Improving Safety after Abdominoplasty: A Retrospective Review of 1128 Cases

Dutot, Marie-Charlotte; Serror, Kévin; Ameri, Omar Al; Chaouat, Marc; Mimoun, Maurice; Boccara, David

doi:10.1097/prs.0000000000004572

Cited by 43 publications

(26 citation statements)

References 22 publications

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“…Previous studies highlighted various risk factors for complications in abdominoplasty, i.e., age, obesity, smoking, weight loss, and blood loss [10,17]. In our study, smoking habit and body weight at the time of abdominoplasty, but not weight loss since bariatric surgery, were independently associated with increased odds of perioperative complications following abdominoplasty.…”

Section: Discussionsupporting

confidence: 54%

LigaSure Impact™ reduces complications after abdominoplasty in weight loss patients

Radünz

Salem

Houben

et al. 2021

Langenbecks Arch Surg

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Purpose Bariatric surgery is on the rise worldwide. With the desired weight loss after bariatric surgery, patients frequently develop massive skin flaps resulting in the need of abdominoplasty. In these patients, this surgical technique is frequently associated with perioperative complications. Strategies to minimize complications are sought after. The objective of our study was to compare two different dissection techniques and their impact on postoperative outcome. Methods We included 66 patients in our study who underwent abdominoplasty after massive weight loss following bariatric surgery. In group 1, abdominoplasty was performed using the conventional technique of diathermia (n = 20). In group 2, abdominoplasty was performed using LigaSure Impact™ (n = 46). The duration of the surgical procedure and perioperative complications were recorded as primary endpoints. Secondary endpoints were length of hospital stay and assessment of additional risk factors. Results Baseline characteristics were comparable between groups. The duration of surgery was significantly shorter in group 2. Postoperative complications were significantly less frequent in group 2 (p = 0.0035). Additional risk factors, e.g., smoking and diabetes mellitus, were not associated with increased rates of perioperative complications. Conclusions The choice of technical device for dissection in abdominoplasty alone will not guarantee minimized complication rates. Yet, the utilization of LigaSure Impact™ in refined surgical techniques may facilitate reduced rates of complications, especially wound infections, and a shortened duration of surgery.

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Section: Discussionsupporting

confidence: 54%

LigaSure Impact™ reduces complications after abdominoplasty in weight loss patients

Radünz

Salem

Houben

et al. 2021

Langenbecks Arch Surg

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“…Although the “fleur-de-lis” is a well-established technique with equivalent complication rates reported in some centers, 64 other authors find the complication rates to be higher. 49 , 54 , 65 It is the author’s opinion that in many cases the aesthetics are better ( Figures 2 and 3 ) without the vertical midline scar, even if some minor side-to-side laxity remains. One center concurs with this assessment and has largely ceased the performance of the “fleur-de-lis” due to concerns regarding the aesthetics of the “hard to disguise” vertical scar as well as, in their experience, a higher complication rate.…”

Section: Discussionmentioning

confidence: 99%

“…Also in this current study, the other baseline risk factors of diabetes, smoking, age, as well as elevated BMI were important, independent and statistically significant contributors to increased complications ( Table 5 ). Along these lines, Dutot et al, 49 in a recent large long-term study, concluded that the other risk factors of age, obesity, and smoking were more important factors than a history of weight loss. The evidence in this current paper as well as the just cited evidence in the literature raises the possibility that although a history of bariatric MWL may present independent risk, there is a collinearity of risk factors that may contribute substantially to the increased complication rates, and these additional comorbidities should be included in the risk calculus.…”

Section: Discussionmentioning

confidence: 99%

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Abdominoplasty in the Massive Weight Loss Patient: Are Aesthetic Goals and Safety Mutually Exclusive?

Restifo¹

2021

Aesthetic Surgery Journal Open Forum

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Background The goals of abdominoplasty in massive weight loss (MWL) patients are often functional, with a greater emphasis on safety than on aesthetic rejuvenation. As important as functional improvements and safety are, however, there may be room for increasing the aesthetic potential of abdominoplasties in these patients. Objectives To determine the safety of the pursuit of aesthetic goals for abdominoplasty in MWL patients. Methods This is a retrospective study examining 910 consecutive female patients consisting of three groups: postpartum (n=718), dietary MWL (n=65) and bariatric MWL (n=127). All patients were approached with a well-defined set of aesthetic goals which were pursued as needed and as feasible. Results The utilization of aesthetic abdominoplasty components was similar all groups, supporting the assertion that the groups were subjected to a similar aesthetic emphasis. Logistic regression showed that a history of bariatric MWL was an independent risk factor for multiple complications (OR 2.738, p=0.014), and that elevated BMI, smoking, diabetes and age were likewise independent risk factors for complications. Propensity score matched case-control pairs showed that bariatric MWL patients were more likely than dietary MWL patients to experience multiple complications (9.52% vs 0 percent, p=0.031). Conclusions Bariatric MWL patients but not dietary weight loss patients seem to have higher risk than postpartum patients. Other comorbidities (elevated BMI, smoking, diabetes, age) seem to be more important predictors of complications than MWL status. Select MWL patients can likely be approached with an emphasis on aesthetic goals, without increasing risks as compared to the postpartum population.

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“… 11 , 12 , 22 , 43 One recent study reported 64 hematomas among 1128 anticoagulated abdominoplasty patients (5.7%). 43 Hematomas should not be considered an acceptable trade for a VTE, particularly if a VTE can be identified early in its development, when it is not dangerous, and managed with minimal disruption to the patient's activities and recovery. 10 , 19 Hematomas are distressing to patients and surgeons.…”

mentioning

confidence: 99%

Reconsidering the Role of Routine Anticoagulation for Venous Thromboembolism Prevention in Plastic Surgery

Swanson

2020

Ann Plast Surg

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Improving Safety after Abdominoplasty: A Retrospective Review of 1128 Cases

Abstract: Therapeutic, IV.

Cited by 43 publications

References 22 publications

LigaSure Impact™ reduces complications after abdominoplasty in weight loss patients

LigaSure Impact™ reduces complications after abdominoplasty in weight loss patients

Abdominoplasty in the Massive Weight Loss Patient: Are Aesthetic Goals and Safety Mutually Exclusive?

Reconsidering the Role of Routine Anticoagulation for Venous Thromboembolism Prevention in Plastic Surgery

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