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van Uittert G, Hoogbergen M, Beaudart C, Li N, Boers M, Hiligsmann M. Patients' health related quality of life after massive weight loss reconstruction in the Netherlands. Expert Rev Pharmacoecon Outcomes Res 2024:1-10. [PMID: 39158932 DOI: 10.1080/14737167.2024.2393328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 07/08/2024] [Accepted: 08/04/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVES The present study aimed to evaluate the impact of undergoing massive weight loss reconstruction (MWR) on health-related quality of life (HR-QoL) in the Netherlands. METHOD A retrospective study was performed among 131 Dutch bariatric patients, divided into two groups: an intervention group (93 patients who had undergone MWR) and a control group (38 patients who had not undergone MWR). HR-QoL was assessed by the validated BODY-q questionnaire. The sign test was used to measure the difference between the 0 and 12 months' measurements of HR-QoL in both groups, whereas multiple regression analysis was conducted to assess whether undergoing MWR significantly predicted participants' incremental HR-QoL. RESULTS Whereas the intervention group showed a significance improvement on all parameters of the BODY-q between 0 and 12 months (all parameters p < .001), the control group did not. The multiple regression analysis showed that having undergone a MWR significantly and positively predicted incremental HR-QoL on all scales on the BODY-q (all parameters p < 0.05). CONCLUSION The present study suggests a positive impact of MWR on the HR-QoL of bariatric patients.
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Affiliation(s)
- Guus van Uittert
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Maarten Hoogbergen
- Department Plastic Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - Charlotte Beaudart
- Namur Research Institute for Life Sciences (NARILIS), Department of Biomedical Sciences, Faculty of Medicine, University of Namur, Namur, Belgium
- Department of Health Services Research - Faculty of Medicine, University of Namur, Namur, Belgium
| | - Nannan Li
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Mijke Boers
- Department Plastic Surgery, Rijnstate Hospital, Arnhem, The Netherlands
| | - Mickaël Hiligsmann
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Amro C, Ryan IA, Lemdani MS, McGraw JR, Schafer S, Broach RB, Fischer JP. Accelerating Fleur-de-lis Panniculectomy with the Absorbable Dermal Stapler-A Study of Efficiency, Aesthetics, and Quality-of-life. Aesthetic Plast Surg 2024; 48:3137-3146. [PMID: 38769148 DOI: 10.1007/s00266-024-04068-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/09/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Fleur-de-lis panniculectomy (FDL), a contouring technique involving vertical and horizontal tissue resections, often involves longer operative times and potential complications. This study assessed operative time, postoperative outcomes, and patient-reported quality of life (PRO) with Insorb® Absorbable Subcuticular Skin Stapler versus traditional sutures during FDL. METHODS A retrospective review from 2015 to 2022 of FDL patients excluded those with complex concomitant procedures. Demographics, operative details, and surgical outcomes were compared between patients using the dermal stapler and those with suture-only closures. RESULTS Forty subjects were identified, with 25 (62.5%) in the dermal stapler cohort. The dermal stapler significantly reduced total procedure time (66.76 vs. 125.33 min, p < 0.05). There were no significant differences in surgical site occurrences, aesthetic outcomes, readmissions, or reoperations. Multivariate regression analysis further highlighted the choice of closure technique as an independent predictor of operative time, with traditional sutures indicating a significantly increased operative time compared to using the dermal stapler (AOR 76.53, CI 38.11-114.95, p < 0.001). Regarding PROs, both groups saw improvements across multiple BODY-Q domains, but the dermal stapler group reported greater enhancements (six out of nine domains vs. three for sutures). CONCLUSION The absorbable dermal stapler significantly reduces FDL operative time without increasing wound healing or aesthetic dissatisfaction incidents and maintains comparable quality-of-life improvements to standard suture closure. LEVEL OF EVIDENCE 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 https://link.springer.com/journal/00266 .
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Affiliation(s)
- Chris Amro
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone, New York, NY, USA.
| | - Isabel A Ryan
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Mehdi S Lemdani
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - J Reed McGraw
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Sogand Schafer
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Robyn B Broach
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - John P Fischer
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
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Kitching S, Harwood R, Ross GL. Validation of the Manchester Cosmetic Clinician-Reported Outcomes Questionnaire (MCCRO-Q). J Plast Reconstr Aesthet Surg 2024; 95:283-287. [PMID: 38943700 DOI: 10.1016/j.bjps.2024.05.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/26/2024] [Accepted: 05/31/2024] [Indexed: 07/01/2024]
Abstract
Patient-reported outcome measures (PROM) are collected pre- and post-operatively following cosmetic surgery. Clinicians assess their own outcomes following surgery, but without a validated clinician-reported outcome measure (CROM), there is no way to compare the clinical results among clinicians or compare these to PROM. Assessment of clinical outcomes is important to address the patients' expectations in the consenting process and to provide recommendations to patients preoperatively to improve post-operative appearance. To address the lack of validated CROM for cosmetic surgery, the Manchester Cosmetic Clinical Reported Outcome Questionnaire (MCCRO-Q) was developed. This study assessed the inter-rater reliability of assessors using the four-point scale pre- and post-operative MCCRO-Q questionnaires. Fifteen assessors reviewed photos from pre- and post-operative assessments in the UK between July 2016 and February 2020. Ninety-five patients were included in this validation study, with each patient assessed by a minimum of 3 assessors. MCCRO-Q showed consistency between reviewers, with all intra-class coefficient averages >0.5 for pre- and post-operative assessments. Moreover, 26% of preoperative assessments demonstrated perfect agreement, 56% had a maximum one-point difference and 18% had a two-point difference to the median score. Furthermore, 1% of postoperative assessments demonstrated perfect agreement, 36% had a one-point difference and 63% had a maximum point difference of 2 to the median score. The inter-rate agreement showed that MCCRO-Q is a reliable tool when used with 3 or more assessors to judge patient appearance clinically, preoperatively and post-operatively, concerning abdominoplasty.
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Affiliation(s)
- Samuel Kitching
- School of Medical Sciences, University of Manchester, Oxford Rd, Manchester M14 4PX, UK.
| | - Rachel Harwood
- Statistics Department, Research and Innovation, Manchester University NHS Foundation Trust, Manchester, UK
| | - Gary Leslie Ross
- School of Biological Sciences, University of Manchester, Oxford Rd, Manchester M13 9PL, UK
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Dijkhorst PJ, Monpellier VM, Terwee CB, Liem RSL, van Wagensveld BA, Janssen IMC, Ottosson J, Halpern B, Flint SW, van Rossum EFC, Saadi A, West-Smith L, O'Kane M, Halford JCG, Coulman KD, Al-Sabah S, Dixon JB, Brown WA, Ramos Salas X, Abbott S, Budin AJ, Holland JF, Poulsen L, Welbourn R, Wijling N, Divine L, Isack N, Birney S, Keenan JMB, Kyle TK, Bahlke M, Healing A, Patton I, de Vries CEE. Core Set of Patient-Reported Outcome Measures for Measuring Quality of Life in Clinical Obesity Care. Obes Surg 2024; 34:2980-2990. [PMID: 39008218 PMCID: PMC11289183 DOI: 10.1007/s11695-024-07381-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 06/21/2024] [Accepted: 07/01/2024] [Indexed: 07/16/2024]
Abstract
PURPOSE The focus of measuring success in obesity treatment is shifting from weight loss to patients' health and quality of life. The objective of this study was to select a core set of patient-reported outcomes and patient-reported outcome measures to be used in clinical obesity care. MATERIALS AND METHODS The Standardizing Quality of Life in Obesity Treatment III, face-to-face hybrid consensus meeting, including people living with obesity as well as healthcare providers, was held in Maastricht, the Netherlands, in 2022. It was preceded by two prior multinational consensus meetings and a systematic review. RESULTS The meeting was attended by 27 participants, representing twelve countries from five continents. The participants included healthcare providers, such as surgeons, endocrinologists, dietitians, psychologists, researchers, and people living with obesity, most of whom were involved in patient representative networks. Three patient-reported outcome measures (patient-reported outcomes) were selected: the Impact of Weight on Quality of Life-Lite (self-esteem) measure, the BODY-Q (physical function, physical symptoms, psychological function, social function, eating behavior, and body image), and the Quality of Life for Obesity Surgery questionnaire (excess skin). No patient-reported outcome measure was selected for stigma. CONCLUSION A core set of patient-reported outcomes and patient-reported outcome measures for measuring quality of life in clinical obesity care is established incorporating patients' and experts' opinions. This set should be used as a minimum for measuring quality of life in routine clinical practice. It is essential that individual patient-reported outcome measure scores are shared with people living with obesity in order to enhance patient engagement and shared decision-making.
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Affiliation(s)
- Phillip J Dijkhorst
- Department of Surgery, OLVG Hospital & Nederlandse Obesitas Kliniek [Dutch Obesity Clinic], Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands.
| | - Valerie M Monpellier
- Department of Science, Nederlandse Obesitas Kliniek [Dutch Obesity Clinic], Huis Ter Heide, the Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Methodology, Amsterdam, the Netherlands
| | - Ronald S L Liem
- Department of Surgery, Nederlandse Obesitas Kliniek [Dutch Obesity Clinic], The Hague, Gouda, the Netherlands
- Department of Surgery, Groene Hart Ziekenhuis, Gouda, the Netherlands
| | | | - Ignace M C Janssen
- Department of Surgery, Nederlandse Obesitas Kliniek [Dutch Obesity Clinic], Huis Ter Heide, the Netherlands
| | - Johan Ottosson
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Bruno Halpern
- Obesity Center, 9 de Julho Hospital, São Paulo, Brazil
- Brazilian Association for the Study of Obesity (ABESO), São Paulo, Brazil
| | - Stuart W Flint
- School of Psychology, University of Leeds, Leeds, UK
- Scales Insights, Nexus, University of Leeds, Leeds, UK
| | - Elisabeth F C van Rossum
- Obesity Center CGG [Healthy Weight Centre], Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Alend Saadi
- Department of Surgery, Neuchâtel Hospital, Neuchâtel, Switzerland
- Biology and Medicine Faculty, Lausanne University, Lausanne, Switzerland
| | - Lisa West-Smith
- Department of Surgery, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Mary O'Kane
- Department of Nutrition and Dietetics, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Karen D Coulman
- National Institute for Health Research Bristol Biomedical Research Centre, and Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Salman Al-Sabah
- Department of Surgery, Kuwait University, Kuwait City, Kuwait
| | - John B Dixon
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
| | - Wendy A Brown
- Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia
| | - Ximena Ramos Salas
- Obesity Canada, Edmonton, AB, Canada
- European Association for the Study of Obesity, Teddington, UK
| | - Sally Abbott
- Specialist Weight Management Service, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Alyssa J Budin
- Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia
- Bariatric Surgery Registry, Central Clinical School, Monash University, Melbourne, Australia
| | - Jennifer F Holland
- Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia
| | - Lotte Poulsen
- Research Unit for Plastic Surgery, University of Southern Denmark and Odense University Hospital, Odense, Denmark
- Lontoft, Nyhoj and Poulsen Plastic Surgery, Odense, Denmark
| | - Richard Welbourn
- Department of Upper Gastrointestinal and Bariatric Surgery, Musgrove Park Hospital, Taunton, UK
| | - Natasja Wijling
- Dutch Association for Overweight and Obesity (NVOO), Utrecht, the Netherlands
| | - Laura Divine
- People Living With Obesity Representative, Kuwait, Kuwait
| | - Nadya Isack
- Patient Advocate, Trustee of the Obesity Empowerment Network, London, UK
| | - Susie Birney
- European Coalition for People Living With Obesity (ECPO), Dublin, Ireland
| | | | | | - Melanie Bahlke
- Adipositascirurgie Selbsthilfe Deutschland E.V. (Obesity Surgery Self-Help Organization), Mannheim, Germany
| | - Andrew Healing
- European Coalition for People Living With Obesity (ECPO), Dublin, Ireland
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Welling MS, de Groot CJ, Mohseni M, Meeusen RE, Boon MR, van Haelst MM, van den Akker EL, van Rossum EF. Treatment with liraglutide or naltrexone-bupropion in patients with genetic obesity: a real-world study. EClinicalMedicine 2024; 74:102709. [PMID: 39050109 PMCID: PMC11268126 DOI: 10.1016/j.eclinm.2024.102709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/15/2024] [Accepted: 06/18/2024] [Indexed: 07/27/2024] Open
Abstract
Background Rare genetic obesity commonly features early-onset obesity, hyperphagia, and therapy-resistance to lifestyle interventions. Pharmacotherapy is often required to treat hyperphagia and induce weight loss. We describe clinical outcomes of glucagon-like peptide-1 analogue liraglutide or naltrexone-bupropion treatment in adults with molecularly confirmed genetic obesity (MCGO) or highly suspected for genetic obesity without definite diagnosis (HSGO). Methods We conducted a real-world cohort study at the Obesity Center CGG at Erasmus University Center, Rotterdam, Netherlands, between March 19, 2019, and August 14, 2023. All patients with MCGO and HSGO who were treated with either liraglutide or naltrexone-bupropion were included. Liraglutide 3 mg and naltrexone-bupropion were administered according to the manufacturer's protocol. Treatment evaluation occurred short-term, after 12 weeks on maximum or highest-tolerated dose, preceded by the 4-5 week dose escalation phase. Differences in anthropometrics, body composition, metabolic markers, self-reported appetite, eating behaviour, and quality of life (QoL) were evaluated. Findings Ninety-eight adults were included in the analysis: 23 patients with MCGO and 75 patients with HSGO, with median BMI of 42.0 kg/m2 (IQR 38.7-48.2) and 43.7 kg/m2 (IQR 38.0-48.7), respectively. After liraglutide treatment, median weight at evaluation significantly decreased compared to baseline in both groups: -4.7% (IQR -6.0 to -1.5) in patients with MCGO and -5.2% (IQR -8.1 to -3.5) in patients with HSGO. Additionally, improvements were observed in appetite, fat mass, fasting glucose, and HbA1c in both patients with MCGO and with HSGO. Patients with HSGO also reported significant improvements in several domains of QoL and eating behaviour. In patients with MCGO and HSGO treated with naltrexone-bupropion, mean weight at evaluation significantly differed from baseline: -5.2% ± 5.8 in patients with MCGO and -4.4% ± 4.7 in patients with HSGO. Appetite, fat mass, and waist circumference significantly decreased in both groups. Obesity-related comorbidities improved in significant proportions of patients treated with liraglutide or naltrexone-bupropion. Interpretation In conclusion, our short-term findings show potential of liraglutide and naltrexone-bupropion as treatment options for adults with (a clinical phenotype of) genetic obesity. Funding MB, EvdA, and EvR are supported by the Elisabeth Foundation, a non-profit foundation supporting academic obesity research.
