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重度减重患者减重后腹壁成形术的经验:一项前瞻性研究。

Experience in Post-Bariatric Abdominoplasty for Patients with Significant Weight Loss: A Prospective Study.

作者信息

Cuomo Roberto, Cuccaro Claudia, Seth Ishith, Rozen Warren M, Vastarella Maria Giovanna, Lombardo Giuseppe A G, Ciancio Francesco, Pagliara Domenico, Pieretti Gorizio, Ciccarelli Feliciano

机构信息

Plastic Surgery Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy.

Organization of Hospital Services Unit, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy.

出版信息

J Pers Med. 2024 Jun 25;14(7):681. doi: 10.3390/jpm14070681.

Abstract

BACKGROUND

Abdominoplasty is a critical aesthetic and functional procedure for individuals who have undergone massive weight loss. Numerous techniques have been proposed to optimize aesthetic results while minimizing complications.

METHODS

This prospective study examined 500 patients who underwent abdominoplasty during body-contouring procedures between 1 January 2018 and 31 December 2021 at a tertiary center. The Skin-Adipose Tissue-Muscle (SAM) protocol was employed to analyze the operative strategies and complication rates and compare them with the existing literature. Furthermore, patient satisfaction and aesthetic outcomes were measured one year post-operation using a comprehensive four-point questionnaire evaluated by the patients themselves and two independent surgeons.

RESULTS

Participants had an average age of 34.8 years and a mean BMI of 31.1 kg/m. The surgeries included 328 full abdominoplasties and 172 T-inverted abdominoplasties. Notable complications included wound infection (4%), wound dehiscence (8.6%), tissue necrosis (0.6%), seroma (8.4%), and hematoma (2.6%). A higher BMI was correlated with an increased risk of complications and lower patient satisfaction. Data analysis was performed using Stata version 18 software.

CONCLUSIONS

The increasing prevalence of obesity highlights an urgent need for more bariatric surgeries and subsequent abdominoplasties to mitigate the effects of massive weight loss. A crucial link between elevated BMI and a heightened risk of postoperative complications, emphasizing the necessity for standardized surgical protocols tailored to individuals with higher BMI, was noted. Innovatively, future studies must further investigate the intricate dynamics between BMI and surgical risks. Exploring and establishing uniform, adaptive surgical guidelines promise to revolutionize patient care by significantly reducing complications and enhancing recovery and satisfaction following abdominoplasty.

摘要

背景

腹壁成形术对于经历过大量体重减轻的个体而言,是一项关键的美学和功能性手术。已经提出了许多技术来优化美学效果,同时将并发症降至最低。

方法

这项前瞻性研究调查了2018年1月1日至2021年12月31日期间在一家三级中心接受身体塑形手术的500例接受腹壁成形术的患者。采用皮肤 - 脂肪组织 - 肌肉(SAM)方案分析手术策略和并发症发生率,并与现有文献进行比较。此外,术后一年使用由患者本人和两名独立外科医生评估的综合四点问卷来测量患者满意度和美学效果。

结果

参与者的平均年龄为34.8岁,平均体重指数为31.1kg/m。手术包括328例全腹壁成形术和172例T形倒置腹壁成形术。显著的并发症包括伤口感染(4%)、伤口裂开(8.6%)、组织坏死(0.6%)、血清肿(8.4%)和血肿(2.6%)。较高的体重指数与并发症风险增加和患者满意度降低相关。使用Stata 18版软件进行数据分析。

结论

肥胖患病率的上升凸显了迫切需要更多的减肥手术及后续的腹壁成形术,以减轻大量体重减轻的影响。注意到体重指数升高与术后并发症风险增加之间的关键联系,强调了为体重指数较高的个体制定标准化手术方案的必要性。创新性地,未来的研究必须进一步调查体重指数与手术风险之间的复杂动态关系。探索并建立统一、适应性强的手术指南有望通过显著减少并发症、促进恢复和提高腹壁成形术后的满意度来彻底改变患者护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/928f/11278261/8ccd5881bc04/jpm-14-00681-g001.jpg

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