Analysis of laboratory markers in body contouring procedures after bariatric surgery does not indicate particular risks for perioperative complications.
Bariatric surgery
Body contouring
Complication
Laboratory markers
Massive weight loss
Obesity
Journal
Perioperative medicine (London, England)
ISSN: 2047-0525
Titre abrégé: Perioper Med (Lond)
Pays: England
ID NLM: 101609072
Informations de publication
Date de publication:
27 Jun 2024
27 Jun 2024
Historique:
received:
10
11
2023
accepted:
13
06
2024
medline:
28
6
2024
pubmed:
28
6
2024
entrez:
27
6
2024
Statut:
epublish
Résumé
Body contouring surgery after massive weight loss is associated with different risk factors. Wound healing disorders and seromas commonly occur postoperatively. Bariatric interventions lead to massive weight loss with excess skin and soft tissue. In this study, perioperatively collected laboratory markers of this special patient population were analyzed. Fifty-nine patients were analyzed retrospectively regarding bariatric surgery, weight loss, body contouring surgery, laboratory markers, and complication rates. Body contouring surgery (n = 117) was performed in 59 patients. Weight loss was achieved after gastric bypass (40.1%), gastric banding (33.9%), or sleeve gastrectomy (26.0%), with an average of 69.2 kg. The most common body contouring procedure included abdominoplasty (n = 50), followed by thigh lift (n = 29), mammaplasty (n = 19), brachioplasty (n = 14), and upper body lift (n = 5). Analysis of laboratory markers revealed no exceptional and clinically relevant variations. Correlation analysis revealed associations between resection weight, amount of drain fluid, and particular laboratory markers. Analysis of perioperative laboratory markers in this special patient population after massive weight loss did not indicate clinically relevant risk factors regardless of the type of bariatric or body contouring surgery. Body contouring surgeries after bariatric interventions prove to be safe and low risk concerning perioperative laboratory markers and postoperative hospitalization.
Sections du résumé
BACKGROUND
BACKGROUND
Body contouring surgery after massive weight loss is associated with different risk factors. Wound healing disorders and seromas commonly occur postoperatively. Bariatric interventions lead to massive weight loss with excess skin and soft tissue. In this study, perioperatively collected laboratory markers of this special patient population were analyzed.
METHODS
METHODS
Fifty-nine patients were analyzed retrospectively regarding bariatric surgery, weight loss, body contouring surgery, laboratory markers, and complication rates.
RESULTS
RESULTS
Body contouring surgery (n = 117) was performed in 59 patients. Weight loss was achieved after gastric bypass (40.1%), gastric banding (33.9%), or sleeve gastrectomy (26.0%), with an average of 69.2 kg. The most common body contouring procedure included abdominoplasty (n = 50), followed by thigh lift (n = 29), mammaplasty (n = 19), brachioplasty (n = 14), and upper body lift (n = 5). Analysis of laboratory markers revealed no exceptional and clinically relevant variations. Correlation analysis revealed associations between resection weight, amount of drain fluid, and particular laboratory markers.
CONCLUSION
CONCLUSIONS
Analysis of perioperative laboratory markers in this special patient population after massive weight loss did not indicate clinically relevant risk factors regardless of the type of bariatric or body contouring surgery. Body contouring surgeries after bariatric interventions prove to be safe and low risk concerning perioperative laboratory markers and postoperative hospitalization.
Identifiants
pubmed: 38937810
doi: 10.1186/s13741-024-00422-7
pii: 10.1186/s13741-024-00422-7
doi:
Types de publication
Journal Article
Langues
eng
Pagination
63Informations de copyright
© 2024. The Author(s).