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Affiliation(s)
- Mila S. Welling
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Cornelis J. de Groot
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, IJsselland Hospital, Capelle aan den IJssel, the Netherlands
| | - Mostafa Mohseni
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Renate E.H. Meeusen
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Mariëtte R. Boon
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Mieke M. van Haelst
- Department of Human Genetics, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Emma Center for Personalized Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Erica L.T. van den Akker
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Elisabeth F.C. van Rossum
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Mou D, Smith SR, Patel A, Stetler J, Srinivasan J, Oyefule O, Lin E, Davis S, Hechenbleikner EM. How does sleeve gastrectomy impact long-term eating-related symptoms, distress, and behavior? A cross-sectional study using the BODY-Q patient-reported outcome measures. Surg Endosc 2024:10.1007/s00464-024-10984-8. [PMID: 38886234 DOI: 10.1007/s00464-024-10984-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/02/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Patients undergoing sleeve gastrectomy (SG) experience transformative changes in eating-related experiences that include eating-related symptoms, emotions, and habits. Long-term assessment of these endpoints with rigorous patient-reported outcome measures (PROMs) is limited. We assessed patients undergoing SG with the Body-Q Eating Module PROMs. METHODS All patients evaluated at the Emory Bariatric Center were given the Body-Q Eating Modules questionnaire at preoperative/postoperative clinic visits. Rasch scores and prevalence of relevant endpoints were assessed across six time-points of interest: preoperatively, post-operative months 0-6, 7-12, 12-24, 24-36, and over 36. Student's t-test and Chi-square test were used for analysis. RESULTS Overall, 1,352 questionnaires were completed pre-operatively and 493 postoperatively. Survey compliance was 81%. Compared to the pre-operative group, the post-operative group had lower BMI (39.7 vs. 46.4, p < 0.001) and higher age (46.3 vs. 44.9, p = 0.019). Beginning one year after SG, patients experience more frequent eating-related pain, nausea and constipation compared to pre-operative baseline (p < 0.05). They also more frequently experience eating-related regurgitation and dumping syndrome-related symptoms beginning post-operative year two (p < 0.05). In the first year after SG, patients more rarely feel eating-related embarrassment, guilt, and disappointment compared to pre-operative baseline (p < 0.05). These improvements disappear one year after SG, after which patients more frequently experience feeling out of control, unhappy, like a failure, disappointed, and guilty (p < 0.05). In the first year after SG, patients experience an increased frequency in positive eating behaviors (ate healthy foods, showed self-control, stopped before full; (p < 0.05). Only two eating-related behavior improvements persist long-term: feeling in control and eating the right amount (p < 0.05). CONCLUSIONS Patients undergoing SG may experience more frequent eating-related symptoms, distress, and behavior in the long-term. These findings can enhance the pre-operative informed consent and guide development of a more tailored approach to postoperative clinical management such as more frequent visits with the dietician.
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Affiliation(s)
- Danny Mou
- Department of Surgery, Emory University, 1364 Clifton Road, NE, Atlanta, GA, USA.
| | - Savannah R Smith
- Department of Surgery, Emory University, 1364 Clifton Road, NE, Atlanta, GA, USA
| | - Ankit Patel
- Department of Surgery, Emory University, 1364 Clifton Road, NE, Atlanta, GA, USA
| | - Jamil Stetler
- Department of Surgery, Emory University, 1364 Clifton Road, NE, Atlanta, GA, USA
| | - Jahnavi Srinivasan
- Department of Surgery, Emory University, 1364 Clifton Road, NE, Atlanta, GA, USA
| | - Omobolanle Oyefule
- Department of Surgery, Emory University, 1364 Clifton Road, NE, Atlanta, GA, USA
| | - Edward Lin
- Department of Surgery, Emory University, 1364 Clifton Road, NE, Atlanta, GA, USA
| | - Scott Davis
- Department of Surgery, Emory University, 1364 Clifton Road, NE, Atlanta, GA, USA
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Kazmouz SG, Riccio CA, Patel K, Haran O, Shifrin D. Implant-Based Gluteal Augmentation: Comparing Complications Between Single- and Double-Incision Techniques. Aesthetic Plast Surg 2024:10.1007/s00266-024-04130-x. [PMID: 38839612 DOI: 10.1007/s00266-024-04130-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 05/09/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Gluteal implants are gaining popularity as an alternative to fat grafting for gluteal augmentation. This study aims to compare complication rates between single- and double-incision techniques for implant placement in gluteal augmentation from a single surgeon's experience. METHODS Retrospective analysis of a single surgeon's implant-based gluteal augmentations was conducted between October 2018 and August 2022. Consecutive patient cases were reviewed at the beginning and end of the designated period to compare both incision techniques after switching from the single- to double-incision technique in September 2020. Demographics and postoperative complications were compared. Statistical comparisons were made using the independent sample t-test for quantitative variables and the Fisher's exact test for categorical variables. RESULTS The study included 134 single-incision patients (247 implants) and 47 double-incision patients (91 implants). Baseline demographic and clinical characteristics between the two groups were similar. Overall complication rate per implant was higher in the single-incision group (16.6% vs. 6.6%, p = 0.02). The most common complication per implant was delayed wound healing (single incision: 9.7%, double incision: 5.5%). The odds ratio of developing at least one complication in the double compared to the single-incision group was 0.44 (95% CI: 0.19, 0.92). CONCLUSIONS The double incision technique demonstrates a lower complication rate than the single-incision technique for implant-based gluteal augmentation. The most common complication in both groups was delayed wound healing which responded in most patients to conservative wound care. These results support using the double-incision technique for implant-based gluteal augmentation. LEVEL OF EVIDENCE 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 .
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Affiliation(s)
- Sobhi G Kazmouz
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Illinois at Chicago College of Medicine, 1853 W. Polk Street, Chicago, IL, 60612-7332, USA.
| | | | - Krishna Patel
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Illinois at Chicago College of Medicine, 1853 W. Polk Street, Chicago, IL, 60612-7332, USA
| | | | - David Shifrin
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Illinois at Chicago College of Medicine, 1853 W. Polk Street, Chicago, IL, 60612-7332, USA
- Shifrin Plastic Surgery, Chicago, IL, USA
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Berkane Y, Saget F, Lupon E, Mocquard C, Pluvy I, Watier E, Lellouch AG, Duisit J, Chaput B, Bertheuil N. Abdominoplasty and Lower Body Lift Surgery Improves the Quality of Life after Massive Weight Loss: A Prospective Multicenter Study. Plast Reconstr Surg 2024; 153:1101e-1110e. [PMID: 37189244 DOI: 10.1097/prs.0000000000010683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND This study was conducted to assess the impact of abdominoplasty and lower body lift surgery following massive weight loss on both the general quality of life and the sexual life of patients. METHODS The authors performed a multicenter prospective study on the quality of life after massive weight loss using three scoring questionnaires: The Short-Form 36 questionnaire, the Female Sexual Function Index questionnaire, and the Moorehead-Ardelt Quality of Life Questionnaire. Seventy-two patients who underwent lower body lift and 57 patients who underwent abdominoplasty in three centers with preoperative and postoperative evaluation were included. RESULTS The mean age of the patients was 43.2 ± 13.2 years. All categories of the Medical Outcomes Study Short-Form 36 Health Status Survey questionnaire were statistically significant at 6 months, and all categories except health change were significantly improved at 12 months postoperatively. Overall, the Moorehead-Ardelt questionnaire showed a higher quality of life in general (1.78 ± 0.92 and 1.64 ± 1.03 at 6 and 12 months, respectively) and in all domains (ie, self-esteem, physical activity, social relationships, work performance, and sexual activity). Interestingly, global sexual activity improved at 6 months but not at 12 months. Some domains of sexual life improved at 6 months (ie, desire, arousal, lubrication, satisfaction), but only desire remained improved at 12 months. CONCLUSIONS Abdominoplasty and lower body lift improve the quality of life of patients after massive weight loss and the sexual quality of life. This should be an additional valid reason for promoting reconstructive surgery for massive weight loss patients. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Affiliation(s)
- Yanis Berkane
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, and Shriners Children Boston
- Harvard Medical School
| | - François Saget
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
| | - Elise Lupon
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Nice, Côte d'Azur University
| | - Camille Mocquard
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
- INSERM U1236, University of Rennes 1
- SITI Laboratory, Rennes University Hospital
| | - Isabelle Pluvy
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Besancon, Franche-Comté University
| | - Eric Watier
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, and Shriners Children Boston
- Harvard Medical School
| | - Jérôme Duisit
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
| | - Benoit Chaput
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University
| | - Nicolas Bertheuil
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
- INSERM U1236, University of Rennes 1
- SITI Laboratory, Rennes University Hospital
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9
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Dalaei F, de Vries CE, Poulsen L, Möller S, Kaur MN, Dijkhorst PJ, Thomsen JB, Hoogbergen M, Makarawung DJ, Mink van der Molen AB, Repo JP, Paul MA, Busch KH, Cogliandro A, Opyrchal J, Rose M, Juhl CB, Andries AM, Printzlau A, Støving RK, Klassen AF, Pusic AL, Sørensen JA. Body Contouring Surgery After Bariatric Surgery Improves Long-Term Health-Related Quality of Life and Satisfaction With Appearance: An International Longitudinal Cohort Study Using the BODY-Q. Ann Surg 2024; 279:1008-1017. [PMID: 38375665 PMCID: PMC11086676 DOI: 10.1097/sla.0000000000006244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
OBJECTIVE To examine health-related quality of life (HRQL) and satisfaction with appearance in patients who have undergone bariatric surgery (BS) with or without subsequent body contouring surgery (BCS) in relation to the general population normative for the BODY-Q. BACKGROUND The long-term impact of BS with or without BCS has not been established using rigorously developed and validated patient-reported outcome measures. The BODY-Q is a patient-reported outcome measure developed to measure changes in HRQL and satisfaction with appearance in patients with BS and BCS. METHODS Prospective BODY-Q data were collected from 6 European countries (Denmark, the Netherlands, Finland, Germany, Italy, and Poland) from June 2015 to February 2022 in a cohort of patients who underwent BS. Mixed-effects regression models were used to analyze changes in HRQL and appearance over time between patients who did and did not receive BCS and to examine the impact of patient-level covariates on outcomes. RESULTS This study included 24,604 assessments from 5620 patients. BS initially led to improved HRQL and appearance scores throughout the first postbariatric year, followed by a gradual decrease. Patients who underwent subsequent BCS after BS experienced a sustained improvement in HRQL and appearance or remained relatively stable for up to 10 years postoperatively. CONCLUSIONS Patients who underwent BCS maintained an improvement in HRQL and satisfaction with appearance in contrast to patients who only underwent BS, who reported a decline in scores 1 to 2 years postoperatively. Our results emphasize the pivotal role that BCS plays in the completion of the weight loss trajectory.
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Affiliation(s)
- Farima Dalaei
- Research Unit of Plastic Surgery, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
- OPEN, Odense Explorative Patient Network, Odense, Denmark
| | - Claire E.E. de Vries
- Department of Surgery, OLVG West Hospital, Amsterdam, The Netherlands
- Department of Surgery, Brigham and Women’s Hospital, Harvard University, Boston, MA
| | - Lotte Poulsen
- Research Unit of Plastic Surgery, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Sören Möller
- OPEN—Odense Patient data Explorative Network, Odense, University Hospital and University of Southern Denmark, Odense, Denmark
| | - Manraj N. Kaur
- Brigham and Women’s Hospital, Harvard University, Boston, MA
| | - Phillip J. Dijkhorst
- Department of Surgery, OLVG West Hospital, Amsterdam, The Netherlands
- Dutch Obesity Clinic (NOK), Amsterdam, The Netherlands
| | - Jørn Bo Thomsen
- Research Unit of Plastic Surgery, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Maarten Hoogbergen
- Department of Plastic Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - Dennis J.S. Makarawung
- Department of Plastic and Reconstructive Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Aebele B. Mink van der Molen
- Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Jussi P. Repo
- Unit of Musculoskeletal Diseases, Department of Orthopaedic, Tampere University Hospital and University of Tampere, Tampere, Finland
| | | | - Kay-Hendrik Busch
- Department of Plastic Surgery, Johanniter-Krankenhaus und Waldkrankenahaus Bonn, Bonn, Germany
| | - Annalisa Cogliandro
- Fondazione Policlinico Universitario Campus Bio-Medico, Research Unit of Plastic, Reconstructive and Aesthetic Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Jakub Opyrchal
- Department of Oncologic and Reconstructive Surgery, Maria Sklodowska-Curie Memorial National Cancer Center, Gliwice, Poland
| | - Michael Rose
- Department of Plastic and Breast Surgery, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Science in Malmö, Lund University, Lund, Sweden
| | - Claus B. Juhl
- University Hospital of Southwest Jutland, Institute for Regional Health Research, University of Southern Denmark and Steno Diabetes Center, Odense, Denmark
| | - Alin M. Andries
- Department of Endocrinology, Hospital of Southwest Jutland, Esbjerg, Denmark
| | | | - René K. Støving
- Center for Eating Disorders, Odense University Hospital, Odense, Denmark
- Research Unit for Medical Endocrinology, Odense University Hospital, Odense, Denmark
- Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Anne F. Klassen
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Andrea L. Pusic
- Department of Surgery, Brigham and Women’s Hospital, Harvard University, Boston, MA
| | - Jens A. Sørensen
- Research Unit of Plastic Surgery, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
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10
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Alessandri Bonetti M, Liu H, Gusenoff JA, Rubin JP, Egro FM. A Bibliometric Analysis of the 50 Most Cited Articles on Body Contouring Surgery After Massive Weight Loss. Aesthetic Plast Surg 2024; 48:2132-2141. [PMID: 38347130 DOI: 10.1007/s00266-024-03854-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/09/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Body contouring surgery after massive weight loss has emerged a safe and reliable option to improve self-esteem, social life, work ability, physical activity, and sexual activity, and it is considered as an essential step in the multidisciplinary approach to morbid obesity. In this study, we aim to provide a comprehensive overview of the current state of literature on body contouring after massive weight loss, identifying research trends and areas for future investigation. METHODS The Web of Science Core Collection was used to identify the 50 most cited publications on post-massive weight loss surgery. Data collected from each article included: title, journal, publication year, total citations, average citations per year, authors, study type, study topic, country, and institution of origin. RESULTS The top 50 most-cited articles include 44 original articles and 6 review articles. The most cited article, published by Lockwood in 1991, received a total of 224 citations. The research areas included surgical outcomes and complications (n=19, 38%), psychological aspects such as body image, quality of life and desire for body contouring procedures (n=18, 36%), surgical techniques (n=11, 22%), an anatomical study (n=1, 2%), and a classification system (n=1; 2%). Plastic and Reconstructive Surgery journal published most (44%) of the papers identified. The University of Pittsburgh was the single institution that contributed the most (n=11; 22%). CONCLUSION This bibliometric analysis provides insights and research trends for clinicians interested in body contouring after massive weight loss, facilitating the understanding and evolution of post-bariatric surgery and elucidating the rationale behind current practice. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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 .
