Gmür Roger U, Banic Andrej, Erni Dominique
Division of Plastic Surgery, Inselspital, University Hospital Bern, Switzerland.
Ann Plast Surg. 2003 Oct;51(4):353-7. doi: 10.1097/01.SAP.0000070644.58346.4A.
The development of sophisticated bariatric surgery techniques has led to an increasing number of patients demanding a complexity of body contouring procedures that can be achieved either with a step-by-step approach or by combining dermolipectomy in various regions. The aim of this study was to test the hypothesis that abdominoplasty-related morbidity and outcome may be worsened by combining abdominoplasty with other dermolipectomies and to determine whether any predictive risk factor could be identified. Seventy-three consecutive patients undergoing abdominoplasty with (n = 26) and without (n = 47) additional dermolipectomy on the upper arms, inner thighs, breasts, and buttocks were included in this study. Additional dermolipectomies did not increase abdominoplasty-related morbidity but revealed better long-term results (p = 0.10). Statistically significant risk factors were male sex, age (>41 years), overweight (BMI > 30), prolonged operations (>3 hours), and extensive blood loss (1,000 mL). Most importantly, better outcome was obtained in patients whose weight reduction was greater (p = 0.04). The authors' results suggest that combined dermolipectomy procedures can be advocated in patients who have reached their intended level of weight reduction and if prolonged operative time and excessive blood loss are avoided.
先进的减肥手术技术的发展导致越来越多的患者要求进行复杂的身体塑形手术，这些手术可以通过逐步的方法或通过在不同区域联合皮肤切除术来实现。本研究的目的是检验以下假设：将腹壁成形术与其他皮肤切除术联合进行可能会使腹壁成形术相关的发病率和结果恶化，并确定是否可以识别出任何预测性风险因素。本研究纳入了73例连续接受腹壁成形术的患者，其中26例在上臂、大腿内侧、乳房和臀部进行了额外的皮肤切除术，47例未进行额外的皮肤切除术。额外的皮肤切除术并没有增加腹壁成形术相关的发病率，但显示出更好的长期效果（p = 0.10）。具有统计学意义的风险因素为男性、年龄（>41岁）、超重（BMI>30）、手术时间延长（>3小时）和大量失血（1000 mL）。最重要的是，体重减轻更多的患者获得了更好的结果（p = 0.04）。作者的结果表明，对于已经达到预期体重减轻水平且避免了手术时间延长和失血过多的患者，可以提倡联合皮肤切除术。
