Complications in abdominoplasty: A risk factor analysis

Momeni, Arash; Heier, Mathias; Bannasch, Holger; Stark, G. Björn

doi:10.1016/j.bjps.2008.03.043

Cited by 151 publications

(88 citation statements)

References 20 publications

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“…Specifically, several studies have demonstrated an association between male gender and hematoma formation in patients undergoing facelift surgery and body contouring procedures. 6,10,12,14,[26][27][28] These results are consistent with the findings from the present study, as male gender was found to be the strongest risk factor for hematoma formation with a RR of 1.98 (P < 0.01). Prior investigators have attempted to explain this association in patients undergoing facelift surgery by evaluating the facial skin perfusion of both genders using a laser Doppler flow probe.…”

Section: Risk Factorssupporting

confidence: 82%

Incidence and Risk Factors for Major Hematomas in Aesthetic Surgery: Analysis of 129,007 Patients

Kaoutzanis

Winocour

Gupta

et al. 2017

Aesthetic Surgery Journal

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Background: Postoperative hematomas are one of the most frequent complications following aesthetic surgery. Identifying risk factors for hematoma has been limited by underpowered studies from single institution experiences. Objectives: To examine the incidence and identify independent risk factors for postoperative hematomas following cosmetic surgery utilizing a prospective, multicenter database. Methods: A prospectively enrolled cohort of patients who underwent aesthetic surgery between 2008 and 2013 was identified from the CosmetAssure database. Primary outcome was occurrence of major hematomas requiring emergency room visit, hospital admission, or reoperation within 30 days of the index operation. Univariate and multivariate analysis was used to identify potential risk factors for hematomas including age, gender, body mass index (BMI), smoking, diabetes, type of surgical facility, procedure by body region, and combined procedures. Results: Of 129,007 patients, 1180 (0.91%) had a major hematoma. Mean age (42.0 ± 13.0 years vs 40.9 ± 13.9 years, P < 0.01) and BMI (24.5 ± 5.0 kg/m 2 vs 24.3 ± 4.6 kg/m 2 , P < 0.01) were higher in patients with hematomas. Males suffered more hematomas than females (1.4% vs 0.9%, P < 0.01). Hematoma rates were higher in patients undergoing combined procedures compared to single procedures (1.1% vs 0.8%, P < 0.01), and breast procedures compared to body/extremity or face procedures (1.0% vs 0.8% vs 0.7%, P < 0.01). On multivariate analysis, independent predictors of hematoma included age (Relative Risk [RR] 1.01), male gender (RR 1.98), the procedure being performed in a hospital setting rather than an office-based setting (RR 1.68), combined procedures (RR 1.35), and breast procedures rather than the body/extremity and face procedures (RR 1.81). Conclusions: Major hematoma is the most common complication following aesthetic surgery. Male patients and those undergoing breast or combined procedures have a significantly higher risk of developing hematomas.

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Section: Risk Factorssupporting

confidence: 82%

Incidence and Risk Factors for Major Hematomas in Aesthetic Surgery: Analysis of 129,007 Patients

Kaoutzanis

Winocour

Gupta

et al. 2017

Aesthetic Surgery Journal

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“…As abdominoplasty is a very different surgical procedure from the cervicofacial rhytidectomy when corresponded with the flap dissection, thickness, composition, blood supply, and anatomical layes of the flap, necrosis of the abdominoplasty flap seems to be related to a large number of causes described clearly in the literature. Risk factors for the occurence of major or minor wound complications after abdominoplasty have been described in the various studies, including smoking, previous abdominal surgery, hypertension, and male sex [16]. Obesity is another well known risk factor for complications after abdominoplasty.…”

Section: Discussionmentioning

confidence: 99%

“…A body mass index higher than 30 kg/m 2 at the time of surgery is a cause for wound complications. Suturation of the distal edge of the abdominal flap under significant tension may be considered to be a risk for potential wound problems [16][17].…”

Section: Discussionmentioning

confidence: 99%

Does the tumescent infiltration have an adverse effect on the full abdominoplasty flap?

Gümüş¹,

Yilmaz²

2012

CMJ

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Aim. Abdominoplasty is one of the most common aesthetic surgical procedures, which restores abdominal contour and shape in patients who have significant abdominal deformations involving musculofacial laxicity and sagged abdominal wall. Besides its benefits, procedure has some complications such as seroma, hematoma, fat necrosis, wound dehiscense, skin necrosis and flap necrosis. All of which seems to be related either directly or indirectly with the blood perfusion of the abdominal flap. Methods. Presented here, is a patient who underwent full abdominoplasty with tumescent infiltration under conscious sedation after which a severe complication, flap necrosis developed in zone 1, suggesting that it was related with the full abdominoplasty technique combined with adrenaline. Results. In the follow-up examinations, wound care, antibiotic treatment, and debridment of the necrotic tissues under local anesthesia were performed during 6 months. Finally wound closed itself, leaving significant lower abdominal scar which needed a major revisional surgery. Conclusion. In full abdominoplasty procedure, when combined with tumescent anesthesia adrenaline content of the tumescent may compromise blood perfusion of the zone 1, so preventive procedures such as limited lateral dissection of the flap, protection of the some musculocutaneous perforators and short transverse incision, should be kept in mind to avoid ischemia of the flap.

