Philadelphia, Pa. From the Division of Plastic Surgery, Hospital of the University of Pennsylvania.
Plast Reconstr Surg. 2013 Dec;132(6):1411-1420. doi: 10.1097/PRS.0b013e3182a806b3.
The purpose of this study was to examine the incidence and predictors of surgical and medical morbidity following body contouring procedures.
The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2010 for all identifiable body contouring cases including Current Procedural Terminology codes for brachioplasty, medial thigh lift, abdominoplasty, and suction-assisted lipectomy. Independent predictors of morbidity were determined.
A total of 1797 patients underwent body contouring during the study period, and most were female (n = 1600; 89.0 percent). The average body mass index was 31.6 kg/m, and 239 were morbidly obese (body mass index ≥ 40 kg/m). The most common area of intervention was the trunk region, with 1652 patients (91.9 percent) receiving abdominal contouring and/or contouring of the hips and buttocks. Minor wound complications occurred in 114 individuals (6.3 percent), 122 patients (6.8 percent) suffered a major surgical morbidity, and 40 (2.2 percent) experienced a medical complication. Multiple comorbidities (OR, 15.87; p = 0.014), presence of bleeding disorder (OR, 20.31; p = 0.026), preoperative albumin level (OR, 0.14; p = 0.003), and malnutrition (OR, 0.19; p = 0.065) were associated with an increased odds of minor wound complications. Inpatient procedures (OR, 4.64; p = 0.06) and functional status (OR, 9.71; p = 0.011) were associated with an increased odds of major surgical morbidity.
This study characterizes the 30-day morbidity rates in patients undergoing body contouring procedures using a large, prospective, validated national data set, highlighting the critical importance of careful preoperative patient evaluation and underscoring the need for detailed preoperative counseling and risk stratification.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
本研究旨在探讨身体塑形手术后手术和医疗并发症的发生率和预测因素。
作者回顾了美国外科医师学会国家手术质量改进计划数据库，该数据库涵盖了 2005 年至 2010 年间所有可识别的身体塑形病例，包括 brachioplasty、medial thigh lift、abdominoplasty 和 suction-assisted lipectomy 的现行程序术语代码。确定了发病率的独立预测因素。
研究期间共有 1797 例患者接受了身体塑形，其中大多数为女性（n=1600；89.0%）。平均 BMI 为 31.6kg/m，239 例为病态肥胖（BMI≥40kg/m）。干预最常见的部位是躯干区域，有 1652 例患者（91.9%）接受腹部整形和/或臀部和臀部塑形。114 例（6.3%）出现轻微伤口并发症，122 例（6.8%）发生重大手术并发症，40 例（2.2%）发生医疗并发症。多种合并症（OR，15.87；p=0.014）、存在出血性疾病（OR，20.31；p=0.026）、术前白蛋白水平（OR，0.14；p=0.003）和营养不良（OR，0.19；p=0.065）与轻微伤口并发症的风险增加相关。住院治疗（OR，4.64；p=0.06）和功能状态（OR，9.71；p=0.011）与重大手术并发症的风险增加相关。
本研究使用大型、前瞻性、验证过的全国性数据，对接受身体塑形手术的患者 30 天内的发病率进行了描述，强调了仔细的术前患者评估的重要性，并强调了详细的术前咨询和风险分层的必要性。
临床问题/证据水平：风险，III 级。
