Department of Plastic and General Surgery Turku University Hospital, Turku, Finland; Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
J Plast Reconstr Aesthet Surg. 2019 Apr;72(4):649-655. doi: 10.1016/j.bjps.2018.12.030. Epub 2018 Dec 15.
Body contouring surgery following massive weight loss positively affects a patient's quality of life. However, the procedure is prone to complications. Herein, we stratified complications timewise. Furthermore, we examined whether the weight loss method - bariatric surgery or lifestyle changes - affected the frequency or severity of complications. In this single-centre retrospective analysis, we included 158 patients with massive weight loss undergoing body contouring surgery between 2009 and 2015. We recorded 96 complications in 80 patients, with an overall rate of 51%. Most complications (80.2%) were minor (Clavien-Dindo grades 1 and 2) and superficial wound infections. Immediate complications (0-24 hours post-operation) affected 8.3% of patients, with early complications (1-7 post-operative days) affecting 16.7% of them and late complications (8-30 post-operative days) affecting 58.3% of them. We found no statistical difference in complication rates when comparing bariatric and non-bariatric patients. Older age (p = 0.042) at operation is associated with an increased risk for immediate haematoma or bleeding requiring surgery. Among early complications, a high maximum weight (p = 0.035) and a high preoperative weight (p = 0.0053) significantly correlated with a haematoma or bleeding requiring surgery. For late complications, seroma correlated with older age (p = 0.0061). Complications are primarily minor and non-life threatening after body contouring surgery because of frequent massive weight loss. Here, no particular subgroup of massive weight loss patients appeared more prone to complications. Thus, for each patient, the risks associated with body contouring surgery following massive weight loss should be considered individually.
大量体重减轻后的身体塑形手术对患者的生活质量有积极影响。然而，该手术容易发生并发症。在此，我们按时间对并发症进行分层。此外，我们还检查了减肥方法（减重手术或生活方式改变）是否会影响并发症的频率或严重程度。在这项单中心回顾性分析中，我们纳入了 2009 年至 2015 年间接受身体塑形手术的 158 例大量体重减轻患者。我们记录了 80 例患者中的 96 种并发症，总体发生率为 51%。大多数并发症（80.2%）为轻微（Clavien-Dindo 分级 1 和 2）和浅表伤口感染。立即并发症（术后 0-24 小时）影响 8.3%的患者，早期并发症（术后 1-7 天）影响 16.7%的患者，晚期并发症（术后 8-30 天）影响 58.3%的患者。我们发现，比较减重患者和非减重患者，并发症发生率没有统计学差异。手术时年龄较大（p=0.042）与需要手术的即时血肿或出血风险增加相关。在早期并发症中，最大体重高（p=0.035）和术前体重高（p=0.0053）与需要手术的血肿或出血显著相关。对于晚期并发症，血清肿与年龄较大（p=0.0061）相关。由于经常发生大量体重减轻，身体塑形手术后的并发症主要为轻微且非危及生命。在这里，没有特定的大量体重减轻患者亚组似乎更容易发生并发症。因此，对于每个患者，都应单独考虑大量体重减轻后身体塑形手术的相关风险。
