Hospital of St. John of God (Barmherzige Brüder) Salzburg, Department of Plastic, Aesthetic and Reconstructive Surgery, Paracelsus Medical University, Kajetanerplatz 1, 5020, Salzburg, Austria.
Research Office - Biostatistics, Paracelsus Medical University, Salzburg, Austria.
Obes Surg. 2018 Oct;28(10):3253-3258. doi: 10.1007/s11695-018-3337-2.
Abdominoplasty is a common procedure in postbariatric surgery. Over the years, a high number of technical refinements of the procedure have been established to improve safety and reduce associated complications. Nevertheless, the complication rate is high. The purpose of this study was to examine the incidence of postoperative complications in patients undergoing abdominoplasty in association with prolonged postoperative immobilization.
Retrospective analysis of 82 patients who underwent abdominoplasty was performed. Patients were divided in two study groups regarding their immobilization period. Group 1 included patients with an immobilization period defined as strict bed rest for at least 45 h after surgery. Group 2 included all patients with shorter immobilization time, but earliest mobilization in the evening on the day of surgery.
Overall, complication rate was 27%. Major complications were observed in 15% in group 1 and in 23% in group 2. Hematoma requiring surgical revision was observed in 5% in group 1 and in 14% in group 2. Surgical revisions within the first 60 days were necessary in 5% in group 1 and in 20% in group 2.
Prolonged immobilization after abdominoplasty does not crucially lower the overall complication rate, but influences the severity of complications in a positive way. Increasing the duration of postoperative immobilization up to 45 h after abdominoplasty significantly decreases the reoperation rate in our practice. The risk for a surgical revision is nearly four times higher if the patient leaves bed earlier. Surgeons should consider this option especially in patients with a high risk for complication development.
腹部整形术是减肥手术后的常见手术。多年来，该手术的技术改进数量众多，旨在提高安全性并降低相关并发症。尽管如此，并发症发生率仍然很高。本研究的目的是研究在腹部整形术患者中延长术后固定时间与术后并发症发生率的关系。
对 82 例行腹部整形术的患者进行回顾性分析。根据固定时间，将患者分为两组。第 1 组患者的固定时间定义为术后至少严格卧床休息 45 小时。第 2 组患者为固定时间较短，但最早在手术当天晚上就开始活动。
总体并发症发生率为 27%。第 1 组的主要并发症发生率为 15%，第 2 组为 23%。第 1 组血肿需要手术修复的发生率为 5%，第 2 组为 14%。第 1 组在第 60 天内需要手术修复的比例为 5%，第 2 组为 20%。
腹部整形术后长时间固定并不能显著降低总体并发症发生率，但会以积极的方式影响并发症的严重程度。在腹部整形术后将固定时间延长至 45 小时以上，显著降低了我们实践中的再次手术率。如果患者提前离床，手术修正的风险增加近四倍。对于那些有高并发症风险的患者，外科医生应该考虑这种选择。
