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Ziegler UE, Sakova P, Reith HB. [Abdominoplasties and Suppurative Hydradenitis (Acne inversa) in Patients after Massive Weight Loss]. Zentralbl Chir 2023. [PMID: 37473764 DOI: 10.1055/a-2109-3015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Post-bariatric surgical procedures in patients after massive weight loss (MWL) are often associated with elevated minor and major complications (17-55%). If there is additionally a long history of hydradenitis suppurativa (HS) in the lower abdomen and groin area, complications of infection can appear in all patients. Differentiated pre-, peri- and postoperative therapy regime is then indicated.From 2010 to 2021, a total of 12 (66.6% women, 33.3% men) consecutive patients underwent conventional (Pittsburg rating scale [PRS]: Grade 2) or fleur-de-lis abdominoplasty (PRS: Grade 3) after massive weight loss. All patients simultaneously suffered long term HS in the lower abdomen and groin area (Hurley classification Grade 2: n = 10, Grade 3: n = 2). The prevalence in our study was 1.09%.Postoperative minor and major complications (follow-up 12 months) are determined and correlated with risk factors (e.g. age, method of weight loss, nicotine abuse…).Mean age was 45.2 years (± 10.3), mean BMI pre-operative 33.24 kg/m2 (± 8.7), the mean decrease in BMI was 19.01 kg/m2 (± 5.9) and the maximum BMI before weight loss 52.25 kg/m2. The mean duration of the suppurative hydradenitis was 31.5 years and n = 2 (17.0%) had current medical therapy against this. All patients showed further locations of the HS in other parts of the body and 66.6% had had surgical procedures because of the HS. 42.0% had nicotine abuse. The mean operation time was 98 minutes and the mean resection weight was 2210 grams. The overall complication rate was n = 10 (83.0%), and the rate of major complications n = 8 (66.4%) with surgical intervention in full anaesthesia. No patient had an infected haematoma, abscess or acute bleeding in the first 24 hours postoperatively.The antibiotic regime prevented the expected soft tissue infection in all patients. Inspection of the abdomen and groin area 4 weeks before surgery is recommended, in order to start preoperative therapy for the HS.
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Affiliation(s)
- Ulrich Eugen Ziegler
- Plastische und Ästhetische Chirurgie, Robert-Bosch-Krankenhaus Klinik Charlottenhaus, Stuttgart, Deutschland
| | - Petronela Sakova
- Plastische und Ästhetische Chirurgie, Robert-Bosch-Krankenhaus Klinik Charlottenhaus, Stuttgart, Deutschland
| | - Hans Bernd Reith
- Allgemein-, Viszeralchirurgie und Proktologie, AGAPLESION DIAKONIE KLINIKEN KASSEL, Kassel, Deutschland
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Marouf A, Mortada H. Complications of Body Contouring Surgery in Postbariatric Patients: A Systematic Review and Meta-Analysis. Aesthetic Plast Surg 2021; 45:2810-2820. [PMID: 34018015 DOI: 10.1007/s00266-021-02315-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 04/13/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Obesity is a major global health problem. With an increasing number of bariatric surgeries, the need for body-contouring procedures has grown. These procedures are associated with multiple complications because of various patient characteristics and risk factors. OBJECTIVES In this study, we performed a systematic literature review of all the complications of postbariatric body contouring surgeries, as well as a meta-analysis to estimate the effects of body mass index (BMI) and the weight of the tissue resected during body contouring on the development of complications. METHODS We conducted a literature search of the PubMed and Cochrane databases in September 2020, using the MeSH terms plastic surgery, weight loss, and complications. Studies were included if they involved more than 35 postbariatric patients and reported postoperative complication rates and types. RESULTS In total, 561 articles were initially identified, and 25 studies were included after the final review. The overall weighted rate of postbariatric body contouring surgical complications in all studies was 31.5%. The most frequent complication from all regions of body contouring was seroma (weighted rate 12.7-13.9%). Regarding risk factors, analysis indicated that a BMI < 30 kg/m2 and low mean weight of resected tissue were associated with fewer complications. CONCLUSION Body contouring procedures are relatively safe. Although complications after contouring are common, most either resolve spontaneously or require minimal intervention. In body contouring after bariatric surgery, there is a 37% increased risk of developing complications if the BMI is ≥ 30 kg/[Formula: see text] before body contouring. A higher weight of resected tissue appears to be linked to a greater risk of 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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Affiliation(s)
- Azmi Marouf
- Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hatan Mortada
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
- Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia.
