Histological Skin Assessment of Patients Submitted to Bariatric Surgery: A Prospective Longitudinal Cohort Study.
Obes Surg 2023;
33:836-845. [PMID:
36627534 DOI:
10.1007/s11695-023-06453-1]
[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: 06/11/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/12/2023]
Abstract
BACKGROUND
Obesity is a stigmatizing disease that can cause dermatological aberrations, such as sagging after rapid weight loss.
OBJECTIVE
This study is to evaluate the effects of obesity and massive weight loss following bariatric surgery on collagen and elastic fibers of the extracellular matrix of the skin.
METHODS
Thirty-three skin biopsies were collected from patients prior to bariatric surgery and one year after surgery. Histological analyses were performed using hematoxylin-eosin and Weigert's resorcin-fuchsin staining for collagen and elastic and elaunin fibers, respectively. Differences between means were submitted to the Student's t-test or Mann-Whitney U test, with p < 0.05 significant.
RESULTS
The study demonstrated an architectural alteration of the skin 1 year after bariatric surgery. In the histological analysis of the skin samples, a significant difference in the thickness of the epidermis was found 1 year after surgery in all age groups as well as in the 38-to-68-kg weight loss group (p < 0.0001). In addition to laxity, disorganization of collagen was found, with an apparent decrease in quantity and an increase in elastic fibers, although fragmented (p < 0.0001).
CONCLUSION
Obesity and massive weight loss following bariatric surgery cause the disorganization of collagen fibers and the fragmentation of elastic fibers of the extracellular matrix of the skin.
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