From the Long Island Plastic Surgical Group.
Plast Reconstr Surg. 2019 Apr;143(4):721e-726e. doi: 10.1097/PRS.0000000000005413.
The incidence of obesity is on the rise worldwide. Many surgeons elect not to perform abdominoplasty on patients with a high body mass index, fearing an increased risk of perioperative complications. In this study, the authors compare the outcomes of obese and nonobese patients who underwent abdominoplasty.
A retrospective chart analysis was performed on all patients who underwent abdominoplasty by a single surgeon from 2009 to 2016. Complication rates were compared in obese and nonobese patients. Patients were excluded if they did not undergo a full abdominoplasty, underwent a combined surgical procedure, or underwent liposuction in an area outside of the abdomen or flanks at the time of the abdominoplasty.
A total of 83 patients were included: 62 nonobese and 21 obese patients. The obese group had a higher average body mass index (34. 9 kg/m versus 25.1 kg/m; p < 0.001). Follow-up time was similar (310 days versus 265 days; p = 0.468). No significant differences were seen with regard to perioperative seroma formation (14.2 percent versus 22.5 percent; p = 0.419)), wound dehiscence (9.5 percent versus 11.29 percent; p = 0.822), hematoma formation (4.7 percent versus 1.6 percent; p = 0.438), or surgical-site infection (9.5 percent versus 8.0 percent; p = 0.835). No instances of venous thromboembolism were observed.
Abdominoplasty, with or without concurrent liposuction, in obese patients, is a safe and effective procedure with similar perioperative complication rates as the nonobese patient population. No significant differences were observed in perioperative complications.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.
肥胖的发病率在全球范围内呈上升趋势。许多外科医生选择不在身体质量指数较高的患者身上进行腹部整形术,因为他们担心会增加围手术期并发症的风险。在这项研究中,作者比较了接受腹部整形术的肥胖和非肥胖患者的结果。
对 2009 年至 2016 年间由一位外科医生进行的所有腹部整形术患者进行回顾性图表分析。比较了肥胖和非肥胖患者的并发症发生率。如果患者未接受完整的腹部整形术、接受联合手术或在腹部整形术时在腹部或侧腰以外的部位进行吸脂术,则将其排除在外。
共纳入 83 例患者:62 例非肥胖患者和 21 例肥胖患者。肥胖组的平均身体质量指数(34.9kg/m2 与 25.1kg/m2;p<0.001)更高。随访时间相似(310 天与 265 天;p=0.468)。在围手术期血清肿形成(14.2%与 22.5%;p=0.419)、伤口裂开(9.5%与 11.29%;p=0.822)、血肿形成(4.7%与 1.6%;p=0.438)或手术部位感染(9.5%与 8.0%;p=0.835)方面,两组之间没有显著差异。没有观察到静脉血栓栓塞的病例。
对于肥胖患者,无论是否同时进行吸脂术,腹部整形术都是一种安全有效的手术,其围手术期并发症发生率与非肥胖患者人群相似。在围手术期并发症方面没有观察到显著差异。
临床问题/证据水平:风险,II。