Cinclair Richard, Shang Zhiguo, Aly Al, Kenkel Jeffrey
Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Aesthet Surg J Open Forum. 2022 Jul 28;4:ojac063. doi: 10.1093/asjof/ojac063. eCollection 2022.
Nonsurgical and surgical weight loss options have improved over the past several decades resulting in an increased number of patients who present with body contour deformities. This review focuses on the upper truncal deformity. This deformity is discernable by its residual tissue laxity in the upper arm, back, lateral chest, and breast.
The purpose of this study is to evaluate the morbidity of this procedure when these regions are treated in one operative setting.
A retrospective chart review of patients who underwent an upper body lift for truncal deformities after massive weight loss by the senior author between August 2006 and December 2019 was performed. Patient comorbidities and demographics, preoperative parameters, operative factors, and minor and major complications were assessed.
No intraoperative or major complications occurred. The overall complication rate was 71% (20/28), which were all minor and most related to wound breakdown. Using logistical regression analysis, we found that neither BMI nor amount of weight resected contributed to a higher complication rate in this cohort. Simple matching coefficients analysis identified anemia, hypertension, lifetime smoking history, celecoxib use, and multiple concurrent procedures as comorbidities and intraoperative factors with an increased risk for adverse outcomes.
This review helps define the role of upper body lift in the care of patients with massive weight loss and addresses the morbidity of a comprehensive approach to upper body deformity. Appropriate patient selection, preoperative patient counseling, sound operative technique, and supportive postoperative care can help to avoid adverse outcomes.
在过去几十年中,非手术和手术减肥方法都有所改进,导致出现身体轮廓畸形的患者数量增加。本综述聚焦于上躯干畸形。这种畸形可通过上臂、背部、侧胸和乳房的残余组织松弛来识别。
本研究的目的是评估在同一手术环境中治疗这些区域时该手术的发病率。
对2006年8月至2019年12月期间由资深作者为大量减重后出现躯干畸形的患者进行上半身提升手术的病例进行回顾性图表分析。评估患者的合并症和人口统计学特征、术前参数、手术因素以及 minor 和 major 并发症。
未发生术中或 major 并发症。总体并发症发生率为71%(20/28),均为 minor 并发症,且大多与伤口裂开有关。通过逻辑回归分析,我们发现该队列中BMI和切除的体重数量均未导致更高的并发症发生率。简单匹配系数分析确定贫血、高血压、终生吸烟史、使用塞来昔布以及多个同期手术为合并症和术中因素,这些因素会增加不良结局的风险。
本综述有助于明确上半身提升手术在大量减重患者护理中的作用,并探讨对上半身畸形采取综合治疗方法的发病率。适当的患者选择、术前患者咨询、合理的手术技术以及支持性的术后护理有助于避免不良结局。