Impact of Obesity on Outcomes in Breast Reconstruction: Analysis of 15,937 Patients from the ACS-NSQIP Datasets

Surgical Site Infections after Free Flap Breast Reconstruction: An Analysis of 2,899 Patients from the ACS-NSQIP Datasets

“…In a review of 15,937 breast reconstructions from the 2005 to 2010 ACS-NSQIP databases, the authors previously found that compared with a nonobese cohort, patients in increasing WHO obesity classes were significantly more likely to develop wound infections (for Class III, II, I, and nonobese patients, respectively, 5.5 vs. 3.3 vs. 2.7 vs. 1.3%, p < 0.001). 17 On multivariate regression, a BMI greater than 30 was found to be an independent predictor of wound complications (OR 2.1, p < 0.001). As stated previously, however, this article included both autologous and implant-based reconstructions, which differ intrinsically in complication rates.…”

Effects of Obesity on Postoperative Complications After Breast Reconstruction Using Free Muscle-Sparing Transverse Rectus Abdominis Myocutaneous, Deep Inferior Epigastric Perforator, and Superficial Inferior Epigastric Artery Flap

“…[1][2][3][4][16][17][18]36 On the contrary, few large-scale studies or meta-analyses of adverse effects of obesity have specifically focused on muscle-conserving abdominal flaps, including msTRAM, DIEP, and SIEA flaps. Some single-institution studies of these flaps have shown no significant difference in postoperative morbidity between obese and nonobese patients.…”

“…Obesity was frequently combined with other medical morbidities such as hypertension, diabetes, hyperlipidemia, and other cardiopulmonary diseases, 23,36 which can impede microvascular hemodynamics and eventually flap survival, and therefore, it is difficult to conclude that the high rate of flap loss is attributable solely to negative effects of obesity. However, it is clear that the rate of flap survival was lower in obese patients, although the overall success rate was high.…”

Does obesity affect the outcomes of pulmonary resections for lung cancer? A National Surgical Quality Improvement Program analysis

“…4,12 Although several authors have described worse outcomes in obese patients after procedures such as colectomy and adrenalectomy, other studies have shown no differences related to BMI in outcomes for procedures such as esophagectomy and cholecystectomy. [13][14][15][16][17] Although it might be a common assumption that obesity represents a major risk factor for poor operative outcomes, there are studies reporting that not only this paradigm may be false, but also that overweight and moderate obesity might even be associated with improved early operative outcomes. 12,18 There is no clear explanation for this protective effect, which has been described as the ''obesity paradox,'' and is observed not only after surgery, but also in critically ill, hospitalized patients.…”