Références
Agha-Mohammadi S, Hurwitz DJ. Nutritional deficiency of post-bariatric surgery body contouring patients: what every plastic surgeon should know. Plast Reconstr Surg. 2008;122(2):604–13 (PubMed PMID: 18626380 Epub 2008/07/16).
doi: 10.1097/PRS.0b013e31817d6023
pubmed: 18626380
Agha-Mohammadi S, Hurwitz DJ. Enhanced recovery after body-contouring surgery: reducing surgical complication rates by optimizing nutrition. Aesthetic Plast Surg. 2010;34(5):617–25 (PubMed PMID: 20464396 Epub 2010/05/14).
doi: 10.1007/s00266-010-9522-x
pubmed: 20464396
Baillot A, Asselin M, Comeau E, Meziat-Burdin A, Langlois MF. Impact of excess skin from massive weight loss on the practice of physical activity in women. Obes Surg. 2013;23(11):1826–34 (PubMed PMID: 23620304 Epub 2013/04/27).
doi: 10.1007/s11695-013-0932-0
pubmed: 23620304
Bal BS, Finelli FC, Shope TR, Koch TR. Nutritional deficiencies after bariatric surgery. Nat Rev Endocrinol. 2012;8(9):544–56 (PubMed PMID: 22525731 Epub 2012/04/25).
doi: 10.1038/nrendo.2012.48
pubmed: 22525731
Barbour JR, Iorio ML, Oh C, Tung TH, O’Neill PJ. Predictive value of nutritional markers for wound healing complications in bariatric patients undergoing panniculectomy. Ann Plast Surg. 2015;75(4):435–8 (PubMed PMID: 25180951 Epub 2014/09/03).
doi: 10.1097/SAP.0000000000000188
pubmed: 25180951
Cai A, Maringa L, Hauck T, Boos AM, Schmitz M, Arkudas A, et al. Body contouring surgery improves physical activity in patients after massive weight loss-a retrospective study. Obes Surg. 2020;30(1):146–53 (PubMed PMID: 31444775. Epub 2019/08/25).
doi: 10.1007/s11695-019-04145-3
pubmed: 31444775
Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. 1988.
Correia-Sa I, Serrao P, Marques M, Vieira-Coelho MA. Hypertrophic scars: are vitamins and inflammatory biomarkers related with the pathophysiology of wound healing? Obes Surg. 2017;27(12):3170–8 (PubMed PMID: 28569361 Epub 2017/06/02).
pubmed: 28569361
De Francesco Daher E, Mesquita Martiniano LV, Lopes Lima LL, Viana Leite Filho NC, de Oliveira Souza LE, Duarte Fernandes PH, et al. Acute kidney injury due to excessive and prolonged intramuscular injection of veterinary supplements containing vitamins A, D and E: a series of 16 cases. Nefrologia. 2017;37(1):61–7 PubMed PMID: 27577045 Epub 2016/09/01.
doi: 10.1016/j.nefro.2016.05.017
pubmed: 27577045
Dragu A, Horch RE. [Concept of reconstructive body shaping in obesity] Evidence-based therapy algorithm. Chirurg. 2014;85(1):37–41 (PubMed PMID: 24132586 Epub 2013/10/18. Plastische Korperkorrektur im Gesamtkonzept der Adipositastherapie. Evidenzbasierter Therapiealgorithmus).
doi: 10.1007/s00104-013-2628-3
pubmed: 24132586
Dragu A, Bach AD, Polykandriotis E, Kneser U, Horch RE. Pseudotumors after primary abdominal lipectomy as a new sequela in patients with abdominal apron. Obes Surg. 2009;19(11):1599–604 (PubMed PMID: 18546050 Epub 2008/06/12).
doi: 10.1007/s11695-008-9559-y
pubmed: 18546050
Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2005;365(9468):1415–28 (PubMed PMID: 15836891 Epub 2005/04/20).
doi: 10.1016/S0140-6736(05)66378-7
pubmed: 15836891
Engin A. The definition and prevalence of obesity and metabolic syndrome. Adv Exp Med Biol. 2017;960:1–17 (PubMed PMID: 28585193 Epub 2017/06/07).
doi: 10.1007/978-3-319-48382-5_1
pubmed: 28585193
Enrique Bayter-Marin J, Cardenas-Camarena L, Pena WE, Duran H, Ramos-Gallardo G, Robles-Cervantes JA, et al. Patient blood management strategies to avoid transfusions in body contouring operations: controlled clinical trial. Plast Reconstr Surg. 2021;147(2):355–63 (PubMed PMID: 33565826 Epub 2021/02/11).
doi: 10.1097/PRS.0000000000007524
pubmed: 33565826
Fliss E, Manheim S, Zoabi T, Bashi T, Meilik B, Fliss-Isakov N, et al. The age factor in postbariatric body contouring surgery outcome. Plast Reconstr Surg. 2022;149(3):417e–23e (PubMed PMID: 35196674 Epub 2022/02/24).