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Affiliation(s)
- Mario Alessandri Bonetti
- Department of Plastic Surgery, University of Pittsburgh Medical Center, 3550 Terrace Street 6B Scaife Hall, Pittsburgh, PA, 15261, USA
| | - Hilary Liu
- Department of Plastic Surgery, University of Pittsburgh Medical Center, 3550 Terrace Street 6B Scaife Hall, Pittsburgh, PA, 15261, USA
| | - Jeffrey A Gusenoff
- Department of Plastic Surgery, University of Pittsburgh Medical Center, 3550 Terrace Street 6B Scaife Hall, Pittsburgh, PA, 15261, USA
| | - J Peter Rubin
- Department of Plastic Surgery, University of Pittsburgh Medical Center, 3550 Terrace Street 6B Scaife Hall, Pittsburgh, PA, 15261, USA
| | - Francesco M Egro
- Department of Plastic Surgery, University of Pittsburgh Medical Center, 3550 Terrace Street 6B Scaife Hall, Pittsburgh, PA, 15261, USA.
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11
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Dalaei F, Dijkhorst PJ, Möller S, de Vries CEE, Poulsen L, Voineskos SH, Kaur MN, Thomsen JB, van Veen RN, Juhl CB, Andries A, Støving RK, Cano SJ, Klassen AF, Pusic AL, Sørensen JA. Minimal important difference in weight loss following bariatric surgery: Enhancing BODY-Q interpretability. Clin Obes 2024:e12675. [PMID: 38777325 DOI: 10.1111/cob.12675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/04/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024]
Abstract
BODY-Q is a patient-reported outcome measure for comprehensive assessment of outcomes specific to patients undergoing bariatric surgery. The clinical utility of BODY-Q is hampered by the lack of guidance on score interpretation. This study aimed to determine minimal important difference (MID) for assessment of BODY-Q. Prospective BODY-Q data from Denmark and the Netherlands pre- and post-bariatric surgery were collected. Two distribution-based methods were used to estimate MID by 0.2 standard deviations of baseline scores and the mean standardized response change of scores from baseline to 3-years postoperatively. In total, 5476 assessments from 2253 participants were included of which 1628 (72.3%) underwent Roux-en-Y gastric bypass, 586 (26.0%) sleeve gastrectomy, 33 (1.5%) gastric banding, and 6 (0.03%) other surgeries. The mean age was 45.1 ± 10.9 with a mean BMI of 46.6 ± 9.6. Baseline MID ranged from 1 to 4 in health-related quality of life (HRQL) and from 2 to 8 in appearance scales. The mean change of scores ranged from 4 to 5 in HRQL and from 4 to 7 in the appearance scales. The estimated MID for the change in BODY-Q HRQL and appearance scales ranged from 3 to 8 and is recommended for use to interpret BODY-Q scores and assess treatment effects in bariatric surgery.
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Affiliation(s)
- Farima Dalaei
- Research Unit of Plastic Surgery, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
- OPEN: Open Patient data Explorative Network, Odense, Denmark
| | - Phillip J Dijkhorst
- Department of Surgery, OLVG West Hospital & Dutch Obesity Clinic (NOK), Amsterdam, The Netherlands
| | - Sören Möller
- OPEN: Open Patient data Explorative Network, Odense, Denmark
- Odene University Hospital and University of Southern Denmark, Odense, Denmark
| | - Claire E E de Vries
- Department of Surgery, OLVG West Hospital & Dutch Obesity Clinic (NOK), Amsterdam, The Netherlands
- Department of Surgery, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, USA
| | - Lotte Poulsen
- Research Unit of Plastic Surgery, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Sophocles H Voineskos
- Division of Plastic Surgery, Department of Surgery, Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, Canada
| | - Manraj N Kaur
- Department of Surgery, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, USA
| | - Jørn Bo Thomsen
- Research Unit of Plastic Surgery, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | | | - Claus B Juhl
- Hospital of Southwest Jutland, Institute for Regional Health Research, University of Southern Denmark and Steno Diabetes Center, Odense, Denmark
- Department of Endocrinology, Hospital of Southwest Jutland, Esbjerg, Denmark
| | - Alin Andries
- Department of Endocrinology, Hospital of Southwest Jutland, Esbjerg, Denmark
| | - René K Støving
- Center for Eating Disorders, Odense University Hospital, Odense, Denmark
- Research Unit for Medical Endocrinology, Odense University Hospital, Odense, Denmark
- Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | | | - Anne F Klassen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Andrea L Pusic
- Department of Surgery, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, USA
| | - Jens A Sørensen
- Research Unit of Plastic Surgery, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
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12
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Marangi GF, Gratteri M, Savani L, Porso D, Cimmino A, Arcari L, Romano FD, Segreto F, Mirra C, Persichetti P. Correction of Rectus Abdominis Diastasis: A Prospective Comparative Study Between a New Suturable Polypropylene Mesh vs Polypropylene Standard Suture Plication. Aesthet Surg J 2024; 44:633-640. [PMID: 38243919 DOI: 10.1093/asj/sjae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/23/2023] [Accepted: 01/04/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Duramesh (Mesh Suture Inc., Chicago, IL) is a new suturing concept, combining the principles of mesh with the precision, flexibility, and versatility of a suture, suitable also for abdominal rectus diastasis (ARD) correction. OBJECTIVES This prospective research aimed to compare mesh with the standard polypropylene suture plication for rectus diastasis repair with regard to safety (infection, seroma, hematoma, surgical wound dehiscence, and fistula rates and hospital stay); effectiveness (ARD recurrence by ultrasound sonography, palpability of the muscular suture, surgical time, and postoperative pain evaluation); and satisfaction of the patients based on the BODY-Q, a patient-reported outcome measure. METHODS Sixty-five of the initial 70 patients who underwent rectus diastasis repair with a 6-month follow-up were randomly divided into 2 groups, comprising 33 patients treated with Duramesh and 32 patients treated with standard 0 polypropylene suture plication. Data regarding infection, seroma, hematoma, surgical wound dehiscence, and fistula rates; hospital stay; ARD recurrence; palpability of the muscular suture; surgical time; postoperative pain evaluation (measured by visual analog scale, or VAS); and the BODY-Q were analyzed by Prism 9 (GraphPad Software Inc., San Diego, CA). RESULTS No significant differences were reported between the 2 groups with regard to infection, seroma, hematoma, surgical wound dehiscence, and fistula rates and hospital stay. The mesh decreased the time required to perform plication compared with standard polypropylene detached sutures. No statistically significant differences were found with respect to the VAS and BODY-Q data. CONCLUSIONS Duramesh 0 application for rectus diastasis repair is safe and effective without compromising aesthetic improvement when compared with standard 0 polypropylene plication. LEVEL OF EVIDENCE: 2
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13
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Buhl LF, Lehmann Christensen L, Diederichsen A, Lindholt JS, Kistorp CM, Glintborg D, Andersen M, Frystyk J. Impact of androgenic anabolic steroid use on cardiovascular and mental health in Danish recreational athletes: protocol for a nationwide cross-sectional cohort study as a part of the Fitness Doping in Denmark (FIDO-DK) study. BMJ Open 2024; 14:e078558. [PMID: 38719280 PMCID: PMC11086435 DOI: 10.1136/bmjopen-2023-078558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 04/26/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION The use of androgenic anabolic steroids (AASs) among recreational athletes is steadily increasing. However, knowledge regarding the potentially harmful effects of AAS primarily originates from case reports and small observational studies. This large-scale study aims to investigate the impact of AAS use on vascular plaque formation, preclinical coronary disease, cardiac function, circulating cardiovascular risk markers, quality of life (QoL) and mental health in a broad population of illicit AAS users. METHODS AND ANALYSES A nationwide cross-sectional cohort study including a diverse population of men and women aged ≥18 years, with current or previous illicit AAS use for at least 3 months. Conducted at Odense University Hospital, Denmark, the study comprises two parts. In part A (the pilot study), 120 recreational athletes with an AAS history will be compared with a sex-matched and age-matched control population of 60 recreational athletes with no previous AAS use. Cardiovascular outcomes include examination of non-calcified coronary plaque volume and calcium score using coronary CT angiography, myocardial structure and function via echocardiography, and assessing carotid and femoral artery plaques using ultrasonography. Retinal microvascular status is evaluated through fundus photography. Cardiovascular risk markers are measured in blood. Mental health outcomes include health-related QoL, interpersonal difficulties, body image concerns, aggression dimensions, anxiety symptoms, depressive severity and cognitive function assessed through validated questionnaires. The findings of our comprehensive study will be used to compose a less intensive investigatory cohort study of cardiovascular and mental health (part B) involving a larger group of recreational athletes with a history of illicit AAS use. ETHICS AND DISSEMINATION The study received approval from the Regional Committee on Health Research Ethics for Southern Denmark (S-20210078) and the Danish Data Protection Agency (21/28259). All participants will provide signed informed consent. Research outcomes will be disseminated through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER NCT05178537.
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Affiliation(s)
- Laust Frisenberg Buhl
- Department of Endocrinology, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | | | - Axel Diederichsen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | | | - Caroline Michaela Kistorp
- Department of Hormones and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Kobenhavn, Denmark
| | - Dorte Glintborg
- Department of Endocrinology, Faculty of Health Sciences University of Southern Denmark, Odense, Denmark
| | - Marianne Andersen
- Department of Endocrinology, Faculty of Health Sciences University of Southern Denmark, Odense, Denmark
| | - Jan Frystyk
- Department of Endocrinology, Faculty of Health Sciences University of Southern Denmark, Odense, Denmark
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14
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Chen A, Garvey SR, Nanda AD, Friedman R, Jia E, Morgenstern M, Barron S, Tobias A, Cauley RP. Patient-Reported Outcomes on Subjective Nipple Sensation After Double-Incision and Periareolar Mastectomy for Chest Masculinization: Subjective Nipple Sensation After Chest Masculinization. Ann Plast Surg 2024; 92:383-388. [PMID: 38527342 DOI: 10.1097/sap.0000000000003821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
ABSTRACT We evaluated patient-reported outcomes to assess for patient and procedural factors associated with postchest masculinization subjective nipple sensation. Patients who underwent double-incision or periareolar mastectomies for chest masculinization by a single senior surgeon (2015-2019) were surveyed at 2 time points regarding postoperative nipple sensation and satisfaction, including patient-reported outcomes using BODY-Q modules (Q-Portfolio.org). Demographic, operative, and postoperative variables were obtained from medical records. Patients were stratified according to survey responses. Univariate and multivariate analyses were performed.Response rate was 42% for survey 1 and 22% for survey 2. Of the 151 survey 1 responders, 138 (91.4%) received double-incision mastectomies and 13 (8.6%) received periareolar mastectomies. Among Survey 1 responders, 84.6% periareolar patients and 69.6% double-incision patients reported "completely" or "a little" nipple sensation preservation, and the difference trended toward significance (P = 0.0719). There was a stepwise increase in proportion of patients reporting sensation with greater recovery time until response to survey 1. Obesity (P = 0.0080) and greater tissue removed (P = 0.0247) were significantly associated with decreased nipple sensation. Nipple satisfaction scores were significantly higher for patients reporting improved nipple sensation (P = 0.0235). Responders to survey 2 who reported greater satisfaction with nipple sensation were significantly more likely to report preserved sensitivity to light touch (P = 0.0277), pressure (P = 0.0046), and temperature (P = 0.0031). Preserved erogenous sensation was also significantly associated with greater satisfaction (P = 0.0018).In conclusion, we found that nipple sensation may be associated with postoperative nipple satisfaction. Operative techniques to optimize nipple sensation preservation may improve this population's postoperative satisfaction.
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Affiliation(s)
- Amy Chen
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston
| | - Shannon R Garvey
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston
| | - Asha D Nanda
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston
| | - Rosie Friedman
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston
| | - Emmeline Jia
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston
| | - Monica Morgenstern
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston
| | - Sivana Barron
- Division of Plastic and Reconstructive Surgery, University of Massachusetts Medical Center, Worcester, MA
| | - Adam Tobias
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston
| | - Ryan P Cauley
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston
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15
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Merker VL, Thompson HL, Wolters PL, Buono FD, Hingtgen CM, Rosser T, Barton B, Barnett C, Smith T, Haberkamp D, McManus ML, Baldwin A, Moss IP, Röhl C, Martin S. Recommendations for assessing appearance concerns related to plexiform and cutaneous neurofibromas in neurofibromatosis 1 clinical trials. Clin Trials 2024; 21:6-17. [PMID: 38140900 PMCID: PMC10922038 DOI: 10.1177/17407745231205577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
BACKGROUND/AIMS Individuals with neurofibromatosis 1 may experience changes in their appearance due to physical manifestations of the disorders and/or treatment sequelae. Appearance concerns related to these physical changes can lead to psychological distress and poorer quality of life. While many neurofibromatosis 1 clinical trials focus on assessing changes in tumor volume, evaluating patients' perspectives on corresponding changes in symptoms such as physical appearance can be key secondary outcomes. We aimed to determine whether any existing patient-reported outcome measures are appropriate for evaluating changes in appearance concerns within neurofibromatosis 1 clinical trials. METHODS After updating our previously published systematic review process, we used it to identify and rate existing patient-reported outcome measures related to disfigurement and appearance. Using a systematic literature search and initial triage process, we focused on identifying patient-reported outcome measures that could be used to evaluate changes in appearance concerns in plexiform or cutaneous neurofibroma clinical trials in neurofibromatosis 1. Our revised Patient-Reported Outcome Rating and Acceptance Tool for Endpoints then was used to evaluate each published patient-reported outcome measures in five domains, including (1) respondent characteristics, (2) content validity, (3) scoring format and interpretability, (4) psychometric data, and (5) feasibility. The highest-rated patient-reported outcome measures were then re-reviewed in a side-by-side comparison to generate a final consensus recommendation. RESULTS Eleven measures assessing appearance concerns were reviewed and rated; no measures were explicitly designed to assess appearance concerns related to neurofibromatosis 1. The FACE-Q Craniofacial Module-Appearance Distress scale was the top-rated measure for potential use in neurofibromatosis 1 clinical trials. Strengths of the measure included that it was rigorously developed, included individuals with neurofibromatosis 1 in the validation sample, was applicable to children and adults, covered item topics deemed important by neurofibromatosis 1 patient representatives, exhibited good psychometric properties, and was feasible for use in neurofibromatosis 1 trials. Limitations included a lack of validation in older adults, no published information regarding sensitivity to change in clinical trials, and limited availability in languages other than English. CONCLUSION The Response Evaluation in Neurofibromatosis and Schwannomatosis patient-reported outcome working group currently recommends the FACE-Q Craniofacial Module Appearance Distress scale to evaluate patient-reported changes in appearance concerns in clinical trials for neurofibromatosis 1-related plexiform or cutaneous neurofibromas. Additional research is needed to validate this measure in people with neurofibromatosis 1, including older adults and those with tumors in various body locations, and explore the effects of nontumor manifestations on appearance concerns in people with neurofibromatosis 1 and schwannomatosis.
