Nutritional Assessment of Bariatric Surgery Patients Presenting for Plastic Surgery: A Prospective Analysis

Abstract

The results suggest that inadequate nutrition is common among postbariatric patients presenting for body contouring. The lack of correlation between methods of nutritional assessment supports the combination of multiple methods in determining overall nutritional status. The presence of dumping syndrome, a large change in body mass index, and advanced age may help to identify patients with an increased risk of nutritional deficiency.

Autologous breast reconstruction in the postbariatric patient population

“…However, there is surprisingly little guidance regarding the risks and outcomes of autologous breast reconstruction in the postbariatric, massive weight loss patient. These patients may present with poor skin quality, significant ptosis, and uncorrected nutritional deficiencies (Bossert, & Rubin, ; Gusenoff, ; Naghshineh et al, ; Staalesen, Fagevik Olsen, & Elander, ; Xanthakos, )—factors which may put them at an increased risk of wound complications, even when compared to the obese patients undergoing breast reconstruction.…”

Pearls and Perils of Caring for the Postbariatric Body Contouring Patient

“…Folate, thiamine, calcium, and fat-soluble vitamins may also be deficient. 21,22 It is most prudent to wait for weight to stabilize and address body contouring procedures no sooner than 12 to 18 months after gastric bypass surgery to minimize latent nutritional issues and allow equilibration. 23,24 Patients with gross malnutrition need to be directed to a nutritionist and ultimately cleared.…”

Removal of excess skin after massive weight loss: challenges and solutions

“…19 Therefore, the preoperative laboratory work-up should include metabolic and nutritional parameters, like hematocrit, hemoglobin, basic metabolic panel, and prealbumin levels, as inadequate nutrition is common among postbariatric patients presenting for body contouring. 20 Finally, particular attention should be paid to previous incisions that may compromise blood flow to flaps elevated during body-contouring procedures. Hernias are common in patients who have undergone open surgical procedures (laparotomy, cholecystectomy) while still obese, and there might be a need for abdominal wall reconstruction affecting the surgical plan.…”

“…Wound-healing problems are the most frequent after body-contouring procedures, and they more often occur in patients with obesity, diabetes, endocrine disorders, Ehlers-Danlos syndrome, and autoimmune disease, advanced age, peripheral vascular, and coronary artery disease. 12,63,64 Multiple comorbidities, presence of bleeding disorders, preoperative albumin level, and malnutrition have recently been significantly associated with increased odds of minor wound complications, 20,65 while inpatient procedures and functional status have been linked with an increased odds of major surgical morbidity. 66…”