiver operating characteristic analysis of the validation sample (n = 7528).ResultsA total of 18,822 abdominoplasty procedures were identified. The proportion of patients who developed a composite surgical site complication was 6.8%. Independent risk factors for composite surgical site complication included inpatient procedure (P < 0.01), smoking (P < 0.01), American Society of Anesthesiologists class ≥3 (P < 0.01), and body mass index ≥25.0 and ≤18.0 kg/m2 (P < 0.01). African American race was a protective factor against surgical site complications (P < 0.01). The factors were integrated into a scoring system, ranging from −5 to 42, and the receiver operating characteristic analysis revealed an area under the curve of 0.71.ConclusionsWe present a validated scoring system for postoperative 30-day surgical site morbidity after abdominoplasty. This system will enable surgeons to optimize patient selection to decrease morbidity and unnecessary healthcare expenditure.

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“…However, our patient did not present any previously described risk factors of abdominoplasty complications like overweight and obesity, tobacco smoking, diabetes mellitus, age ⩾65 years. 15 , 16 …”

Section: Discussionmentioning

confidence: 99%

Caesarean Scar Endometriosis May Require Abdominoplasty

Barczyński

Sobstyl

Frąszczak

et al. 2021

Clin Med Insights Case Rep

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Endometriosis is defined as an ectopic presence of endometrium-like tissue outside uterine cavity, which most commonly involves intraperitoneal organs. However, one of the less frequent forms of the disease is abdominal wall endometriosis usually developing in surgical scars following obstetric and gynaecological surgeries involving uterine cavity entering, that is, caesarean section, myomectomy or hysterectomy. In this case report we present a case of a patient with extensive caesarean scar endometriosis, who required complex surgical management. Successful surgical treatment involved not only radical tumour resection and application of mesh in postoperative hernia prevention but also adequate wound closure ensuring satisfactory cosmetic results, which was most challenging. The abdominal wall defect could not be sutured by traditional technique, thus polypropylene mesh was used and partial abdominoplasty was performed. The wound healed without complication and 24-month follow-up showed no evidence of local recurrence and satisfactory cosmetic result. In case of extensive endometrial abdominal wall tumours surgical treatment may involve application of advanced plastic surgery techniques, like abdominoplasty or skin/musculocutaneous flaps transposition.

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Abdominoplasty and Patient Safety: The Impact of Body Mass Index and Bariatric Surgery on Complications Profile

Cited by 24 publications

References 30 publications

Post-Bariatric Plastic Surgery: Abdominoplasty, the State of the Art in Body Contouring

Post-Bariatric Plastic Surgery: Abdominoplasty, the State of the Art in Body Contouring

Optimizing Abdominoplasty Surgical Site Morbidity Profiling Through an Effective and Nationally Validated Risk Scoring System

Caesarean Scar Endometriosis May Require Abdominoplasty

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