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Affiliation(s)
- Vanessa L Merker
- Department of Neurology and Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - Heather L Thompson
- Department of Communication Sciences and Disorders, California State University, Sacramento, Sacramento, CA, USA
| | - Pamela L Wolters
- Pediatric Oncology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Frank D Buono
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Tena Rosser
- Division of Neurology, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Belinda Barton
- Faculty of Health, Discipline of Psychology, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Carolina Barnett
- Division of Neurology, Department of Medicine, University Health Network and University of Toronto, Toronto, ON, Canada
| | - Taylor Smith
- Department of Psychology and Child Development, California Polytechnic State University, San Luis Obispo, CA, USA
| | | | | | - Andrea Baldwin
- Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | | | - Claas Röhl
- NF Kinder, NF Patients United, Vienna, Austria
| | - Staci Martin
- Pediatric Oncology Branch, National Cancer Institute, Bethesda, MD, USA
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16
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Janik PE, Opyrchał J, Ambroziak M, Noszczyk B, Paul MA. Polish Translation and Linguistic Validation of the SCAR-Q. Cureus 2024; 16:e52848. [PMID: 38406147 PMCID: PMC10885187 DOI: 10.7759/cureus.52848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction Patient-reported outcome measurements (PROMs) are gaining considerable popularity as tools to assess the effectiveness of the treatment in plastic surgery, being a complement to surgical outcomes. The SCAR-Q questionnaire has been recently developed for patients with surgical, traumatic, and burn scars. Aim The study aims to describe the process of translation and linguistic validation of the scar questionnaire (SCAR-Q) for use in Polish patients undergoing scar treatment. Material and methods An official Polish translation and language validation of the SCAR-Q were done in adherence to International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. The process consisted of four steps: two independent forward translations, a back translation, a review of the back translation, and cognitive participant interviews. Results The field-tested version of the SCAR-Q consisted of 29 items across three scales measuring appearance concerns, symptoms, and the psychosocial impact of the scar. The forward translation was done by two independent translators and revealed specific difficulties in translation to the Polish language (4/29 items). The back translation showed no significant differences compared to the original English version. Cognitive debriefing interviews involved nine Polish patients with postraumatic scars, burn scars, and scars after skin tumor resection. Participants have not reported any major difficulties in understanding the content of the questionnaire. Conclusions The ISPOR provides a straightforward and thorough guideline for the PROMs translation process. The new SCAR-Q is an accessible and efficient PROM that can be implemented in Polish patients to assess the effectiveness of scar treatment.
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Affiliation(s)
- Piotr E Janik
- Plastic Surgery, Department of Plastic and Reconstructive Surgery, Centre of Postgraduate Medical Education, Prof. W. Orlowski Memorial Hospital, Warsaw, POL
| | - Jakub Opyrchał
- Reconstructive Surgery, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, POL
| | | | - Bartłomiej Noszczyk
- Plastic Surgery, Department of Plastic and Reconstructive Surgery, Centre of Postgraduate Medical Education, Prof. W. Orlowski Memorial Hospital, Warsaw, POL
| | - Marek A Paul
- Plastic and Reconstructive Surgery, Doc Paul Klinika, Bytom, POL
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17
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Dalaei F, de Vries CE, Cano SJ, Kaur MN, Poulsen L, Pfob A, Mou D, Repo JP, Salzillo R, Opyrchal J, Sørensen JA, Pusic AL, Klassen AF. BODY-Q Normative Scores: Psychometric Validation of the BODY-Q in the General Population in Europe and North America. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5401. [PMID: 38025628 PMCID: PMC10653602 DOI: 10.1097/gox.0000000000005401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/20/2023] [Indexed: 12/01/2023]
Abstract
Background BODY-Q is a rigorously developed patient-reported outcome measure designed to measure outcomes of weight loss and body contouring patients. To allow interpretation and comparison of BODY-Q scores across studies, normative BODY-Q values were generated from the general population. The aim of this study was to examine the psychometric properties of BODY-Q in the normative population. Methods Data were collected using two crowdsourcing platforms (Prolific and Amazon Mechanical Turk) in 12 European and North American countries. Rasch measurement theory (RMT) was used to examine reliability and validity of BODY-Q scales. Results RMT analysis supported the psychometric properties of BODY-Q in the normative sample with ordered thresholds in all items and nonsignificant chi-square values for 167 of 176 items. Reliability was high with person separation index of greater than or equal to 0.70 in 20 of 22 scales and Cronbach alpha values of greater than or equal to 0.90 in 17 of 22 scales. Mean scale scores measuring appearance, health-related quality of life, and eating-related concerns scales varied as predicted across subgroups with higher scores reported by participants who were more satisfied with their weight. Analysis to explore differential item functioning by sample (normative versus field-test) flagged some potential issues, but subsequent comparison of adjusted and unadjusted person estimates provided evidence that the scoring algorithm worked equivalently for the normative sample as in the field-test samples. Conclusions The BODY-Q scales showed acceptable reliability and validity in the normative sample. The normative values can be used as reference in research and clinical practice in combination with local estimates for parallel analysis and comparison.
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Affiliation(s)
- Farima Dalaei
- From the Research Unit of Plastic Surgery, Odense University Hospital, Denmark
- University of Southern Denmark, Odense, Denmark
- OPEN, Odense Explorative Patient Network, Odense, Denmark
| | - Claire E.E. de Vries
- Department of Surgery, OLVG, Amsterdam, the Netherlands
- Department of Surgery, Brigham and Women’s Hospital, Harvard University, Boston, Mass
| | | | - Manraj N. Kaur
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass
| | - Lotte Poulsen
- From the Research Unit of Plastic Surgery, Odense University Hospital, Denmark
- University of Southern Denmark, Odense, Denmark
| | - André Pfob
- University Breast Unit, Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Danny Mou
- Department of General Surgery, Brigham and Women’s Hospital, Harvard University, Boston, Mass
| | - Jussi P. Repo
- Unit of Musculoskeletal Surgery, Department of Orthopedics and Traumatology, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Rosa Salzillo
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Jakub Opyrchal
- Department of Oncologic and Reconstructive Surgery, Maria Sklodowska-Curie Memorial National Cancer Center, Gliwice, Poland
| | - Jens A. Sørensen
- From the Research Unit of Plastic Surgery, Odense University Hospital, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Andrea L. Pusic
- Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass
| | - Anne F. Klassen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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18
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Makarawung DJS, Dijkhorst PJ, de Vries CEE, Monpellier VM, Wiezer MJ, van Veen RN, Geenen R, Mink van der Molen AB. Body Image and Weight Loss Outcome After Bariatric Metabolic Surgery: a Mixed Model Analysis. Obes Surg 2023; 33:2396-2404. [PMID: 37354307 DOI: 10.1007/s11695-023-06690-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/10/2023] [Accepted: 06/16/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE As in nonsurgical weight loss populations, body image may partly explain differences in weight loss outcomes after surgery. The aim of this study was to determine the prospective association between body image and weight loss in a longitudinal cohort of patients up to 3 years after bariatric metabolic surgery. MATERIALS AND METHODS The BODY-Q self-report questionnaire was used to assess body image. Linear mixed models evaluated associations of baseline body image with weight loss in the first year as well as associations of body image at 12 months and first-year change in body image with weight loss 12 to 36 months after surgery. RESULTS Available body image data included 400 (100%), 371 (93%), 306 (77%), 289 (72%), and 218 (55%) patients at baseline and 4, 12, 24, and 36 months, respectively. Body image scores improved significantly until 12 months, followed by a gradual decline. Scores remained improved in comparison to baseline (β = 31.49, 95% CI [27.8, 35.2], p < .001). Higher baseline body image was associated with less weight loss during the first year, and the effect size was trivial (ß = -0.05, 95% CI [-0.09, -0.01], p = .009). Body image and change in body image were not associated with weight loss 12 to 36 months after surgery. CONCLUSION Body image improved after bariatric metabolic surgery. Although no clinically relevant associations of body image with weight loss were demonstrated, the gradual decline in body image scores underlines the importance of long-term follow-up with regular assessment of this aspect of quality of life.
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Affiliation(s)
- Dennis J S Makarawung
- Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435, CM, Nieuwegein, the Netherlands.
- Department of Plastic, Reconstructive and Hand Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, the Netherlands.
| | - Phillip J Dijkhorst
- Department of Surgery, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands
| | - Claire E E de Vries
- Department of Surgery, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands
| | - Valerie M Monpellier
- Dutch Obesity Clinic (Nederlandse Obesitas Kliniek), Amersfoortseweg 43, 3712 BA, Huis ter Heide, the Netherlands
| | - M J Wiezer
- Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435, CM, Nieuwegein, the Netherlands
| | - Ruben N van Veen
- Department of Surgery, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands
| | - Rinie Geenen
- Department of Psychology, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, the Netherlands
| | - Aebele B Mink van der Molen
- Department of Plastic, Reconstructive and Hand Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, the Netherlands
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19
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Dijkhorst PJ, Makarawung DJS, Vanhommerig JW, Kleipool SC, Dalaei F, de Vries CEE, van der Molen AB, Poulsen L, Sorensen JA, Bonjer HJ, de Castro SMM, van Veen RN. Predictors of improved psychological function after bariatric surgery. Surg Obes Relat Dis 2023; 19:872-881. [PMID: 36842930 DOI: 10.1016/j.soard.2023.01.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/16/2023] [Accepted: 01/21/2023] [Indexed: 02/03/2023]
Abstract
BACKGROUND Negative psychological sequelae have been reported after bariatric surgery. It is unclear which factors affect psychological function in the first postoperative years. OBJECTIVE Evaluation of significant predictors of improved psychological function following bariatric surgery by analyzing data from the BODY-Q questionnaire. SETTING Multicenter prospective cohort in 3 centers located in The Netherlands and Denmark. METHODS The BODY-Q questionnaire was used to assess 6 domains of health-related quality of life. The domain of interest, psychological function, consists of 10 questions from which a converted score of 0 (low) to 100 (high) can be calculated. Linear mixed models were used to analyze which patient characteristics were most predictive of the psychological function score. Secondary outcomes of interest were cross-sectional scores of psychological function and the impact of weight loss, and the effect of major short-term complications on psychological function. RESULTS Data were analyzed from 836 patients who underwent bariatric surgery from 2015 to 2020. Patients with lower expectations concerning weight loss (<40% desired total weight loss), higher educational level, no history of psychiatric illness, and employment before bariatric surgery demonstrated the highest psychological function scores after bariatric surgery. At 1 and 2 years after bariatric surgery, more weight loss was associated with significantly higher psychological function scores. Experiencing a major short-term complication did not significantly impact psychological function. CONCLUSIONS Several relevant predictors of improved postoperative psychological function have been identified. This knowledge can be used to enhance patient education preoperatively and identify patients at risk for poor psychological functioning postoperatively.
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Affiliation(s)
- Phillip J Dijkhorst
- Department of Surgery, OLVG & Dutch Obesity Clinic, Amsterdam, The Netherlands.
| | | | | | - Suzanne C Kleipool
- Department of Surgery, OLVG & Dutch Obesity Clinic, Amsterdam, The Netherlands
| | - Farima Dalaei
- Research Unit for Plastic Surgery, Odense University Hospital and University of Southern Denmark, Odense, Denmark; Odense Explorative Patient Network (OPEN), Odense, Denmark
| | - Claire E E de Vries
- Department of Surgery, OLVG & Dutch Obesity Clinic, Amsterdam, The Netherlands
| | | | - Lotte Poulsen
- Research Unit for Plastic Surgery, Odense University Hospital and University of Southern Denmark, Odense, Denmark; Odense Explorative Patient Network (OPEN), Odense, Denmark
| | - Jens A Sorensen
- Research Unit for Plastic Surgery, Odense University Hospital and University of Southern Denmark, Odense, Denmark; Odense Explorative Patient Network (OPEN), Odense, Denmark
| | - H Jaap Bonjer
- Department of Surgery, Amsterdam Medical University Center, Amsterdam, The Netherlands
| | - Steve M M de Castro
- Department of Surgery, OLVG & Dutch Obesity Clinic, Amsterdam, The Netherlands
| | - Ruben N van Veen
- Department of Surgery, OLVG & Dutch Obesity Clinic, Amsterdam, The Netherlands
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20
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Pantelis AG, Vakis G, Kotrotsiou M, Lapatsanis DP. Status of Body Contouring Following Metabolic Bariatric Surgery in a Tertiary Hospital of Greece-Still a Long Way to Go. J Clin Med 2023; 12:jcm12093196. [PMID: 37176639 PMCID: PMC10179396 DOI: 10.3390/jcm12093196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 04/22/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
Obesity is a disease rather than a state, and metabolic bariatric surgery (MBS) is its most effective treatment. Body contouring surgery (BCS) is an integral part of the continuum of care following MBS, provided that the body mass index (BMI) has stabilized for an adequate period. This study is an attempt to capture the current status of BCS following MBS in Greece, based on data from one of the country's highest-volume hospitals. We recruited patients from the Bariatric and Plastic-Reconstructive Surgery registries who had undergone both MBS and BCS and invited them to answer a structured questionnaire with components on demographics, safety and effectiveness of previous operations, quality of life (QoL), body image, social activity, sexual activity, and doctor-patient communication. Twenty-four patients participated in the survey (response rate 88.1%). The mean BMI pre-MBS was 43.8 kg/m2 and that pre-BCS was 28.6 kg/m2. Based on the Bariatric sub-cohort, only 2.5% of post-bariatric patients underwent BCS. The mean interval between MBS and BCS was 2.9 years. The distribution of patients by MBS was as follows: sleeve gastrectomy 8 (33.3%), gastric band 7 (29.2%), gastric bypass 5 (20.8%), and gastric plication 2 (8.3%). The distribution of patients by BCS was as follows: abdominoplasty 23 (94.7%), breast contouring 8 (33.3%), thigh contouring 3 (12.5%), and arm contouring 5 (20.8%). Most positive components (70.6%) regarding QoL were appraised by >80% of the participants, indicating overall satisfaction after BCS. Conversely, only 12.5% of negative components were endorsed by >20% of patients. In conclusion, BCS has a low prevalence after MBS, although it is related to an improved quality of life and body image.
