The Effect of Weight Loss Surgery and Body Mass Index on Wound Complications After Abdominal Contouring Operations

Greco, J; Castaldo, Eric T.; Nanney, Lillian B.; Wendel, J. Jason; Summitt, James B.; Kelly, Kevin J.; Braün, Stéphane A.; Hagan, Kevin F.; Shack, R. Bruce

doi:10.1097/sap.0b013e318166d351

Cited by 133 publications

(81 citation statements)

References 25 publications

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“…Consequently, the pathogenic bacteria which thrive in the moist environment of skin folds have an ideal environment for invasion and tissue breakdown. Lastly, skin-on-skin contact causes friction that can lead to ulceration that are particularly frequent in obese individuals [76,86,87].…”

Section: Imbalanced Diet Is Critical For the Physiologic Wound Healingmentioning

confidence: 99%

Impaired wound healing: facts and hypotheses for multi-professional considerations in predictive, preventive and personalised medicine

Avishai¹,

2017

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Whereas the physiologic wound healing (WH) successfully proceeds through the clearly defined sequence of the individual phases of wound healing, chronic non-healing wounds/ulcers fail to complete the individual stages and the entire healing process. There are many risk factors both modifiable (such as stress, smoking, inappropriate alcohol consumption, malnutrition, obesity, diabetes, cardio-vascular disease, etc.) and non-modifiable (such as genetic diseases and ageing) strongly contributing to the impaired WH. Current statistics demonstrate that both categories are increasingly presented in the populations, which causes dramatic socio-economic burden to the healthcare sector and society at large. Consequently, innovative concepts by predictive, preventive and personalised medicine are crucial to be implemented in the area. Individual risk factors, causality, functional interrelationships, molecular signature, predictive diagnosis, and primary and secondary prevention are thoroughly analysed followed by the expert recommendations in this paper.

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Section: Imbalanced Diet Is Critical For the Physiologic Wound Healingmentioning

confidence: 99%

Impaired wound healing: facts and hypotheses for multi-professional considerations in predictive, preventive and personalised medicine

Avishai¹,

2017

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“…Pre-body contouring BMI [2-4, 6, 7], percentage excessive weight loss [5], smoking [8][9][10], diabetes mellitus and/or hypertension [8], nutritional deficiency [11] ASA classification [5], total amount of removed tissue [4,7], intra-operation time, multiple procedures, maximum BMI and change in BMI from maximum to current BMI [12] are mentioned variable as risk factors.…”

Section: Introductionmentioning

confidence: 99%

Complications after Body Contouring Surgery in Post-Bariatric Patients: The Importance of a Stable Weight Close to Normal

2011

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Objective: Body contouring surgery is in high demand following the increase in bariatric surgery. Massive weight loss leads to an excess of lax, overstretched skin causing physical and psychosocial discomfort. Plastic surgical procedures can give rise to an improvement in quality of life, but the relative high complication rate could negatively affect these potential gains. The purpose of this study is to identify predictors of complications in order to optimize outcomes in this patient population. Methods: Out of a group of 465 post-bariatric patients, 61 patients underwent body contouring surgery following massive weight loss. A total of 43 respondents were reviewed retrospectively for demographic data, pre- and post-operative weight status and co-morbidities. Medical complications were categorized according to the modified Clavien classification. All cases were analyzed for risk factors. Results: A stable weight over a period of at least 3 months prior to body contouring surgery is associated with a significant lower complication rate (odds ratio 0.24; CI 0.07–0.79) and the percentage excess weight loss (odds ratio 0.96; 95% CI 0.92–1.00) was an independent predictor for the occurrence of complications. The overall complication rate was 27.9% with a major complication rate of 8.8%. Most frequent procedures were abdominoplasty (61%) and breast reduction/ mammapexy (25%). Conclusion: This study emphasizes the importance to strive for a stable weight close to normal before surgery to minimize the risk of complications. The positive effects of the long-term results of bariatric surgery tolerate the relative high complications rate. Careful pre-operative planning and patient selection are essential to optimize the results of body contouring surgery of post-bariatric patients.

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“…There are data indicating that the complication rates are higher in post bariatric patients compared to patients who have lost weight following dieting, despite similar preoperative BMI in both groups (55). It has been suggested that malnutrition in post bariatric patients may be a possible explanation of these findings (54). The risk of complications also tends to be higher with combined procedures compared to …”

Section: Complications Of Body Contouring Surgerymentioning

confidence: 72%

“…The corresponding data for patients who have not undergone bariatric surgery tends to be lower (22-29%) (54,55). There are data indicating that the complication rates are higher in post bariatric patients compared to patients who have lost weight following dieting, despite similar preoperative BMI in both groups (55).…”

Section: Complications Of Body Contouring Surgerymentioning

confidence: 88%

Bedre liv for slankeopererte?

Hokland¹

2015

Tidsskriftet

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Aim: A negative effect of massive weight loss is the development of excess skin. Excess skin causes both physical and psychological problems for those affected and their families. The overall aim of this thesis was to improve the knowledge of the prevalence and associated problems of excess skin in post bariatric patients and to evaluate the outcome of abdominoplasty regarding HRQL. Patients and methods:A literature search was performed to evaluate the quality of evidence for health benefits of abdominoplasty. Thereafter, adult post bariatric patients were sent the Sahlgrenska Excess Skin Questionnaire (SESQ) together with a study specific questionnaire to evaluate their experience with excess skin regarding physical, functional and psychosocial impairments, amount and discomfort regarding the same and requested and undergone body contouring surgery. Further, post bariatric adolescents answered the same questionnaires as the adults, and measurements of excess skin were performed. Finally, post bariatric patients undergoing abdominoplasty answered the Short Form-36 (SF-36), a modified version of SESQ and the EuroQol-5D (EQ-5D) before and one year after abdominoplasty. Prior to the surgery, all study participants were randomly assigned to either undergo or not undergo rectus fascia plication, and measurement of the amount of abdominal excess skin was performed.Results: The quality of evidence of positive health effects for patients undergoing abdominoplasty was very low regarding HRQL. Most of the post bariatric patients, including both adolescents and adults of both genders, reported that they suffered from excess skin in several body parts. The majority of the post bariatric patients also requested body contouring surgery. Abdominoplasty increased the physical function subscale of the SF-36 and all 10 items regarding physical, functional and psychosocial impairments of the SESQ. However, plication did not influence the outcome of abdominoplasty regarding HRQL. In addition, low correlations were found between the measured amount of abdominal excess skin and discomfort with the same or change in the physical function subscale of SF-36 following abdominoplasty. Conclusions:Most of the post bariatric patients seem to suffer greatly from excess skin independent of sex or age, and a majority request body contouring surgery at several body sites. Abdominoplasty appears to improve physical and psychosocial dimensions of HRQL. However, the impact of the preoperative measured amount of abdominal excess skin on the improvements in HRQL is low.Keywords: Post bariatric patients, massive weight loss, excess skin, body contouring surgery, health related quality of life, plication, abdominal rectus fascia ISBN: 978-91-628-9139-8 (tryckt)

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The Effect of Weight Loss Surgery and Body Mass Index on Wound Complications After Abdominal Contouring Operations

Cited by 133 publications

References 25 publications

Impaired wound healing: facts and hypotheses for multi-professional considerations in predictive, preventive and personalised medicine

Impaired wound healing: facts and hypotheses for multi-professional considerations in predictive, preventive and personalised medicine

Complications after Body Contouring Surgery in Post-Bariatric Patients: The Importance of a Stable Weight Close to Normal

Bedre liv for slankeopererte?

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