doi: 10.1097/PRS.0000000000008817
pubmed: 35196674
Garcia Botero A, Garcia Wenninger M, Fernandez Loaiza D. Complications after body contouring surgery in postbariatric patients. Ann Plast Surg. 2017;79(3):293–7 (PubMed PMID: 28737553 Epub 2017/07/25).
doi: 10.1097/SAP.0000000000001109
pubmed: 28737553
Gruener JS, Horch RE, Geierlehner A, Mueller-Seubert W, Cai A, Arkudas A, et al. Is instillational topical negative pressure wound therapy in peri-prosthetic infections of the breast effective? A pilot study. J Pers Med. 2022;12(12):2054 (PubMed PMID: 36556274 Pubmed Central PMCID: PMC9786689. Epub 2022/12/24).
doi: 10.3390/jpm12122054
pubmed: 36556274
pmcid: 9786689
Hauck T, Schmitz M, Horch RE, Arkudas A, Boos AM, Cai A, et al. Operating on the edge? Body contouring procedures in patients with body mass index greater 35. Obes Surg. 2019;29(5):1563–70 (PubMed PMID: 30617912 Epub 2019/01/09).
doi: 10.1007/s11695-018-03697-0
pubmed: 30617912
Hurwitz DJ, Agha-Mohammadi S, Ota K, Unadkat J. A clinical review of total body lift surgery. Aesthet Surg J. 2008;28(3):294–303 discussion 4-5 (PubMed PMID: 19083540 Epub 2008/12/17).
doi: 10.1016/j.asj.2008.03.001
pubmed: 19083540
Lee HJ, Jang YJ. Recent understandings of biology, prophylaxis and treatment strategies for hypertrophic scars and keloids. Int J Mol Sci. 2018;19(3):711 (PubMed PMID: 29498630 Pubmed Central PMCID: PMC5877572. Epub 2018/03/03).
doi: 10.3390/ijms19030711
pubmed: 29498630
pmcid: 5877572
Marouf A, Mortada H. Complications of body contouring surgery in postbariatric patients: a systematic review and meta-analysis. Aesthetic Plast Surg. 2021;45(6):2810–20 (PubMed PMID: 34018015 Epub 2021/05/22).
doi: 10.1007/s00266-021-02315-2
pubmed: 34018015
Michaels JT, Coon D, Rubin JP. Complications in postbariatric body contouring: postoperative management and treatment. Plast Reconstr Surg. 2011;127(4):1693–700 (PubMed PMID: 21460677 Epub 2011/04/05).
doi: 10.1097/PRS.0b013e31820a649f
pubmed: 21460677
Mohapatra S, Gangadharan K, Pitchumoni CS. Malnutrition in obesity before and after bariatric surgery. Dis Mon. 2020;66(2):100866 (PubMed PMID: 31301800 Epub 2019/07/16).
doi: 10.1016/j.disamonth.2019.06.008
pubmed: 31301800
Ng O, Keeler BD, Mishra A, Simpson A, Neal K, Brookes MJ, et al. Iron therapy for pre-operative anaemia. Cochrane Database Syst Rev. 2015;22(12):CD011588 (PubMed PMID: 26694949 Epub 2015/12/24).
Nguyen NT, Varela JE. Bariatric surgery for obesity and metabolic disorders: state of the art. Nat Rev Gastroenterol Hepatol. 2017;14(3):160–9 (PubMed PMID: 27899816 Epub 2016/12/03).
doi: 10.1038/nrgastro.2016.170
pubmed: 27899816
Niessen FB, Schalkwijk J, Vos H, Timens W. Hypertrophic scar formation is associated with an increased number of epidermal Langerhans cells. J Pathol. 2004;202(1):121–9 (PubMed PMID: 14694529 Epub 2003/12/25).
doi: 10.1002/path.1502
pubmed: 14694529
Pajula S, Jyranki J, Tukiainen E, Koljonen V. Complications after lower body contouring surgery due to massive weight loss unaffected by weight loss method. J Plast Reconstr Aesthet Surg. 2019;72(4):649–55 (PubMed PMID: 30616907 Epub 2019/01/09).
