Abdominoplasty and Patient Safety: The Impact of Body Mass Index and Bariatric Surgery on Complications Profile
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ORIGINAL ARTICLE
BODY CONTOURING
Abdominoplasty and Patient Safety: The Impact of Body Mass Index and Bariatric Surgery on Complications Profile I´ris M. Brito1 • Rita Meireles1 • Joa˜o Baltazar1 • Carla Branda˜o1 • Fernanda Sanches1 Ma´rio J. Freire-Santos1
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Received: 20 February 2020 / Accepted: 9 April 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract Background Abdominoplasty is a frequent aesthetic surgical procedure. Despite its popularity, patient safety requires further attention because of an important risk of complications. Obesity and bariatric surgery are potential risk factors. This study evaluated the impact of body mass index (BMI) and bariatric surgery on complications profile. Methods A retrospective review of patients undergoing abdominoplasty over a 5-year period was conducted. Patient demographics, comorbidities, BMI, bariatric surgery, complications (minor and major) and drainage outcomes were evaluated. Univariate and multivariate logistic regression analyses were performed for risk assessment. Results The 191 study patients showed an overall complication rate of 32.5%, comprising minor (27.7%) and major complications (7.9%). Seroma was the most common complication (20.9%). Mean BMI was 27.1 kg/m2. Obesity was present in 14.1%, and bariatric surgery in 53.4%. Obese patients had significant higher rates of overall complications (74.1%, p \ 0.001), minor complications (66.7%, p \ 0.001), seroma (51.9%, p \ 0.001) and drainage outputs (p \ 0.001). Bariatric patients showed an increased time (p = 0.003) and volume of drainage (p \ 0.001), without significant differences in complications. Obesity and preoperative BMI were the only independent risk factors for overall complications (OR 8.3; and OR 1.3; p \ 0.001), minor complications (OR 7.4; and OR 1.3; p \ 0.001) and seroma (OR 4.5; and
& ´Iris M. Brito [email protected] 1
Department of Plastic Surgery and Burns Unit, Coimbra University Hospital Center, 3000-075 Coimbra, Portugal
OR 1.2; p = 0.002). Diabetes was an independent risk for major complications (OR 4.6; p = 0.047). Conclusion Obesity has negatively impacted the profile and risk of complications, whereas bariatric surgery independently did not. Our study provides an accurate understanding of abdominoplasty complications, allowing better risk stratification, candidate selection refinement, morbidity reduction, fair patient counseling and overall improvement in patient safety. EBM Level III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Keywords Abdominoplasty Patient safety Body mass index Bariatric surgery Complications Risk factors
Introduction Abdominoplasty is one of the most performed aesthetic surgical procedures, ranking fourth most popular worldwide in 2018 (888,712 procedure
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