Kalmar Christopher L, Park Benjamin C, Kassis Salam, Higdon Kent K, Perdikis Galen
Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, United States.
Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, United States.
J Plast Reconstr Aesthet Surg. 2022 Sep;75(9):3541-3550. doi: 10.1016/j.bjps.2022.04.057. Epub 2022 Apr 28.
Amidst the rising trend of bariatric surgical procedures being performed across the country and around the world, patients seeking functional panniculectomy after massive weight loss represent a different population than those seeking cosmetic abdominoplasty. The purpose of this study was to determine whether certain complications are more likely to occur in patients undergoing functional panniculectomy, as well as identify risk factors that are implicated in the occurrence of adverse events.
Retrospective cohort study was conducted of patients undergoing cosmetic abdominoplasty and functional panniculectomy in North America between 2015 and 2019 using the National Surgical Quality Improvement Program database sponsored by the American College of Surgeons. Comorbidities and postoperative complications between these two cohorts were analyzed with appropriate statistics.
During the study interval, 11,137 patients underwent excision of excessive infraumbilical abdominal skin, including 57.4% (n = 6397) patients undergoing functional panniculectomy and 42.6% (n = 4740) patients undergoing cosmetic abdominoplasty. Patients undergoing functional panniculectomy were significantly more likely to have comorbidities than those undergoing cosmetic abdominoplasty (p < .001). Overall adverse events (p < .001), medical complications (p = .047), surgical complications (p < .001), related readmission (p < .001), and related reoperation (p < .001) were significantly higher in patients undergoing functional panniculectomy. Surgical complications significantly higher in functional panniculectomy included superficial incisional infection (p < .001), deep incisional infection (p < .001), organ/space infection (p < .001), dehiscence (p = .003), and bleeding requiring transfusion (p = .003).
Patients undergoing functional panniculectomy are significantly more likely to have comorbidities and experience postoperative wound infection, dehiscence, sepsis, bleeding, related readmission, and related reoperation.
在国内外减肥手术实施数量呈上升趋势的背景下，大量减重后寻求功能性腹壁成形术的患者与寻求美容性腹部整形术的患者属于不同群体。本研究的目的是确定某些并发症是否更易在接受功能性腹壁成形术的患者中发生，并确定与不良事件发生相关的风险因素。
使用美国外科医师学会赞助的国家外科质量改进计划数据库，对2015年至2019年期间在北美接受美容性腹部整形术和功能性腹壁成形术的患者进行回顾性队列研究。对这两组患者的合并症和术后并发症进行了适当的统计学分析。
在研究期间，11137例患者接受了脐下腹部多余皮肤切除术，其中57.4%（n = 6397）为接受功能性腹壁成形术的患者，42.6%（n = 4740）为接受美容性腹部整形术的患者。接受功能性腹壁成形术的患者比接受美容性腹部整形术的患者合并症显著更多（p <.001）。接受功能性腹壁成形术的患者总体不良事件（p <.001）、医疗并发症（p =.047）、手术并发症（p <.001）、相关再入院（p <.001）和相关再次手术（p <.001）显著更高。功能性腹壁成形术中显著更高的手术并发症包括浅表切口感染（p <.001）、深部切口感染（p <.001）、器官/腔隙感染（p <.001）、裂开（p =.003）和需要输血的出血（p =.003）。
接受功能性腹壁成形术的患者合并症显著更多，且更易发生术后伤口感染、裂开、脓毒症、出血、相关再入院和相关再次手术。