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Affiliation(s)
- Athanasios G Pantelis
- Bariatric and Metabolic Surgery Unit, 4th Department of General Surgery, Evaggelismos General Hospital of Athens, Ipsilantou 45-47, 106 76 Athens, Greece
| | - Georgios Vakis
- Department of Plastic and Reconstructive Surgery, Evaggelismos General Hospital of Athens, Ipsilantou 45-47, 106 76 Athens, Greece
| | - Maria Kotrotsiou
- Department of Plastic and Reconstructive Surgery, Evaggelismos General Hospital of Athens, Ipsilantou 45-47, 106 76 Athens, Greece
| | - Dimitris P Lapatsanis
- Bariatric and Metabolic Surgery Unit, 4th Department of General Surgery, Evaggelismos General Hospital of Athens, Ipsilantou 45-47, 106 76 Athens, Greece
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21
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Aitzetmüller-Klietz MM, Raschke L, Hirsch T, Kückelhaus M, Wiebringhaus P, Aitzetmüller-Klietz ML, Harati K. Factors Influencing Quality of Life after Massive Weight Loss-What Makes the Difference? Healthcare (Basel) 2023; 11:healthcare11081147. [PMID: 37107981 PMCID: PMC10138039 DOI: 10.3390/healthcare11081147] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Although weight reduction in obesity and morbid obesity has been shown to improve associated comorbidities, there is currently no information on what influences quality of life after a large reduction in body weight. The present study looks at differences in patients' quality of life classified by mode and amount of weight loss. MATERIAL AND METHODS A cross-sectional study was designed using a validated German version of the BODY-Q questionnaire. The internet-based questionnaire was distributed to patients via social media. RESULTS 460 patients (443 female, 17 male) were interviewed for this study via "Surveymonkey". The comparison of conservative and surgical weight loss showed no significant difference in the patients' quality of life (p > 0.05). A high BMI correlates negatively with body image (p = 0.023 *), as does the specific assessment of most body regions. For example, a negative correlation was found between a high BMI and satisfaction with skin appearance (p < 0.001 *) and satisfaction with the inner thigh (p = 0.011 *). CONCLUSION Increased weight loss is associated with a greater ability to maximise quality of life. The type of weight loss, whether conservative or surgical, can be neglected based on the present study. Bariatric surgery cannot be considered a universal solution to obesity. Body contouring interventions should also become a focus of therapy.
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Affiliation(s)
- Matthias Michael Aitzetmüller-Klietz
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Laura Raschke
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Tobias Hirsch
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Maximilian Kückelhaus
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Philipp Wiebringhaus
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Marie-Luise Aitzetmüller-Klietz
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Kamran Harati
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
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22
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Hu FY, Ariagno M, Tavakkoli A, Ghushe N. BODY-Q eating-related symptoms following sleeve gastrectomy. Surg Endosc 2023; 37:2189-2193. [PMID: 35737137 DOI: 10.1007/s00464-022-09389-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 06/06/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Recent data describing gastrointestinal (GI) symptoms experienced by patients after bariatric surgery is lacking, and previous studies in sleeve gastrectomy patients have been limited in scope of follow-up time or extent of GI symptoms examined. We sought to characterize the prevalence and time course of patient-reported eating-related symptoms in sleeve gastrectomy patients. METHODS From July 2020 to July 2021, sleeve gastrectomy patients seen at three Boston area hospitals received electronic surveys and prospectively reported GI symptoms using the BODY-Q eating-related symptoms scale. Descriptive analyses were performed for patient demographics and symptom prevalence. Chi-square tests were used to compare prevalence of eating-related symptoms between follow-up time intervals. RESULTS 491 sleeve gastrectomy patients completed postoperative surveys with mean follow-up time of 1.9 years. Mean age was 46.6 years, and 81.3% were female. The most reported GI symptoms overall included constipation (56.6%), bloating (54.0%), heartburn when standing (41.5%), and heartburn when lying down (39.9%) while the least commonly reported symptoms were palpitations (16.3%), low blood sugar (15.7%), and emesis (15.1%). At greater than 12 months, the most reported symptoms similarly included bloating (60.3%), constipation (53.2%), and heartburn while standing (46.0%). When comparing prevalence of eating-related symptoms across follow-up time intervals from < 1 to > 12 months, patients reported a significant decrease in constipation, abdominal pain, and nausea over time (p = 0.012, p < .0001, p = 0.03, respectively). CONCLUSION Patients experience both upper and lower GI symptoms following sleeve gastrectomy, and symptoms, including bloating, constipation, and heartburn may persist through long-term follow-up. These patient-centered measures add value by guiding preoperative counseling, informing postoperative expectations, and providing real-time clinical feedback for bariatric surgery patients.
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Affiliation(s)
- Frances Y Hu
- Department of Surgery, Brigham and Woman's Hospital, c/o Surgery Education Office, 75 Francis Street, Boston, MA, 02120, USA.
| | - Meghan Ariagno
- Department of Surgery, Brigham and Woman's Hospital, c/o Surgery Education Office, 75 Francis Street, Boston, MA, 02120, USA
| | - Ali Tavakkoli
- Department of Surgery, Brigham and Woman's Hospital, c/o Surgery Education Office, 75 Francis Street, Boston, MA, 02120, USA
| | - Neil Ghushe
- Department of Surgery, Brigham and Woman's Hospital, c/o Surgery Education Office, 75 Francis Street, Boston, MA, 02120, USA.,Department of Surgery, South Shore Hospital, Weymouth, MA, USA
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23
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Biörserud C, Elander A, Fagevik Olsén M. SESQ, a patient-reported outcome instrument addressing excess skin; report on the updated version and the validation process. J Plast Surg Hand Surg 2023; 57:360-364. [PMID: 36093636 DOI: 10.1080/2000656x.2022.2118755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Excess skin after weight loss is perceived as a major problem for the majority of the bariatric patients, between 68 and 90% desire additional reconstructive surgery. However, only about 20% of the patients actually have the possibility to undergo these procedures. Reliable and valid patient-reported outcome instruments, PROM, are required in order to consider the patients' perspective of excess skin when discussing reconstructive surgery. The aim of this study was to present the updated version of Sahlgrenska Excess Skin Questionnaire, SESQ and to report on the validation process. The material for the process to evaluate internal consistency and known group validity was based on four different studies conducted at the Department of Plastic Surgery at Sahlgrenska University Hospital, Sweden. Internal consistency was high in all four groups examined; the normal population, the obese patients, the post-bariatric patients and the post-abdominoplasty patients. Values for Cronbach's alpha were >0.86 in all groups, and the highest value was seen in the obese patients (0.92). Furthermore, regarding known group validity, there were strong significant differences between the answers from the normal population in comparison with most of the other studies. In conclusion, patients thought that the questions in SESQ were easy to understand, that they covered all appropriate aspects of excess skin and the patients did not think that SESQ overlooked any questions or aspects concerning excess skin. SESQ is a valid questionnaire addressing excess skin in post-bariatric patients. The updated version of the SESQ is both accurate and user-friendly.
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Affiliation(s)
- Christina Biörserud
- Department of Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Departent of Surgery, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Elander
- Department of Plastic Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Monika Fagevik Olsén
- Department of Physiotherapy, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Neuroscience and Physiology, Institute of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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24
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Grift A, de Vries C, Monpellier V, Makarawung D, de Raaff C, Nijland L, Mink van der Molen A, Wiezer R, van Wagensveld B, van Veen R, de Castro S, Florisson J, Hoogbergen M. Using the BODY-Q to develop a prospective cohort of patients undergoing bariatric and body contouring surgery: A study protocol. Clin Obes 2023; 13:e12573. [PMID: 36470587 DOI: 10.1111/cob.12573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 10/03/2022] [Accepted: 10/14/2022] [Indexed: 12/12/2022]
Abstract
The BODY-Q is a patient-reported outcome measure designed to measure health-related quality of life, satisfaction with appearance and experience with healthcare in patients with obesity who undergo bariatric surgery and/or body contouring surgery after massive weight loss. The aim of this study is to collect long term PRO-data from patients living with obesity undergoing bariatric surgery, comparing patient undergoing or not undergoing body contouring surgery. This study will be a multicentre, prospective longitudinal cohort study with participation of three bariatric medical centres in the Netherlands. The BODY-Q will be used to measure the satisfaction with appearance and HRQL. Patients undergoing bariatric surgery, age >18 years and <65 years and who are able to read and understand Dutch can be included. All bariatric procedures are eligible for inclusion. Administration of the questionnaires will be done preoperatively for bariatric and body contouring surgery as well as at 3, 12, 24, 36, 48 and 60 months post-operatively. Patient-reported outcomes measurements are becoming more important with the shift to patient-centred healthcare. The collected longitudinal data can be helpful in determining the effectiveness and value of bariatric and body contouring surgery from the patient's perspective, and can contribute to patient tailored postoperative care.
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Affiliation(s)
- Annewiek Grift
- Department of Plastic, Reconstructive and Hand Surgery, OLVG, Amsterdam, The Netherlands
| | | | - Valerie Monpellier
- Nederlandse Obesitas Kliniek (Dutch Obesity Clinic), Huis ter Heide, The Netherlands
| | - Dennis Makarawung
- Department of Plastic, Reconstructive and Hand Surgery, Sint Antonius Hospital, Nieuwegein, The Netherlands
| | | | - Leontien Nijland
- Department of Surgery, Amsterdam UMC, Amsterdam, The Netherlands
| | - Aebele Mink van der Molen
- Department of Plastic, Reconstructive and Hand Surgery, Sint Antonius Hospital, Nieuwegein, The Netherlands
| | - Rene Wiezer
- Department of Surgery, Sint Antonius Hospital, Nieuwegein, The Netherlands
| | - Bart van Wagensveld
- Metabolic and Bariatric Department, NMC Royal Hospital, Khalifa City, Abu Dhabi, United Arab Emirates
| | | | | | - Joyce Florisson
- Department of Plastic, Reconstructive and Hand Surgery, OLVG, Amsterdam, The Netherlands
| | - Maarten Hoogbergen
- Department of Plastic, Reconstructive and Hand Surgery, Catharina Hospital, Eindhoven, The Netherlands
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25
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Mardan-Dezfouli S, Reid OG, Fliss MD, Stevenson J, Harris D, Lyon MR, Koehle MS, Mitchell CJ. The Impact of Abdominal Body Contouring Surgery on Physical Function After Massive Weight Loss: A Pilot Prospective Matched Comparison. Aesthet Surg J 2023; 43:NP28-NP37. [PMID: 35946751 DOI: 10.1093/asj/sjac220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Many individuals develop excess skin (ES) following massive weight loss (MWL). Patient-reported outcomes demonstrate that abdominal ES negatively impacts perceived physical function which is improved by abdominal body contouring surgery (ABCS). However, the effect of ABCS on objective measures of physical function is unknown. OBJECTIVES The aim of this study was to examine the impact of ABCS on objective measures of physical function in individuals who have undergone MWL. METHODS Patients who have undergone MWL with abdominal ES (grade, ≥2) underwent the following physical function assessments: 9-item modified physical performance test (mPPT), chair stand, star excursion balance test (SEBT), timed up and go (TUG), modified agility T test, and 6-minute walk test (6-MWT). Perception of physical exertion and BODY-Q questionnaire scales were also collected. Nonsurgical controls (n = 21) and those who had undergone ABCS (n = 6) after the first visit performed a second physical function assessment 8 to 12 weeks later to allow for postoperative healing. RESULTS No ceiling or floor effect was detected for any physical function measure. The intraclass correlation coefficient was 0.78 (95% CI, 0.44, 0.91) for the mPPT and >0.80 for all other measures. The effect sizes were 0.74 (75% CI, 0.19, 1.28) for the mPPT, 0.54 (75% CI, 0.00, 1.08) for the SEBT, -0.63 (75% CI, -1.17, -0.09) for the modified agility T test, and 0.79 (75% CI, 0.24, 0.13) for the 6-MWT. CONCLUSIONS The mPPT and tests involving dynamic balance, agility, and walking were reliable and showed medium to large effect sizes, suggesting that these tests may be sensitive to change following ABCS. LEVEL OF EVIDENCE: 2
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Affiliation(s)
| | - Owen G Reid
- Division of Plastic Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Matthew D Fliss
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Jordan Stevenson
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - David Harris
- Richmond Metabolic and Bariatric Surgery, Vancouver, BC, Canada
| | - Michael R Lyon
- Obesity Medicine and Diabetes Institute, Coquitlam, BC, Canada
| | - Michael S Koehle
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Cameron J Mitchell
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
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Integration and Implementation of Patient-Reported Outcomes: A Prospective, Observational Clinical Quality Improvement Study. Plast Reconstr Surg 2023; 151:184-193. [PMID: 36251864 DOI: 10.1097/prs.0000000000009772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Implementation of patient-reported outcomes (PROs) represents a critical barrier to their widespread use and poses challenges to workflow and patient satisfaction. The authors sought to implement PRO surveys into surgical practice and identify principles for successful and broader implementation. METHODS Outpatient surgical encounters from 2016 through 2019 related to hernia, breast surgery, or postbariatric body contouring were assessed with the Abdominal Hernia-Q, BREAST-Q, or BODY-Q surveys, respectively. Outcomes were implementation rates per quarter and time to optimal implementation (≥80%). Successful implementation principles were identified during the first implemented PRO instrument and applied to subsequent ones. Logistic regression models were used to estimate increase in rate of implementation per quarter by instrument controlling for clinic volume. Risk-adjusted generalized linear models determined predicted mean differences in total clinic time and patient satisfaction. RESULTS A total of 1206 encounters were identified. The overall survey implementation rate increased from 15% in the first quarter to 90% in the last quarter ( P < 0.01). Abdominal Hernia-Q optimal implementation was reached by 15 months. Principles for successful implementation of PROs were workflow optimization, appropriate patient selection, staff engagement, and electronic survey integration. Consistent application of these principles optimized time to optimal implementation for BREAST-Q [9 months; 18.1% increase in implementation per quarter (95% CI, 1.5 to 37.5); P < 0.01] and BODY-Q [3 months; 56.3% increase in implementation per quarter (95% CI, 26.8 to 92.6); P = 0.03]. Neither patient clinic time ( P = 0.16) nor patient satisfaction differed during the implementation of PROs process ( P = 0.98). CONCLUSIONS Prospective implementation of PROs can be achieved in surgical practice without an adverse effect on patient satisfaction or workflow. The proposed principles of implementation may be used to optimize efficiency for implementation of PROs.
