Analysis of Breast Reduction Complications Derived from the BRAVO Study

Cunningham, Bruce L.; Gear, Andrew J.L.; Kerrigan, Carolyn L.; Collins, E. Dale

doi:10.1097/01.prs.0000160695.33457.db

Cited by 202 publications

(153 citation statements)

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“…[16] Other studies similarly found no statistically significant difference in complication rates among the obese. [14,15,17] However, contradictory findings exist in the literature as well, supporting obesity as a risk factor. [6,[9][10][11][12][13] Chun et al [13] identified a threshold of BMI 35.6 at which postoperative complications were increased two-fold, the most common complication being infection.…”

Section: Discussionmentioning

confidence: 98%

“…Some studies associate obesity with increased postoperative complications, [9][10][11][12][13] whereas others find no statistically significant correlation. [14][15][16][17] In 2014, Nelson et al [6] studied obesity and reduction mammaplasty using the 2005-2011 American College of Surgeons -National Surgical Quality Improvement Program (ACS-NSQIP) datasets. NSQIP is a nationally-validated, risk-adjusted surgical outcomes database to measure and improve the quality of surgical care.…”

Section: Introductionmentioning

confidence: 99%

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A propensity score matched analysis of obesity as an independent risk factor for postoperative complications in reduction mammaplasty

Goggin¹,

Wong²,

Pruszynski³

et al. 2016

PAR

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Aim: Reduction mammaplasty is a commonly performed procedure for the treatment of symptomatic macromastia and is increasingly desired by the obese population. With the increasing prevalence obesity in the population, it is imperative to understand its effect on postoperative outcomes. The purpose of this study is to evaluate obesity as an independent risk factor for postoperative complications in breast reduction surgery using 1:1 patient matching through propensity scores between obese patients and nonobese controls. Methods: Between 2005 and 2013, the National Surgical Quality Improvement Program dataset identified a total of 6,016 patients as having undergone primary reduction mammaplasty with 30-day postoperative follow-up. Patients were divided into obese [body mass index (BMI) of 30 or more] vs. not obese (BMI below 30). Patients were initially analyzed using standard multivariable analysis. Using propensity scores obtained from a logistic regression model, patients were subsequently matched 1:1 according to preoperative and operative variables to truly isolate the effect of obesity on surgical outcomes. Outcomes were compared between the matched cohorts using McNemar's test and the Wilcoxon signed rank test. Results: In unmatched multivariable analysis, rates of overall complications (7.2% vs. 5.3%, P = 0.0024), wound complications (5.5% vs. 3.6%, P = 0.0004), superficial surgical site infection (4.1% vs. 2.8%, P = 0.0050), and wound dehiscence (0.3% vs. 1.1%, P = 0.0005) were found to be statistically different between obese vs. non-obese, respectively. However, when comparing 1:1 matched obese and non-obese patients, only wound complications (4.6% vs. 3.1%, P = 0.0334) were significantly increased in the obese cohort. Conclusion: Using the most robust statistical tools available, obesity was

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

A propensity score matched analysis of obesity as an independent risk factor for postoperative complications in reduction mammaplasty

Goggin¹,

Wong²,

Pruszynski³

et al. 2016

PAR

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“…По данным литературы, частота гематом при редук-ционной пластике составляет 0,3-5% [1,2], по нашим данным -2,9%.…”

Section: таблица 1 корригирующие операции на здоровой и сформированнunclassified

“…Подобное осложнение при редукционной маммопла-стике с перемещением САК на вертикальной деэпители-зированной ножке по Lejour, по данным литературы, со-ставляет 1-35% [1,2], у нас -2,9%.…”

Section: таблица 1 корригирующие операции на здоровой и сформированнunclassified

Remedial surgery and possible complications after reconstructive plastic interventions into the breast

