Zuelzer Helen B, Ratliff Catherine R, Drake David B
Department of Plastic and Maxillofacial Surgery, University of Virginia, Charlottesville, VA 22908, USA.
Ann Plast Surg. 2010 May;64(5):598-604. doi: 10.1097/SAP.0b013e3181cf9f9e.
Medical records of 122 patients who underwent an abdominoplasty or panniculectomy from 2003 to 2008 were reviewed to determine current rates of wound complications associated with these procedures in the presence of obesity. An additional aim was to determine current rates of complications as compared with those found 10 years ago at our institution to determine if the finding of obesity alone continues to adversely affect wound outcomes. Sixty-three of 122 patients (51.6%) experienced 1 or more wound-related complications. Major complications occurred in 13 patients (10.7%). A striking finding was that the lowest major complication rate 4.5%, was found in patients with extreme obesity (BMI >40). Comparisons between the 1999 and current studies found that the difference in major complications in those classified as obese, with 2 (9%) in the current study and 8 (40%) in the 1999 study, was significant (P = 0.039). Our findings suggest that high rates of major complications found in those with obesity in the 1999 study are not found today. Extreme obesity is not an absolute contraindication to operation and may be performed safely.
回顾了2003年至2008年间接受腹部整形术或腹壁成形术的122例患者的病历,以确定在肥胖情况下这些手术相关伤口并发症的当前发生率。另一个目的是确定与10年前在我们机构发现的并发症发生率相比的当前发生率,以确定仅肥胖这一因素是否继续对伤口愈合结果产生不利影响。122例患者中有63例(51.6%)出现了1种或更多与伤口相关的并发症。13例患者(10.7%)发生了严重并发症。一个显著的发现是,极端肥胖患者(BMI>40)的严重并发症发生率最低,为4.5%。1999年的研究与当前研究的比较发现,在分类为肥胖的患者中,严重并发症的差异具有统计学意义(P = 0.039),当前研究中有2例(9%),1999年研究中有8例(40%)。我们的研究结果表明,1999年研究中肥胖患者出现的高严重并发症发生率如今并未出现。极端肥胖并非手术的绝对禁忌证,手术可以安全进行。