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Simone P, Savani L, Marchica P, Persichetti P. Puboplasty as an integral step in massive weight loss abdominal contouring: a retrospective assessment of results, stability, and patients' satisfaction. J Plast Surg Hand Surg 2022; 56:387-395. [PMID: 35400280 DOI: 10.1080/2000656x.2022.2061500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Ex-obese patients complain about abdomen and pubis deformities following massive weight loss, due to skin and soft tissue redundancy. Abdominoplasty is often the first corrective procedure performed, but residual mons pubis deformities may impair the final outcome, thus concomitant correction becomes necessary. Sixty patients were treated by the same surgeon between 2008 and 2018, 30 of them receiving only standard umbilical transposition abdominoplasty (A group), and 30 having concurrent monsplasty (AM group), namely skin excess removal, pubic suspension and skin redistribution following superolateral vectors, re-establishment of superficial fascia continuity, with or without liposuction. Retrospective comparison of the two groups included: a subjective evaluation through administration of questionnaires (BODY-QTM, a questionnaire assessing functional and aesthetic improvements after surgery, a questionnaire assessing the overall satisfaction), and an objective evaluation of pre- and post-operative pictures to estimate mons pubis suspension and result stability. Four minor complications were recorded: 1 wound dehiscence in A group, 3 seromas in AM group. All measured outcomes were higher in AM group, with statistically significant difference (p < 0.05) in almost all the questionnaire and BODY-QTM items, and the photographic assessment confirmed higher degree of mons pubis suspension and superior result stability in AM group. We presented a standardized approach to mons pubis reshaping during abdominoplasty, through a straightforward, safe and quick procedure. Our experience supports the significance of the concomitant correction of abdominal and mons pubis deformities, improving the results of the surgery from both a subjective and objective point of view.
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Affiliation(s)
- Pierfranco Simone
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico of Rome University, Rome, Italy
| | - Luca Savani
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico of Rome University, Rome, Italy
| | - Paolo Marchica
- Clinic of Plastic Surgery, Department of Neuroscience, Padua University Hospital, Padua, Italy
| | - Paolo Persichetti
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico of Rome University, Rome, Italy
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Lorenzen MM, Poulsen L, Madsen CB, Tsangaris E, Klassen A, Sørensen JA. Danish translation and linguistic validation of new body-Q scales measuring expectations, eating behavior, distress, symptoms and work life. J Plast Surg Hand Surg 2022; 56:376-380. [PMID: 35235477 DOI: 10.1080/2000656x.2022.2044834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The aim of this study was to translate and achieve a linguistical and cultural adaption of the newly developed BODY-Q Obesity Module for use in Danish patients. The BODY-Q Eating Module consists of five new modules aiming to measure expectations of weight-loss, eating behavior, eating-related distress, eating-related symptoms and work life. Translation and linguistic validation were performed using a combination of the recommendations developed by the World Health Organization and the International Society for Pharmacoeconomics and Outcomes Research. The translation was performed in five steps consisting of a forward translation, backward translation, expert panel meeting, cognitive debriefing and final proofreading. Each step aimed for a conceptual and cultural equal translation that was easily understood by patients. The discrepancies encountered in the forward translation included the use of layperson versus medical terminology, different tense and sentence structure. The harmonized version was then backwards translated which led to no conceptual differences. The expert panel reviewed the instrument in full and found two items needing correction in the instrument. Cognitive debriefing did not lead to any revisions and the instrument was well received by the participant group. Proofreading of the instrument led to few corrections in grammar and punctuation but no conceptual corrections. The translation of the BODY-Q Eating Module led to a conceptual and cultural equal version of the instrument for use in Danish patients. The instrument can be used in clinical care and research to inform advancements in the field of bariatric and body contouring surgery.
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Affiliation(s)
- Mike Mikkelsen Lorenzen
- Research Unit for Plastic Surgery, Odense University Hospital, Odense, Denmark.,University of Southern Denmark, Odense, Denmark
| | - Lotte Poulsen
- Research Unit for Plastic Surgery, Odense University Hospital, Odense, Denmark.,University of Southern Denmark, Odense, Denmark
| | - Christoffer Bing Madsen
- Research Unit for Plastic Surgery, Odense University Hospital, Odense, Denmark.,University of Southern Denmark, Odense, Denmark
| | - Elena Tsangaris
- Patient-Reported Outcomes, Value & Experience (PROVE) Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anne Klassen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Jens Ahm Sørensen
- Research Unit for Plastic Surgery, Odense University Hospital, Odense, Denmark.,University of Southern Denmark, Odense, Denmark
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Santorelli A, Cerullo F, Salti G, Avvedimento S. Gluteal Augmentation with Hyaluronic Acid Filler: A Retrospective Analysis Using the BODY-Q Scale. Aesthetic Plast Surg 2022; 47:1175-1181. [DOI: 10.1007/s00266-022-03166-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/30/2022] [Indexed: 11/17/2022]
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Barbic SP, Young NL, Usuba K, Stankiewicz E. Rasch Measurement Theory's contribution to the psychometric properties of a co-created measure of health and wellness for Indigenous children and youth. J Clin Epidemiol 2022; 151:18-28. [PMID: 35926823 DOI: 10.1016/j.jclinepi.2022.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 07/17/2022] [Accepted: 07/18/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To determine how Rasch Measurement Theory (RMT) methods can be used to assess the psychometric properties of the Aaniish Naa Gegii: the Children's Health and Wellbeing Measure (ACHWM) and Qanuippit. STUDY DESIGN AND SETTING Indigenous children aged 8-18 years, from five communities, completed the 62-item ACHWM. We applied RMT methods to ACHWM data from 401 children (mean age 13.4 ± 3.4 years; 51% male) from across Ontario to examine how well the items captured the full range (±3 logit) of the concept of interest in each domain, targeted the needs of Indigenous children, and met the criteria for unidimensional and invariant measurement. RESULTS RMT results indicated moderate-fit overall fit (raw χ2 = 809, P < 0.001). This model was further improved by aggregating the five response categories into three categories. All four domains showed excellent overall fit to the Rasch model (P > 0.05), with items covering between -4.51 and 6.02 logit, with no gaps along the theoretical continua. CONCLUSION This study provides evidence that a set of conceptually derived items was able to produce a measure that fits the Rasch model. These results aid our understanding of wellness by establishing the clinical meaning of the scale scores.
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Affiliation(s)
- Skye P Barbic
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia (UBC), Vancouver, British Columbia, Canada V6T 2A1; Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada V6Z 1Y6; Foundry, Vancouver, British Columbia, Canada V6Z 2A9.
| | - Nancy L Young
- Evaluating Children's Health Outcomes (ECHO) Research Centre, Laurentian Univeristy, Sudbury, ON P3E 2C6, USA
| | - Koyo Usuba
- Evaluating Children's Health Outcomes (ECHO) Research Centre, Laurentian Univeristy, Sudbury, ON P3E 2C6, USA
| | - Elizabeth Stankiewicz
- Evaluating Children's Health Outcomes (ECHO) Research Centre, Laurentian Univeristy, Sudbury, ON P3E 2C6, USA
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Sexual Dissatisfaction after Hand Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2022; 10:e4600. [PMID: 36299820 PMCID: PMC9592528 DOI: 10.1097/gox.0000000000004600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/23/2022] [Indexed: 12/02/2022]
Abstract
UNLABELLED Using the hand questionnaire (HAND-Q) patient-reported outcome measure, the effects of upper extremity surgery on patients' perception of their sex life were explored. The hand is a uniquely sexual organ, and we hypothesized that self-reported measures of disease severity, quality of life, and emotional impact would correlate with sexual dissatisfaction among patients receiving treatment for hand/upper extremity conditions. METHODS Patients were prospectively enrolled for hand questionnaire participation. Patients with valid responses to the following questions were included: functionality, hand appearance satisfaction, symptom severity, emotional dissatisfaction, sexual dissatisfaction, and treatment satisfaction. Composite scores were created and scored. Sexual dissatisfaction composite scores were compared through Spearman correlation coefficient analysis to quality of life, emotional dissatisfaction, hand appearance, symptom severity, and hand functionality. RESULTS High levels of diminished quality of life correlated with sexual dissatisfaction (rs = 0.748, P < 0.001). Increased emotional dissatisfaction correlated with sexual dissatisfaction (rs = 0.827, P < 0.001). Increased satisfaction with hand appearance negatively correlated with sexual dissatisfaction (rs = -0.648, P = 0.001). Increased levels of dissatisfaction with hand functionality correlated with sexual dissatisfaction (rs = 0.526, P = 0.005). CONCLUSIONS The correlation between sex life and quality of life may allow surgeons to improve patient satisfaction when treating hand/upper extremity issues. The relationship between sex life and emotional dissatisfaction emphasizes the impact that sexual dissatisfaction has on patients' lives. Evaluating the relationship between hand appearance and sexual dissatisfaction may indicate that patient self-perception of hand attractiveness plays a role in sex life.
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Boriani F, Sassu P, Atzeni M, Buckley C, Figus A. The profunda artery perforator flap for upper limb reconstruction: A case report and literature review on the flap applications in reconstruction. Microsurgery 2022; 42:714-721. [PMID: 35876622 PMCID: PMC9796947 DOI: 10.1002/micr.30941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 05/30/2022] [Accepted: 07/08/2022] [Indexed: 01/07/2023]
Abstract
The profunda femoris artery perforator (PAP) flap has been recently popularized as an alternative option for microsurgical reconstruction. The use of PAP flap has never been reported and described for reconstruction of the upper extremities, in particular the forearm. The purpose of this case report is to describe a case suggesting the PAP flap as a further reconstructive option in the upper limb. A 16-year-old girl who sustained a traumatic injury to her right dominant forearm resulting in subtotal circumferential tissue loss following a road traffic accident was referred to the authors' department 2 years post-trauma. The disabling fibrotic sequelae on her volar forearm (15 × 10 cm) resulted in a nonfunctional hand. She was unable to perform any active movement of her wrist or digits. Passive movements in the finger joints were preserved. Following debridement and reconstruction of nerves and tendons, soft tissues were resurfaced with a PAP flap. The transverse skin paddle, 12 × 7 cm, was placed distally with the adipofascial portion positioned proximally above the muscle bellies and anastomoses site. A small raw area (4 × 3 cm) was covered with an acellular dermal matrix (ADM). The postoperative course was uneventful. At 9 months postoperatively, the patient demonstrated active flexion and extension of the fingers with independent function. The patient reported satisfaction with the flap donor site and forearm resurfacing. The PAP flap can be a further option for areas requiring soft tissue coverage in patients refusing visible scars. This flap had both the advantage of reducing the morbidity and visibility of the donor site, as well as the ability to resurface a large recipient site with soft and pliable tissue, covering exposed nerves and tendons.
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Affiliation(s)
- Filippo Boriani
- Department of Plastic Surgery and MicrosurgeryUniversity of CagliariCagliariItaly
| | - Paolo Sassu
- Department of OrthoplasticsIRCCS, Istituto Ortopedico RizzoliBolognaBO40136Italy
| | - Matteo Atzeni
- Department of Plastic Surgery and MicrosurgeryUniversity of CagliariCagliariItaly
| | - Christina Buckley
- Department of Plastic Surgery and MicrosurgeryUniversity of CagliariCagliariItaly
| | - Andrea Figus
- Department of Plastic Surgery and MicrosurgeryUniversity of CagliariCagliariItaly
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Knufinke-Meyfroyt M, Jansen JM, Nienhuijs S, Deckers E, Lodewijks Y. Co-Responsibility: Exploring the Impact of Patient-Partner Dynamics on Health Outcomes After Bariatric Surgery. Bariatr Surg Pract Patient Care 2022. [DOI: 10.1089/bari.2022.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - Simon Nienhuijs
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - Eva Deckers
- Philips Experience Design, Eindhoven, The Netherlands
| | - Yentl Lodewijks
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
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Dalaei F, de Vries CEE, Poulsen L, Kaur MN, Pfob A, Mou D, Jacobsen AL, Repo JP, Salzillo R, Opyrchal J, Klassen AF, Sørensen JA, Pusic AL. General population normative scores for interpreting the BODY-Q. Clin Obes 2022; 12:e12528. [PMID: 35611607 PMCID: PMC9541838 DOI: 10.1111/cob.12528] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/25/2022] [Accepted: 05/03/2022] [Indexed: 12/22/2022]
Abstract
The BODY-Q is a patient-reported outcome measure used to assess outcomes in patients undergoing weight loss and/or body contouring surgery (BC) following massive weight loss. Normative values for the BODY-Q are needed to improve data interpretation and enable comparison. Thus, the aim of this study was to determine normative values for the BODY-Q. Participants were recruited internationally through two crowdsourcing platforms. The participants were invited to complete the BODY-Q scales through an URL link provided within the crowdsourcing platforms. General linear analyses were performed to compare normative means between countries and continents adjusted for relevant covariates. Normative reference values were stratified by age, body mass index (BMI), and gender. The BODY-Q was completed by 4051 (2052 North American and 1999 European) participants. The mean age was 36 years (±14.7 SD) and ranged from 17 to 76 years, the mean BMI was 26.4 (±6.7 SD) kg/m2 , and the sample consisted of 1996 (49.3%) females and 2023 (49.9%) males. Younger age and higher BMI were negatively associated with all BODY-Q scales (p < .001). This study provides normative values for the BODY-Q scales to aid in the interpretation of BODY-Q scores in research and clinical practise. These values enable us to understand the impact of weight loss and BC on patients' lives.
