Parvizi D, Friedl H, Wurzer P, Kamolz Lp, Lebo P, Tuca A, Rappl T, Wiedner M, Kuess K, Grohmann M, Koch H
Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria,
Obes Surg. 2015 Aug;25(8):1482-90. doi: 10.1007/s11695-014-1559-5.
As bariatric surgery becomes ever more popular, so does body-contouring surgery to eliminate excess skin after radical weight loss. To date, the literature has described a number of risk factors affecting the postoperative outcome. Our study aimed to define those factors more closely, focusing on abdominoplasty ("tummy tuck") patients who suffered intra- and postoperative complications.
The study collective included 205 patients over 5 years (2001-2006) who underwent dermolipectomy at our department. The mean follow-up was 5.94 years. Every abdominoplasty was performed under general anesthesia with intraoperative one-dose antibiotic. The analysis included a complete review of all medical records. Statistical analysis was performed with the R-2.5.0 Software for Windows.
The overall rate for major complications that required operative revision and/or antibiotics was 10.2 %, including 2.9 % cases of infections. Forty-one percent had minor complications, such as seromas, hematomas, wound healing problems, and wound dehiscences. The logistic regression models demonstrated that smoking combined with the age, a BMI higher than 30 kg/m(2), and the amount of removed tissue (measured in g) lead to significantly more wound healing problems in nearly all age groups. The probability of infections correlated with later drain removal.
Regardless of the amount of tissue removed, no main risk factor for complications could be identified. A complication-free course and good outcome can be best achieved with careful patient selection and preoperative planning.
随着减肥手术越来越受欢迎,用于消除大幅体重减轻后多余皮肤的身体塑形手术也日益普遍。迄今为止,文献中描述了一些影响术后结果的风险因素。我们的研究旨在更精确地界定这些因素,重点关注接受腹壁成形术(“腹部除皱术”)且出现术中及术后并发症的患者。
研究对象包括2001年至2006年这5年间在我们科室接受皮肤切除术的205例患者。平均随访时间为5.94年。每次腹壁成形术均在全身麻醉下进行,术中使用一剂抗生素。分析内容包括对所有病历的全面审查。使用适用于Windows的R - 2.5.0软件进行统计分析。
需要手术修复和/或使用抗生素的主要并发症总体发生率为10.2%,其中感染病例占2.9%。41%的患者出现轻微并发症,如血清肿、血肿、伤口愈合问题和伤口裂开。逻辑回归模型表明,吸烟加上年龄、体重指数高于30 kg/m²以及切除组织量(以克为单位)在几乎所有年龄组中都会导致明显更多的伤口愈合问题。感染概率与引流管拔除时间较晚相关。
无论切除组织量多少,均无法确定并发症的主要风险因素。通过仔细的患者选择和术前规划能够最好地实现无并发症过程和良好结果。