Frequency and Risk Factors of Blood Transfusion in Abdominoplasty in Post–Bariatric Surgery Patients

Masoomi, Hossein; Rimler, Jonathan; Wirth, Garrett A.; Lee, Christine; Paydar, Keyianoosh Z.; Evans, Gregory R. D.

doi:10.1097/prs.0000000000001161

Cited by 21 publications

(9 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The present study showed that the majority of the patients consisted of women, as well as other studies [13][14][15][16][17][18] . Likewise, the mean age of 41 years was similar to that of other works [15][16][17]19 , but below the age of 44 years in an American work 14 and 48 years evidenced by other series 13,20 . The mean BMI before plastic surgery of 27.4kg/m 2 was similar to that found by other authors [13][14][15][16][17] , but well below the BMI of 35.6Kg/m 2 verified by Shermak et al 21 .…”

Section: Introductionsupporting

confidence: 82%

See 1 more Smart Citation

Anthropometric and clinical profiles of post-bariatric patients submitted to procedures in plastic surgery

Rosa

Macedo²,

Casulari

et al. 2018

Rev. Col. Bras. Cir.

View full text Add to dashboard Cite

show abstract

Section: Introductionsupporting

confidence: 82%

“…As for the treatment of abdominal hernias during abdominoplasty, there was no need to use meshes. These hernias are more common when reductive gastroplasty is performed by open access 19 . In the present study, 57.5%…”

Section: Discussionmentioning

confidence: 99%

Anthropometric and clinical profiles of post-bariatric patients submitted to procedures in plastic surgery

Rosa

Macedo²,

Casulari

et al. 2018

Rev. Col. Bras. Cir.

View full text Add to dashboard Cite

show abstract

“…Data regarding transfusions in abdominoplasties is limited with few recent studies representing rates as low as 0%–1.3% up to 26.6% in post-bariatric circular lipo-abdominoplasty (8, 9, 16, 20). Recently, a large cohort study of 20,310 post-bariatric abdominoplasties in the United States found transfusion rate of 9.3%, but less complex panniculectomies were also included (36). Our high rates may be partly due to the widely varying threshold of giving perioperative transfusions.…”

Section: Discussionmentioning

confidence: 99%

“…This issue has its importance because, although considered generally safe, transfusions can cause immunological responses, including severe hemolytic reactions. Moreover, perioperative transfusions are associated with complications, higher mortality, longer hospitalization and cardiovascular events (36, 39).…”

Section: Discussionmentioning

confidence: 99%

Ligasure impact^™ might reduce blood loss, complications, and re-operation occurrence after abdominoplasty in massive-weight-loss patients: A Comparative Study

et al. 2019

View full text Add to dashboard Cite

Background and Aims: The most effective dissection technique for raising the flap in abdominoplasty is still controversial, particularly in high-risk massive-weight-loss patients. LigaSure Impact™ vessel-sealing system (Medtronic, Dublin, Ireland) is an energy device commonly used among different surgical specialties to reduce morbidity and implement outcomes. The aim of this study was to investigate the effectiveness of LigaSure Impact in abdominoplasty compared with the conventional techniques, diathermia. Material and Methods: Patients underwent primary abdominoplasty after massive weight loss at a single center from 1 January 2008 to 31 May 2015 and were retrospectively reviewed. A total of 94 patients eligible for the study were divided into two groups on basis of the dissection technique: LigaSure Impact group (29 patients) and the conventional technique group (65 patients). Total intraoperative blood loss was the primary endpoint. Duration of the operation, perioperative complications and re-operation were recorded as secondary endpoints. Results: Baseline characteristics were well balanced between the groups. Significant differences were found in intraoperative blood loss favoring LigaSure Impact group (259.6 ± 198.8 mL vs 377.9 ± 190.0 mL, p = 0.004) and blood transfusion rates (13.8% vs 35.4%, p = 0.047). In contrast, operative time was significantly longer in LigaSure Impact group (168.6 ± 121.2 vs 179.7 ± 57.6 min, p = 0.005), while a tendency to shorter hospital stay was found in LigaSure Impact group (3.6 ± 1.1 days vs 4.6 ± 3.2 days, p = 0.081). Overall complications occurrence, Clavien–Dindo grade II (24.1% vs 55.4%) and grade III (13.8% vs 30.8%) complications were significantly lower in LigaSure Impact group (respectively, p = 0.005, p = 0.007, p = 0.016). Late (>30 days) re-operation rate was significantly lower in the LigaSure Impact group (6.9% vs 27.70%, p = 0.0028). Specific wound complications showed no significant difference. Conclusion: LigaSure Impact vessel-sealing system may be beneficial in improving abdominoplasty outcomes in massive-weight-loss patients because it might reduce blood loss, need for transfusions, complications, and re-operations.