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Affiliation(s)
- Farima Dalaei
- Research Unit of Plastic SurgeryOdense University Hospital, University of Southern DenmarkOdenseDenmark
- OPEN, Odense Explorative Patient NetworkOdenseDenmark
| | - Claire E. E. de Vries
- Department of Surgery, OLVGAmsterdamNetherlands
- Department of Surgery, Brigham and Women's HospitalHarvard UniversityBostonMassachusettsUSA
| | - Lotte Poulsen
- Research Unit of Plastic SurgeryOdense University Hospital, University of Southern DenmarkOdenseDenmark
| | - Manraj N. Kaur
- Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - André Pfob
- University Breast Unit, Department of Obstetrics and GynecologyHeidelberg University HospitalHeidelbergBaden‐WürttembergGermany
| | - Danny Mou
- Department of General SurgeryBrigham and Women's Hospital, Harvard UniversityBostonMassachusettsUSA
| | - Amalie L. Jacobsen
- Department of Plastic SurgeryOdense University Hospital, University of Southern DenmarkOdenseDenmark
| | - Jussi P. Repo
- Unit of Musculoskeletal Surgery, Department of Orthopedics and TraumatologyTampere University Hospital and University of TampereTampereFinland
| | - Rosa Salzillo
- Department of Plastic, Reconstructive and Aesthetic SurgeryCampus Bio‐Medico University of RomeRomeItaly
| | - Jakub Opyrchal
- Department of Plastic SurgeryT. Marciniaka Specialized HospitalWroclawPoland
| | - Anne F. Klassen
- Department of PediatricsMcMaster UniversityHamiltonOntarioCanada
| | - Jens Ahm Sørensen
- Research Unit of Plastic SurgeryOdense University Hospital, University of Southern DenmarkOdenseDenmark
| | - Andrea L. Pusic
- Department of Surgery, Brigham and Women's HospitalHarvard UniversityBostonMassachusettsUSA
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Jacobsen AL, DeVries CEE, Poulsen L, Mou D, Klassen AF, Pusic AL, Makarawung DJS, Wiezer MJ, van Veen RN, Sørensen JA. The impact of body mass index (BMI) on satisfaction with work life: An international BODY-Q study. Clin Obes 2022; 12:e12527. [PMID: 35575285 PMCID: PMC9539700 DOI: 10.1111/cob.12527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/07/2022] [Accepted: 04/11/2022] [Indexed: 12/05/2022]
Abstract
Obesity is a global health issue known to have a major influence on health-related quality of life (HR-QOL). HR-QOL is a concept evaluating physical and psychological health. Work life can impact HR-QOL in people with obesity. The aim of this study was to measure the association between body mass index (BMI) and satisfaction with work life. This study included participants from an international multicenter field-test study of BODY-Q scales. Recruitment took place at hospitals in Denmark, The Netherlands and USA between June 2019 and January 2020. The BODY-Q Work Life scale was used to measure work life satisfaction. The difference between BMI groups and work life satisfaction was examined using one-way analysis of variance. Multivariable linear regression analysis was used to examine the association between BMI and work life satisfaction, adjusted for significant confounders. Of 4123 participants, 2515 completed the BODY-Q Work Life scale. BMI groups showed significant difference in work life satisfaction (p < .0001). The Work Life scale mean score was 77.6 for the normal BMI group, 78.5 for the overweight group and 75.0, 68.9 and 63.8 for Class 1, 2 and 3 obesity, respectively. Furthermore, BMI was significantly associated with satisfaction with work life (adjusted regression coefficient -.962, p < .0001). Higher BMI was associated with lower work life satisfaction. This finding suggests that a reduction in BMI may have a positive influence on work life satisfaction in people with obesity.
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Affiliation(s)
- Amalie L. Jacobsen
- Research Unit for Plastic SurgeryOdense University HospitalOdenseDenmark
- OPEN, Open Patient data Explorative NetworkOdense University HospitalOdenseDenmark
| | - Claire E. E. DeVries
- Department of SurgeryBrigham and Women's HospitalBostonMassachusettsUSA
- Department of SurgeryOLVG WestAmsterdamThe Netherlands
| | - Lotte Poulsen
- Research Unit for Plastic SurgeryOdense University HospitalOdenseDenmark
- OPEN, Open Patient data Explorative NetworkOdense University HospitalOdenseDenmark
| | - Danny Mou
- Department of SurgeryBrigham and Women's HospitalBostonMassachusettsUSA
| | - Anne F. Klassen
- Department of PediatricsMcMaster UniversityHamiltonOntarioCanada
| | - Andrea L. Pusic
- Department of SurgeryBrigham and Women's HospitalBostonMassachusettsUSA
| | | | | | | | - Jens A. Sørensen
- Research Unit for Plastic SurgeryOdense University HospitalOdenseDenmark
- Department of Plastic SurgeryUniversity of Southern DenmarkOdenseDenmark
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Makarawung DJS, de Vries CEE, List EB, Monpellier VM, Mou D, Klassen AF, Pusic AL, van Veen RN, Mink van der Molen AB. Patient-Level Factors Associated with Health-Related Quality of Life and Satisfaction with Body After Bariatric Surgery: a Multicenter, Cross-Sectional Study. Obes Surg 2022; 32:3079-3087. [PMID: 35859022 DOI: 10.1007/s11695-022-06214-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Health-Related Quality of Life (HRQL) is a key outcome of success after bariatric surgery. Not all patients report improved HRQL scores postoperatively, which may be due to patient-level factors. It is unknown which factors influence HRQL after surgery. Our objective was to assess patient-level factors associated with HRQL after surgery. METHODS This international cross-sectional study included 730 patients who had bariatric surgery. Participants completed BODY-Q scales pertaining to HRQL and satisfaction with body, and demographic characteristics were obtained. The sample was divided into three groups based on time since surgery: 0 - 1 year, 1 - 3 years and more than 3 years. Uni- and multivariable linear regression analyses were conducted to identify variables associated with the BODY-Q scales per group. RESULTS The 0 - 1 year postoperative group included 377 patients (50.9%), the 1 - 3 years postoperative group 218 (29.4%) and the more than 3 years postoperative group 135 patients (18.2%). Lower current body-mass index (BMI), more weight loss (%TWL), being employed, having no comorbidities, higher age and shorter time since surgery were significantly associated with improved HRQL outcomes postoperatively. None of these factors influenced all BODY-Q scales. The effect of current BMI increased with longer time since surgery. CONCLUSION Factors including current BMI, %TWL, employment status, presence of comorbidities, age and time since surgery were associated with HRQL postoperatively. This information may be used to optimize patient-tailored care, improve patient education and underline the importance of long-term follow-up with special attention to weight regain to ensure lasting improvement in HRQL.
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Affiliation(s)
- Dennis J S Makarawung
- Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, the Netherlands.
- Department of Plastic Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, the Netherlands.
| | - Claire E E de Vries
- Department of Surgery, OLVG West, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands
- Department of Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Emile B List
- Department of Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Valerie M Monpellier
- Dutch Obesity Clinic (Nederlandse Obesitas Kliniek), Amersfoortseweg 43, 3712 BA, Huis Ter Heide, the Netherlands
| | - Danny Mou
- Department of Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Anne F Klassen
- Department of Pediatrics, McMaster University, 1200 Main St W, Hamilton, ON, L8N 3Z5, Canada
| | - Andrea L Pusic
- Department of Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Ruben N van Veen
- Department of Surgery, OLVG West, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands
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Abstract
ABSTRACT Brachioplasty has become one of the fastest-growing aesthetic surgery procedures, paralleling rising rates of weight loss surgery nationally. However, controversy persists regarding incision placement and utility of concurrent liposuction. In this article, the authors describe indications, patient selection, expected outcomes, and photographic standards for patients seeking brachioplasty after weight loss. Preoperative markings, scar placement, and operative steps of a posterior incision technique with or without concurrent liposuction if indicated are described. A personal experience with posterior incision brachioplasty along with current controversies, complications, and patient-reported outcomes after upper arm contouring are reviewed.
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Affiliation(s)
- Amanda R Sergesketter
- From the Division of Plastic, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, NC
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A Prospective, Matched Comparison of Health-Related Quality of Life in Bariatric Patients following Truncal Body Contouring. Plast Reconstr Surg 2022; 149:1338-1347. [PMID: 35383722 DOI: 10.1097/prs.0000000000009098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Massive weight loss after bariatric surgery can lead to excess skin associated with functional and aesthetic sequelae. Access to the benefit provided by body contouring procedures may be limited by insurance approval, which does not consider health-related quality of life. The aim of this study was to quantify the benefit in health-related quality of life for patients who undergo body contouring procedures after massive weight loss. METHODS Patients evaluated for postbariatric body contouring procedures were systematically identified and prospectively surveyed using the BODY-Q. Health-related quality-of-life change for each functional scale was compared between those who underwent body contouring procedures (operative group, preoperatively versus postoperatively) and those who did not (nonoperative group, preoperatively versus resurvey) using t tests. Propensity score matching allowed the authors to balance baseline demographics, comorbidities, physical symptoms, and risk factors between cohorts. RESULTS Fifty-seven matched patients were analyzed (34 operative versus 23 nonoperative). No significant difference in age, body mass index, time between surveys, or preoperative BODY-Q scores existed between cohorts. The surgical group demonstrated a significant improvement in 10 out of 11 BODY-Q functional scales. The nonoperative group realized no improvements and, in the interim, had a significant deterioration in four BODY-Q scales. CONCLUSIONS Postbariatric body contouring procedures represent a critical and final step in the surgical weight loss journey for patients and are associated with significant improvements in health-related quality of life. Further deterioration in psychosocial and sexual health-related quality of life occurs in patients who do not undergo body contouring procedures following bariatric surgery. This study provides prospective comparative data that validate the field's standard intervention and justification for insurance approval. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, II.
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Aitzetmüller MM, Raschke L, Klietz ML, Kueckelhaus M, Hirsch T, Wiebringhaus P, Harati K. After weight loss, what skin removal procedure has the most effect using Body Q metrics? Surg Obes Relat Dis 2022; 18:1049-1056. [DOI: 10.1016/j.soard.2022.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/10/2022] [Accepted: 04/22/2022] [Indexed: 10/18/2022]
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Outcomes of Combined Liposuction/Laser Skin Tightening versus Open Suction-Assisted Brachioplasty in Moderate Arm Ptosis. Plast Reconstr Surg 2022; 149:881e-892e. [PMID: 35259140 DOI: 10.1097/prs.0000000000009058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Only a few studies have directly compared outcomes of different arm contouring techniques across matched cohorts of patients. In this study, the authors present preliminary data comparing outcomes of conventional open suction-assisted brachioplasty (using the Pascal and Le Louarn procedure) versus combined liposuction/laser skin tightening in (grade 2b arm ptosis per El Khatib classification). METHODS Thirty patients (60 arms) (28 women, two men) with moderate brachial ptosis (severe upper arm adiposity and a moderate degree of skin laxity) (grade 2b arm ptosis per El Khatib classification) were included. Objective and subjective measures were used in the assessment of results. RESULTS There were no statistically significant differences in objective measurements (arm circumference reduction ratio and percentage of ptosis elimination) between the groups. Patient satisfaction scores were higher with liposuction/laser skin tightening and found to be statistically significant (p < 0.05). Patients in this latter cohort reported less pain and earlier return to work (mean less than a week) (p < 0.05). Four patients complained of residual ptosis in each group. CONCLUSIONS Liposuction/laser skin tightening is a safe and effective alternative to open suction-assisted brachioplasty (using the Pascal and Le Louarn technique) in patients with severe arm adiposity and moderate brachial ptosis (grade 2b arm ptosis as described by El Khatib classification). Proper patient selection remains critical for the success of this treatment strategy and requires precise clinical analysis as described. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, II.
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Wright C, Kelly JT, Healy R, Musial J, Campbell KL, Hamilton K. Lived experiences and unique psychosocial impacts following bariatric surgery in a publicly funded Australian tertiary hospital: a qualitative study. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2022. [DOI: 10.1080/00049530.2022.2046445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Charlene Wright
- School of Medicine and Dentistry, Centre of Applied Health Economics and Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Jaimon T. Kelly
- School of Medicine and Dentistry, Centre of Applied Health Economics and Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- Centre for Online Health, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
| | - Rebecca Healy
- Nutrition and Dietetics Department, Royal Brisbane and Women’s Hospital, Herston, QLD, Australia
| | - Jane Musial
- Nutrition and Dietetics Department, Royal Brisbane and Women’s Hospital, Herston, QLD, Australia
| | - Katrina L. Campbell
- School of Medicine and Dentistry, Centre of Applied Health Economics and Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- Healthcare Excellence and Innovation, Metro North Hospital and Health Service, Herston, QLD, Australia
| | - Kyra Hamilton
- School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- Health Sciences Research Institute, University of California, Merced, CA, USA
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de Vries CEE, Makarawung DJS, Monpellier VM, Janssen IMC, de Castro SMM, van Veen RN. Is the RAND-36 an Adequate Patient-reported Outcome Measure to Assess Health-related Quality of Life in Patients Undergoing Bariatric Surgery? Obes Surg 2022; 32:48-54. [PMID: 34729711 PMCID: PMC8752557 DOI: 10.1007/s11695-021-05736-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/06/2022]
Abstract
PURPOSE The RAND-36 is the most frequently used patient-reported outcome measure (PROM) to evaluate health-related quality of life (HRQoL) in bariatric surgery. However, the RAND-36 has never been adequately validated in bariatric surgery. The purpose of this study was to validate the RAND-36 in Dutch patients undergoing bariatric surgery. MATERIAL AND METHODS To validate the RAND-36, the following measurement properties were assessed in bariatric surgery patients: validity (the degree to which the RAND-36 measures what it purports to measure (HRQoL)), reliability (the extent to which the scores of the RAND-36 are the same for repeated measurement for patients who have not changed in HRQoL), responsiveness (the ability of the RAND-36 to detect changes in HRQoL over time). RESULTS Two thousand one hundred thirty-seven patients were included. Validity was not adequate due to the irrelevance of some items and response options, the lack of items relevant to patients undergoing bariatric surgery, and the RAND-36 did not actually measure what it was intended to measure in this study (HRQoL in bariatric surgery patients). Reliability was insufficient for the majority of the scales (the scores of patients who had not changed in HRQoL were different when the RAND was completed a second time (intraclass correlation coefficient (ICC) values 0.10-0.69)). Responsiveness was insufficient. CONCLUSION The RAND-36 was not supported by sufficient validation evidence in patients undergoing bariatric surgery, which means that the RAND-36 does not adequately measure HRQoL in this patient population. Future research studies should use PROMs that are specifically designed for assessing HRQoL in patients undergoing bariatric surgery.