doi: 10.1016/j.bjps.2018.12.030
pubmed: 30616907
Parvizi D, Friedl H, Wurzer P, Kamolz L, Lebo P, Tuca A, et al. A multiple regression analysis of postoperative complications after body-contouring surgery: a retrospective analysis of 205 patients : regression analysis of complications. Obes Surg. 2015;25(8):1482–90 (PubMed PMID: 25614453 Epub 2015/01/24).
doi: 10.1007/s11695-014-1559-5
pubmed: 25614453
Promny D, Hauck T, Cai A, Arkudas A, Heller K, Wullich B, et al. Abdominal panniculectomy can simplify kidney transplantation in obese patients. Urol Int. 2021;105(11–12):1068–75 (PubMed PMID: 34130304 Epub 2021/06/16).
doi: 10.1159/000516678
pubmed: 34130304
Romano L, Zoccali G, Orsini G, Giuliani M. Reducing complications in post-bariatric plastic surgery: our experience and literature review. Acta Biomed. 2019;90(4):475–81 (PubMed PMID: 31910172 Pubmed Central PMCID: PMC7233755 Epub 2020/01/08).
pubmed: 31910172
pmcid: 7233755
Salari N, Fatahi B, Bartina Y, Kazeminia M, Heydari M, Mohammadi M, et al. The global prevalence of seroma after abdominoplasty: a systematic review and meta-analysis. Aesthetic Plast Surg. 2021;45(6):2821–36 (PubMed PMID: 34080041 Epub 2021/06/04).
doi: 10.1007/s00266-021-02365-6
pubmed: 34080041
Schlottmann F, Galvarini MM, Dreifuss NH, Laxague F, Buxhoeveden R, Gorodner V. Metabolic effects of bariatric surgery. J Laparoendosc Adv Surg Tech A. 2018;28(8):944–8 (PubMed PMID: 30004821 Epub 2018/07/14).
doi: 10.1089/lap.2018.0394
pubmed: 30004821
Staalesen T, Olsen MF, Elander A. Complications of abdominoplasty after weight loss as a result of bariatric surgery or dieting/postpregnancy. J Plast Surg Hand Surg. 2012;46(6):416–20 (PubMed PMID: 23088637 Epub 2012/10/24).
doi: 10.3109/2000656X.2012.717898
pubmed: 23088637
Stroh C, Manger T, Benedix F. Metabolic surgery and nutritional deficiencies. Minerva Chir. 2017;72(5):432–41 (PubMed PMID: 28565892 Epub 2017/06/02).
pubmed: 28565892
Stumpfe MC, Horch RE, Geierlehner A, Ludolph I. Rare pseudotumor-like hematoma at the latissimus dorsi muscle flap donor site: a treatment strategy utilizing negative pressure wound therapy with instillation and dwell time. Wounds. 2020;32(12):E101–5 (PubMed PMID: 33476290 Epub 2021/01/22).
pubmed: 33476290
Stumpfe MC, Horch RE, Arkudas A, Cai A, Muller-Seubert W, Hauck T, et al. The value of negative-pressure wound therapy and flap surgery in hidradenitis suppurativa - a single center analysis of different treatment options. Front Surg. 2022;9:867487 (PubMed PMID: 35836613 Pubmed Central PMCID: PMC9273893. Epub 2022/07/16).
doi: 10.3389/fsurg.2022.867487
pubmed: 35836613
pmcid: 9273893
Tabesh MR, Maleklou F, Ejtehadi F, Alizadeh Z. Nutrition, physical activity, and prescription of supplements in pre- and post-bariatric surgery patients: a practical guideline. Obes Surg. 2019;29(10):3385–400 (PubMed PMID: 31367987 Epub 2019/08/02).
doi: 10.1007/s11695-019-04112-y
pubmed: 31367987
Vieira BL, Dorfman R, Turin S, Gutowski KA. Rates and predictors of readmission following body contouring procedures: an analysis of 5100 patients from the National Surgical Quality Improvement Program Database. Aesthet Surg J. 2017;37(8):917–26 (PubMed PMID: 28200103 Epub 2017/02/16).
doi: 10.1093/asj/sjx012
pubmed: 28200103