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“…Et cirkumferensielt nedre kroppsløft tar 3 -5 timer og krever 1 -4 dagers innleggelse. Rekonvalesenstiden er normalt 4 -6 uker, såfremt det ikke oppstår komplikasjoner (26,27).…”

Section: Bukplastikk Og Nedre Kroppsløft (Belteplastikk)unclassified

Plastikkirurgi etter fedmekirurgi

Gunnarson¹,

Frøyen²,

Sandbu³

et al. 2015

Tidsskriftet

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Jøran Hjelmesaeth HOVEDBUDSKAPAntall pasienter med alvorlige plager relatert til overflødig hud etter fedmekirurgi og stor vektreduksjon er økende Vår erfaring er at plastikkirurgisk behandling kan gi betydelig bedring av disse plagene Kunnskapsgrunnlaget om behandlingsindikasjoner, metoder, resultater og komplikasjoner er imidlertid mangelfullt Det er spesielt behov for en grundig kartlegging og evaluering av behandlingstilbudet til den store pasientgruppen med BMI  30 kg/m 2 , som ofte blir nektet plastikkirurgi i dag BAKGRUNN Store vekttap etter overvektskirurgi medfører gjerne overflødig hud, noe som kan gi et stigmatiserende utseende og uttalte fysiske og psykiske plager. I denne oversiktsartikkelen drøftes kunnskapsgrunnlaget for postbariatrisk plastikkirurgi og hvilke behandlingstilbud som finnes.KUNNSKAPSGRUNNLAG Artikkelen er basert på et litteratursøk i PubMed med søkeordene «bariatric surgery» AND «plastic surgery», supplert med forfatternes erfaringer fra et stort pasientmateriale.RESULTATER Kroppsformende kirurgi etter store vekttap tilbys hovedsakelig for behandling av medisinsk belastende hudplager. Behandlingen kan bidra til økt livskvalitet og høyere funksjonsnivå. Indikasjon for behandling, valg av plastikkirurgisk metode og grad av komplikasjoner er imidlertid svakt vitenskapelig forankret, og plastikkirurgens egen oppfatning og kliniske erfaring er derfor ofte avgjørende. Mange plastikkirurger setter grensen for kroppsformende kirurgi ved BMI < 28 kg/m 2 . De fleste overvektsopererte har BMI  30 kg/m 2 , og en søknad om kroppsformende kirurgi for disse pasientene blir dermed ofte avslått, med unntak av der det er tungtveiende medisinske årsaker.FORTOLKNING Plastikkirurgiske inngrep kan gi høyere funksjonsnivå og økt livskvalitet. Kunnskapsgrunnlaget for indikasjoner, behandlingsmetoder og resultater bør styrkes gjennom godt planlagte prospektive studier og et pasientregister. Det er spesielt behov for dokumentasjon av behandlingsresultat når det gjelder den store pasientgruppen med BMI  30 kg/m 2 .Kirurgisk vektreduserende behandling (bariatrisk kirurgi) har økt i omfang, og omtrent 3 000 mennesker blir årlig fedmeoperert i Norge (1, 2). Livskvalitet og fedmerelaterte følgesykdommer bedres betydelig etter uttalt vekttap (3), men likevel opplever mange nye fysiske og psykiske plager på grunn av store mengder overflødig hud.I denne oversiktsartikkelen drøftes behandlingsindikasjoner, valg av postbariatriske plastikkirurgiske metoder, resultater og komplikasjoner samt hvilke behandlingstilbud som finnes. KunnskapsgrunnlagLitteratursøk i PubMed 19.11. 2014 med søkestrengen «bariatric surgery» AND «plas-tic surgery» ga 178 artikler. Av disse ble 141 engelsk-og skandinaviskspråklige fulltekstartikler med abstrakt systematisk gjennomgått av førsteforfatter. Artikler basert på kasuistikker eller operasjonsmetoder samt kommentarartikler ble ekskludert.Alle abstraktene ble lest grundig av første-forfatter, og de mest relevante ble plukket ut og gjennomgått av første-og sisteforfatter. Til slutt ble ...

show abstract

Complications in abdominoplasty: A risk factor analysis

Cited by 151 publications

References 20 publications

Incidence and Risk Factors for Major Hematomas in Aesthetic Surgery: Analysis of 129,007 Patients

Incidence and Risk Factors for Major Hematomas in Aesthetic Surgery: Analysis of 129,007 Patients

Does the tumescent infiltration have an adverse effect on the full abdominoplasty flap?

Plastikkirurgi etter fedmekirurgi

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