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Affiliation(s)
- Claire E E de Vries
- Department of Surgery, Obesity Center Amsterdam, OLVG West, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands.
| | - Dennis J S Makarawung
- Nederlandse Obesitas Kliniek (Dutch Obesity Clinic), Amersfoortseweg 43, 3712, Huis Ter Heide, the Netherlands
| | - Valerie M Monpellier
- Nederlandse Obesitas Kliniek (Dutch Obesity Clinic), Amersfoortseweg 43, 3712, Huis Ter Heide, the Netherlands
| | - Ignace M C Janssen
- Nederlandse Obesitas Kliniek (Dutch Obesity Clinic), Amersfoortseweg 43, 3712, Huis Ter Heide, the Netherlands
| | - Steve M M de Castro
- Department of Surgery, Obesity Center Amsterdam, OLVG West, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands
| | - Ruben N van Veen
- Department of Surgery, Obesity Center Amsterdam, OLVG West, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands
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Dobbs TD, Harrison CJ, Ottenhof MJ, Gibson JAG, Matin RN, Rodrigues JN, Hutchings HA, Whitaker IS. Construct validity of the anglicised FACE-Q skin cancer module. J Plast Reconstr Aesthet Surg 2021; 75:1644-1652. [PMID: 34955401 DOI: 10.1016/j.bjps.2021.11.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 11/14/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The FACE-Q Skin Cancer module is a patient-reported outcome measure (PROM) for facial skin cancer. It has been anglicised for the UK population and undergone psychometric testing using classical test theory. In this study, further evaluation of construct validity using Rasch measurement theory and hypothesis testing was performed. METHODS Patients were prospectively recruited to the Patient-Reported Outcome Measures In Skin Cancer Reconstruction (PROMISCR) study and asked to complete the anglicised FACE-Q Skin Cancer module. The scalability and unidimensionality of the data were assessed with a Mokken analysis prior to Rasch analysis. Response thresholds, targeting, fit statistics, local dependency, and internal consistency were examined for all items and subscales. Four a priori hypotheses were tested to evaluate the convergent and divergent validity. We additionally hypothesised that the median 'cancer worry' score would be lower in post-operative than pre-operative patients. RESULTS 239 patients self-completed the questionnaire between August 2017 and May 2019. Of the ten subscales assessed, five showed relative fit to the Rasch model. Unidimensionality was present for all five subscales, with most demonstrating ordered item thresholds and appropriate fit statistics. Two items in the 'cancer worry' subscale had either disordered or very close response thresholds. Subscales of the FACE-Q Skin Cancer module demonstrated convergent and divergent validity with relevant Skin Cancer Index comparators (p < 0.001). Median 'cancer worry' was lower in post-operative patients (44 vs 39, p < 0.001). CONCLUSION The anglicised FACE-Q Skin Cancer module shows psychometric validity through hypothesis testing, and both classical and modern test theory.
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Affiliation(s)
- T D Dobbs
- Reconstructive Surgery & Regenerative Medicine Research Group, Institute Of Life Sciences, Swansea University Medical School, Swansea, UK; Welsh Centre for Burns and Plastics, Morriston Hospital, Swansea, UK.
| | - C J Harrison
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - M J Ottenhof
- Patient-Reported Outcomes, Value and Experience (PROVE) Centre, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA; Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - J A G Gibson
- Reconstructive Surgery & Regenerative Medicine Research Group, Institute Of Life Sciences, Swansea University Medical School, Swansea, UK; Welsh Centre for Burns and Plastics, Morriston Hospital, Swansea, UK
| | - R N Matin
- Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - J N Rodrigues
- Department of Plastic and Reconstructive Surgery, Stoke Mandeville Hospital, Aylesbury, UK
| | - H A Hutchings
- Patient & Population Health & Informatics Research Group, Institute of Life Sciences 2, Swansea University Medical School, Swansea, UK
| | - I S Whitaker
- Reconstructive Surgery & Regenerative Medicine Research Group, Institute Of Life Sciences, Swansea University Medical School, Swansea, UK; Welsh Centre for Burns and Plastics, Morriston Hospital, Swansea, UK
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Christopher AN, Morris MP, Patel V, Broach RB, Fischer JP. Abdominal Body Contouring: Does Body Mass Index Affect Clinical and Patient Reported Outcomes? J Surg Res 2021; 270:348-358. [PMID: 34731733 DOI: 10.1016/j.jss.2021.09.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 08/01/2021] [Accepted: 09/09/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Obese individuals are thought to be higher risk for complications after excisional abdominal body contouring (EAC) due to co-morbidities and significant tissue resection. OBJECTIVES We comparatively analyzed EAC patients with Body Mass Index (BMI) ≥35 kg/m2 and BMI <35 kg/m2 to highlight key differences in clinical and patient-reported-outcomes (PROs). METHODS Patients ≥18 years-old undergoing EAC by a single surgeon from 01/2018-01/2020 were identified and separated into cohorts based on BMI (<35 and ≥35 kg/m2). Patients were excluded if they had a cosmetic abdominoplasty without history of bariatric surgery or massive weight loss, or if they had <1000 gs of tissue resected. Clinical outcomes and PROs using the BODY-Q were comparatively analyzed. RESULTS 70 total patients with median BMIs of 30[26-32] and 41[37-45] kg/m2 in each cohort, were identified. Patients with BMI ≥35 kg/m2 were more likely to have higher ASA (P<0.01) and use of incisional negative pressure wound devices (P = 0.042). Alternatively, they were less likely to have had concurrent liposuction (P = 0.05). There were no differences in development of an SSO, SSI or SSOpi (P>0.05) between cohorts. Multivariate logistic regression showed that BMI ≥35 kg/m2, iNPWD and liposuction were not associated with the development of complications. PROs demonstrated improvement in multiple domains despite BMI. CONCLUSION There was no association with BMI ≥35 kg/m2 and the development of complications within our cohort. We encourage preoperative weight loss when possible, however these procedures can be performed safely with acceptable outcomes even in individuals who are obese and/or require extensive tissue removal.
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Affiliation(s)
- Adrienne N Christopher
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania. Philadelphia, PA; Department of Surgery. Thomas Jefferson University. Philadelphia, PA.
| | - Martin P Morris
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania. Philadelphia, PA
| | - Viren Patel
- Perelman School of Medicine, University of Pennsylvania. Philadelphia, PA
| | - Robyn B Broach
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania. Philadelphia, PA
| | - John P Fischer
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania. Philadelphia, PA.
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Donor Site Morbidity in Unilateral and Bilateral Transverse Musculocutaneous Gracilis (TMG) Flap Breast Reconstruction: Sensation, Function, Aesthesis and Patient-Reported Outcomes. J Clin Med 2021; 10:jcm10215066. [PMID: 34768585 PMCID: PMC8584688 DOI: 10.3390/jcm10215066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/23/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022] Open
Abstract
The transverse musculocutaneous gracilis (TMG) flap has become a popular choice for breast reconstruction. This study aimed to compare the donor site morbidity in unilateral and bilateral procedures. Patients receiving a TMG flap (January 2008–October 2019) were invited to a follow-up and grouped according to unilateral (UL group) or bilateral (BL group) breast reconstruction. Outcome criteria included sensation, function and aesthesis of the thighs. Patient-reported outcomes were surveyed using validated questionnaires. The number and kind of refinement procedures for aesthetic purposes on the donor thighs were evaluated. Thirty-eight patients with 59 TMG flaps were included in the study (UL group: n = 17, BL group: n = 21). Normal to slightly diminished superficial skin sensation was maintained in most of the thigh skin (98.4%). Strength and mobility were without impairment in >80% of the thighs in both groups. Thigh symmetry was achieved in both groups. Symmetrisation procedures were significantly more often performed in the UL group (p = 0.005). The total number of refinement procedures was similar in both groups. Patient-reported outcomes were similar with good appearance of the thighs and scars, excellent function and low pain levels. The TMG flap offers excellent function and sensation on the donor thigh. Thigh symmetry and good patient satisfaction may be achieved in both unilateral and bilateral breast reconstructions.
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A Comparative Analysis of Fleur-de-Lis and Traditional Panniculectomy after Bariatric Surgery. Aesthetic Plast Surg 2021; 45:2208-2219. [PMID: 33544187 DOI: 10.1007/s00266-021-02149-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/17/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The Fleur-de-Lis panniculectomy (FdL) adds a vertical component to correct complex contour deformities after massive weight loss by addressing supra-umbilical horizontal skin excess which is not addressed with infra-umbilical transverse panniculectomy (TP). We aim to perform a head-to-head comparison of clinical outcomes and patient reported outcomes (PROs) between FdL and TP. METHODS A retrospective review of patients ≥18 with a history of bariatric surgery undergoing FdL or TP by a single plastic surgeon between 07/01/2015 and 05/31/2020 was conducted. Surgical site occurrences (SSOs) including surgical site infection (SSI), delayed healing, cellulitis, seroma, hematoma, surgical site occurrences requiring procedural intervention (SSOpi), and a composite of other postoperative outcomes were assessed. In addition, patient satisfaction was analyzed using the Body-Q questionnaire across 12 domains. RESULTS The analysis included 56 patients; 26 and 30 patients who were treated with FdL and TP, respectively. Cohorts were statistically similar in terms of age, gender, BMI, and co-morbid conditions. The overall complication rate was 50% (FdL n = 14 (53.9%), TP n = 14 (46.7%); p = 0.592). On multivariate analysis, pannus weight was associated with the development of SSO (p = 0.04). FdL incision, however, was not an independent risk factor for adverse outcomes. Absolute improvement in PROs was similar in both cohorts across multiple domains. CONCLUSION FdL showed a comparable safety and efficacy profile to TP when performed in post-bariatric surgery patients, with equivalent improvement in PROs across multiple domains. Preoperative weight loss should be encouraged in this population as pannus weight is an independent risk factor for complications. LEVEL OF EVIDENCE 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 .
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Chao GF, Bonham AJ, Stricklen AJ, Ross R, Ghaferi AA. Association Between Validated Psychometric Scales and Follow-up Rates After Bariatric Surgery. Obes Surg 2021; 31:5092-5095. [PMID: 34494231 DOI: 10.1007/s11695-021-05705-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Grace F Chao
- National Clinician Scholars Program, University of Michigan, 2800 Plymouth Road, Building 14, Room G100, Ann Arbor, MI, 48109, USA. .,Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA. .,Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
| | - Aaron J Bonham
- Michigan Bariatric Surgery Collaborative, Ann Arbor, MI, USA.,Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | | | - Rachel Ross
- Michigan Bariatric Surgery Collaborative, Ann Arbor, MI, USA
| | - Amir A Ghaferi
- Michigan Bariatric Surgery Collaborative, Ann Arbor, MI, USA.,Department of Surgery, University of Michigan, Ann Arbor, MI, USA.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
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Bennett BL, Grilo CM, Alperovich M, Ivezaj V. Body Image Concerns and Associated Impairment Among Adults Seeking Body Contouring Following Bariatric Surgery. Aesthet Surg J 2021; 42:275-282. [PMID: 34463702 PMCID: PMC8845003 DOI: 10.1093/asj/sjab327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The current study examined a range of body image concerns and associated distress and impairment in patients who have undergone bariatric surgery and are seeking subsequent body contouring surgery. OBJECTIVES The aim of this study was to investigate the hypotheses that individuals seeking body contouring endorse a broad pattern of body image concerns and that overall body image concern is associated with greater impairment and disability. METHODS The participants were 56 adults seeking body contouring surgery after bariatric surgery. All participants completed a self-report questionnaire designed for the present study to assess body image concerns specific to patients who have undergone bariatric surgery and a battery of established measures of disability, impairment, and eating-disorder psychopathology. RESULTS The most commonly endorsed concerns were related to loose skin (body dissatisfaction, feeling embarrassed in public, and skin rashes) whereas the least endorsed items included concerns related to scars from bariatric surgery (body dissatisfaction, avoidance of social situations, and difficulty concentrating). Participants endorsed a broad pattern of frequent distress and impairment related to physical body image changes post-bariatric surgery. Greater body image concerns were associated significantly with higher levels of disability, work-related impairment, and eating-disorder psychopathology. CONCLUSIONS Patients seeking body contouring surgery reported a range of body image concerns with significant associated distress, disability, and impairment related to physical changes post-bariatric surgery. The present findings underscore that although bariatric surgery is effective for reducing weight and metabolic disturbances, additional interventions for addressing body image concerns that are frequently distressing and impairing may be needed.
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Affiliation(s)
- Brooke L Bennett
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Michael Alperovich
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Valentina Ivezaj
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Corresponding Author: Dr Valentina Ivezaj, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA. E-mail: ; Twitter: @bbennettphd
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Dutton GR, Kinsey AW, Howell CR, Pisu M, Dobelstein AE, Allison DB, Xun P, Levitsky DA, Fontaine K. The daily Self-Weighing for Obesity Management in Primary Care Study: Rationale, design and methodology. Contemp Clin Trials 2021; 107:106463. [PMID: 34082075 PMCID: PMC8429187 DOI: 10.1016/j.cct.2021.106463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/18/2021] [Accepted: 05/28/2021] [Indexed: 11/17/2022]
Abstract
Background Daily self-weighing (DSW) may be an effective harm-reduction intervention to disrupt continued weight gain. Self-Weighing for Obesity Management in Primary Care (SWOP) is a 24-month randomized controlled trial in 400 adults with obesity (BMI: kg/m2 ≥ 30) receiving primary care through a clinical network affiliated with an academic medical center. Objective To test DSW as a potentially scalable way to deter age-related weight gain among primary care patients with obesity. Methods Randomized-controlled trial with two conditions: DSW (instruction to weigh daily and provision of a web-enabled digital scale with graphical weight feedback) or Standard Care (receive a monetary gift card equivalent to value of the scale). Both groups receive standardized weight management educational material. SWOP will test the causal effect of assignment to DSW (Aim 1) and adherence to DSW (Aim 2) on weight (primary outcome) and adoption of weight management practices (secondary outcomes), as well as evaluate the cost-effectiveness of DSW compared to standard care (Aim 3). Findings may inform clinical guidelines for weight management by providing evidence that DSW attenuates continued age-related weight gain among adults with obesity. This trial is registered with ClinicalTrials.gov (NCT04044794).
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Affiliation(s)
- Gareth R Dutton
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Amber W Kinsey
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Carrie R Howell
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Maria Pisu
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Amy E Dobelstein
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - David B Allison
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University-Bloomington, 1025 E. 7th Street, Bloomington, IN 47405, USA.
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University-Bloomington, 1025 E. 7th Street, Bloomington, IN 47405, USA
| | - David A Levitsky
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, 244 Garden Ave, Ithaca, NY 14853, USA.
| | - Kevin Fontaine
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35233, USA.
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Bravo FG. Invited Discussion on: Quality of Life and Concurrent Procedures in Truncal Body Contouring Patients: A Single-Center Retrospective Study. Aesthetic Plast Surg 2021; 45:1628-1632. [PMID: 33693982 DOI: 10.1007/s00266-021-02192-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/13/2021] [Indexed: 01/19/2023]
Affiliation(s)
- Francisco G Bravo
- Private Practice, Clinica Gomez Bravo, c/Claudio Coello 76, 28001, Madrid, Spain.
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