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Lo Torto F, Marcasciano M, Frattaroli JM, Kaciulyte J, Mori FLR, Redi U, Casella D, Cigna E, Ribuffo D. Quality Assessment of Online Information on Body Contouring Surgery in Postbariatric Patient. Aesthetic Plast Surg 2020; 44:839-846. [PMID: 31712871 DOI: 10.1007/s00266-019-01535-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 10/31/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Nowadays, we have to face the fact that the Web represents one of the most important sources of information for patients. Postbariatric patients in particular are usually very motivated, and they are enthusiastic users of the Web as a source of information on the different types of surgery they could undergo after their weight loss in order to reshape and remodel their body thus regaining physical and functional wellness and dignity. The aim of the study was to assess information on the four most commonly performed postbariatric procedures worldwide, tummy tuck, breast, arm and thigh lift, with the same scale. METHODS Google and Yahoo have been probed for the keywords "Post bariatric Mastopexy OR breast lift" and "Post bariatric abdominoplasty OR tummy tuck" and "Post bariatric brachioplasty OR arm lift" and "post bariatric thigh lift". The first 50 hits were included, and the quality of information was evaluated with the expanded EQIP scale. RESULTS There was a critical lack of information about qualitative risks and side-effect description, treatment of potential complications, alert signs for the patient and precautions that the patient may take. Moreover, there was poor information about the sequence of the medical procedure, quantitative benefits and risks and quality of life issues after the procedure, and often, there were no other sources of information. CONCLUSIONS Due to the poor and not reliable information offered by the Web, health professionals should seek for a good communication practice with their patients. LEVEL OF EVIDENCE V 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)
- Federico Lo Torto
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy.
| | - Marco Marcasciano
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy
| | - Jacopo M Frattaroli
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy
| | - Juste Kaciulyte
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy
| | - Francesco L R Mori
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy
| | - Ugo Redi
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy
| | - Donato Casella
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy
| | - Emanuele Cigna
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Università degli Studi di Pisa, Pisa, Italy
| | - Diego Ribuffo
- Department of Surgery "P.Valdoni", Unit of Plastic and Reconstructive Surgery, Policlinico Umberto I, Sapienza University of Rome, via Ettore Fieramosca 200, 00159, Rome, Italy
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Bjørklund G, Semenova Y, Pivina L, Costea DO. Follow-up after bariatric surgery: A review. Nutrition 2020; 78:110831. [PMID: 32544850 DOI: 10.1016/j.nut.2020.110831] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/20/2020] [Accepted: 03/22/2020] [Indexed: 12/11/2022]
Abstract
Bariatric surgery is becoming increasingly popular in the treatment of severely obese patients who failed to lose weight with the help of non-surgical interventions. Such patients are at increased risk for premature death, type 2 diabetes, high blood pressure, gallstones, coronary heart disease, dyslipidemia, some cancers, anxiety, depression, and degenerative joint disorders. Although bariatric surgery appears to be the most effective and durable treatment option for obesity, it is associated with a number of surgical and medical complications. These include a range of conditions, of which dumping syndrome and malnutrition due to malabsorption of vitamins and minerals are the most common. To achieve better surgery outcomes, a number of postsurgical strategies must be considered. The aim of this review was to describe possible complications, ailments, and important moments in the follow-up after bariatric surgery. Adequate lifelong monitoring is crucial for the achievement of long-lasting goals and reduction of post-bariatric complications.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Mo i Rana, Norway.
| | - Yuliya Semenova
- Semey Medical University, Semey, Kazakhstan; Council for Nutritional and Environmental Medicine Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
| | - Lyudmila Pivina
- Semey Medical University, Semey, Kazakhstan; Council for Nutritional and Environmental Medicine Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
| | - Daniel-Ovidiu Costea
- Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania; 1st Surgery Department, Constanta County Emergency Hospital, Constanta, Romania
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