Арсланов¹,

Zikiryakhodjaev²,

Усов³

et al. 2015

Onkol. Z. im. P.A. Gercena

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12Рак молочной железы (РМЖ) является одной из наи-более распространенных опухолей у женщин. РМЖ в России, как и в большинстве стран мира, занимает первое место по темпу роста заболеваемости. Распространенным методом хирургического лечения является мастэктомия.Утрата молочной железы после радикального хирурги-ческого лечения по поводу рака становится для женщин серьезной психической травмой, во многом определяю- Цель исследования -выбор метода завершающего этапа реконструктивно-пластических операций при раке молочной железы, направленных на улучшение косметического эффекта и качества жизни пациенток и минимизация осложнений после них. Материал и методы. Проведен анализ результатов хирургического лечения 55 больных раком молочной желе-зы, которым были выполнены корригирующие операции на здоровой и реконструированной железе и восстановлен соско-во-ареолярный комплекс (САК) в период 1991-2013 гг. Результаты. У 34 пациенток выполнены корригирующие операции на здоровой и сформированной молочной железе для достижения симметрии. У 14 больных проведена операция по заме-не временного тканевого экспандера на постоянный силиконовый эндопротез. У 46 пациенток выполнена пластика САК. У 8 (23,5%) из 34 пациенток отмечены осложнения. Ведущим фактором ранних послеоперационных осложнений после пластики САК является инфицирование послеоперационной раны, приводящее к некрозу САК. Основными причинами поздних послеоперационных осложнений были: недостаточно выкроенные кожные лоскуты с подкожно-жировой тканью и нарушение техники медицинского татуажа. Заключение. Выбор метода завершающего этапа реконструктивно-пласти-ческих операций при раке молочной железы, направленных на улучшение косметического эффекта и качества жизни пациенток должен быть максимально индивидуализирован. Тщательное планирование и правильный выбор методики ре-конструктивной операции с учетом индивидуальных особенностей пациентки снижает риск осложнений в послеопераци-онном периоде. Завершенная реконструктивно-пластическая операция полностью избавляет пациентку от психологиче-ского, социального и эстетического дискомфорта. Ключевые слова: рак молочной железы, реконструктивно-пластические операции, корригирующие операции.Objective: to choose a method for the closing stage of reconstructive plastic surgery for breast cancer to improve a cosmetic effect and quality of life and to minimize postoperative complications. Subjects and methods. The results of surgical treatment were analyzed in 55 patients with breast cancer who had undergone remedial operations on the healthy and reconstructed breast to restore the nipple-areola complex (NAC) in 1991-2003. Results. Thirty-four patients underwent remedial surgery on the healthy and formed breast to achieve symmetry. Fourteen patients were operated on to change a temporary tissue expander for a continuous silicone implant. NAC plasty was carried out in 46 patients. Complications were noted in 8 (23.5%) of the 34 patients. Infection of a postoperative wound had led to NAC necrosis was a leading factor of early postoperative com...

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“…The reduction mammoplasty operation is one of the procedures frequently performed in plastic surgery [1,2]. There are many techniques described in relation to reduction mammoplasty surgery; however, the common characteristic of these techniques are considerable blood loss during and after the operation [3].…”

Section: Introductionmentioning

confidence: 99%

The effect of high volume adrenalin solution infiltration on blood loss in reduction mammaplasty

Orhan¹

2018

Ann Clin Anal Med

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Aim: One of the important complications during and after the reduction mammoplasty operation is blood loss. The most implemented method to decrease the amount of bleeding is adrenaline infiltration, but adrenalin is mostly infiltrated with the fluid in the volume less than 250cc in the clinic. It is expected that adrenaline will accumulate more in the tissue and thus, exhibit more bleeding-reducing effect by increasing the fluid volume used in the infiltration. In this study, it is aimed to indicate the effect of the infiltration of adrenaline with the high volume fluid, on the amount of blood loss occurring due to the reduction mammoplasty operation. Material and Method: Patients who had undergone bilateral reduction mammoplasty between July 2013 and August 2017 were retrospectively examined. Patients not subjected to infiltration were described as Group 1, patients infiltrated with adrenalin 100cc were described as Group 2, and patients infiltrated with adrenalin 500cc were described as Group 3. Results: The average decrease in the hemoglobin level (bleeding) after the operation was calculated to be 3.4±0.97 in Group 1, 2.8±0.83 in Group 2, 1.0±0.46 in Group 3 and the average amount of bleeding in Group 2 and Group 3 in comparison with Group 1 and the average amount of bleeding in Group 3 in comparison with Group 2 were statistically significantly lower (p<0.001). Discussion: The infiltration of adrenaline in the same concentration with a fluid of a higher volume decreases blood loss after the reduction mammoplasty operation.

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Analysis of Breast Reduction Complications Derived from the BRAVO Study

Cited by 202 publications

References 0 publications

A propensity score matched analysis of obesity as an independent risk factor for postoperative complications in reduction mammaplasty

A propensity score matched analysis of obesity as an independent risk factor for postoperative complications in reduction mammaplasty

Remedial surgery and possible complications after reconstructive plastic interventions into the breast

The effect of high volume adrenalin solution infiltration on blood loss in reduction mammaplasty

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