show abstract

“…We chose to focus on body contouring procedures because of the relatively high risk and high sensitivity for hematomas in this patient population. 18 Furthermore, we aimed to evaluate the differences in complication occurrence, need for reoperation, and hospital length of stay for patients who received ketorolac perioperatively. We hypothesized that there would be no difference in morbidity between the groups after surgery.…”

mentioning

confidence: 99%

Postoperative Ketorolac in Breast and Body Contouring Procedures: A Nationwide Claims Analysis

Kelley

Chung

et al. 2018

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Background NSAIDs are useful alternatives to narcotics for analgesia. However, concerns remain regarding their safety. We evaluated ketorolac use and perioperative complications and hypothesized that there is no association between ketorolac and morbidity following outpatient body contouring procedures. Methods We utilized the Truven Marketscan claims database to evaluate patients undergoing breast and body contouring surgery. We selected patients who received ketorolac and minimum enrollment of 90 days postoperatively. We performed a multivariable logistic regression to calculate the risk of morbidity and associated numbers needed to treat or harm, adjusting for clinical and sociodemographic factors. Results Among the 106,279 patients enrolled, 4,924 patients (4.6%) received postoperative ketorolac. In multivariable regression analysis, ketorolac was not associated with diagnosis of hematoma (OR 1.20; 95% CI 0.99-1.46; P>0.05). There was an increased rate of reoperation within 72 hours (OR 1.22; 95% CI 1.00-1.49; P<0.05; NNH 262). Ketorolac was associated with significantly fewer readmissions (OR 0.76; 95% CI 0.62-0.93; P<0.05; NNT 87) with a reduction in the rate of pain as a diagnosis for admission (0.6% vs 4.3%; P=0.021). Ketorolac was associated with seroma, but this association may not be causal (OR 1.28; 95% CI, 1.05-1.57; P<0.05; NNH 247). Ketorolac provided an average cost savings of over $157 per patient. Conclusions Despite a small increase in odds for reoperation, the benefits of ketorolac likely outweigh the small risks after surgery. Absolute differences in reoperation rates were low and improved rates of hospital readmission impact better cost utilization. Based on these findings, we advocate postoperative ketorolac once the wound is hemostatic.

show abstract

Frequency and Risk Factors of Blood Transfusion in Abdominoplasty in Post–Bariatric Surgery Patients

Abstract: Risk, III.

Cited by 21 publications

References 8 publications

Anthropometric and clinical profiles of post-bariatric patients submitted to procedures in plastic surgery

Anthropometric and clinical profiles of post-bariatric patients submitted to procedures in plastic surgery

Ligasure impact^™ might reduce blood loss, complications, and re-operation occurrence after abdominoplasty in massive-weight-loss patients: A Comparative Study

Postoperative Ketorolac in Breast and Body Contouring Procedures: A Nationwide Claims Analysis

Contact Info

Product

Resources

About

Frequency and Risk Factors of Blood Transfusion in Abdominoplasty in Post–Bariatric Surgery Patients

Abstract: Risk, III.

Cited by 21 publications

References 8 publications

Anthropometric and clinical profiles of post-bariatric patients submitted to procedures in plastic surgery

Anthropometric and clinical profiles of post-bariatric patients submitted to procedures in plastic surgery

Ligasure impact™ might reduce blood loss, complications, and re-operation occurrence after abdominoplasty in massive-weight-loss patients: A Comparative Study

Postoperative Ketorolac in Breast and Body Contouring Procedures: A Nationwide Claims Analysis

Contact Info

Product

Resources

About

Ligasure impact^™ might reduce blood loss, complications, and re-operation occurrence after abdominoplasty in massive-weight-loss patients: A Comparative Study