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缩乳术后并发症与患者体重指数的关系

Postoperative Complications Following Reduction Mammaplasty in Relation to Patient Body Mass Index.

作者信息

Suber Jessica, Berry Grace, Janszen Philip, Haddad Rachel, Janszen Steven

机构信息

Southern Ohio Medical Center, Portsmouth, Ohio.

Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio.

出版信息

Eplasty. 2024 Jul 25;24:e41. eCollection 2024.

Abstract

BACKGROUND

Reduction mammaplasty is a common procedure that is performed for both aesthetic reasons and quality-of-life improvement. It is performed largely to help the patient achieve a proportionate breast size for their individual body type, with the goal of restoring anatomical proportionality and psychological wellness while reducing chronic neck, back, and shoulder pain. The common risks of breast reduction include bleeding, scarring, infection, poor wound healing, fat necrosis, nipple necrosis, and/or seroma. This study is designed to show that patients with a body mass index (BMI) of >30.0 kg/m are at higher risks for all complications.

METHODS

This retrospective study analyzed medical records of 236 patients who underwent breast reduction mammaplasty from January 2015 to February 2022 by a single surgeon at a single institution. Patients were divided into 2 groups based on their BMI: the non-obese group with a BMI ≤29.9 kg/m and the obese group with a BMI ≥30.0 kg/m and above. This study compares postsurgical outcomes and complications in relation to patient BMI.

RESULTS

Of 236 total patients, 104 (44%) had complications specified by predetermined criteria. Of those 104 patients with complications, 94 (90.38%) had a BMI ≥30.0 kg/m. Predetermined complications were as follows: 24 patients (23.08%) experienced wound dehiscence, 23 of whom had a BMI ≥30.0 kg/m; 9 patients (8.65%) experienced hematomas, all of whom had a BMI ≥30.0 kg/m; 37 patients (35.58%) were found to have superficial wounds, 32 of whom had a BMI ≥30.0 kg/m; 39 (37.5%) were found to have a seroma, 35 of whom patients were found to have a BMI ≥30.0 kg/m; 25 patients (24.04%) experienced fat necrosis, 24 of whom had a BMI ≥30.0 kg/m; 3 patients (2.88%) experienced nipple necrosis, all of whom had a BMI ≥30.0 kg/m; 20 patients (19.23%) experienced infection, 19 of whom had a BMI ≥30.0 kg/m.

CONCLUSIONS

On the basis of data gathered and the statistics performed, patients with a BMI ≥30.0 kg/m were 4.86 times more likely to have postsurgical complications than those with a BMI <30.0 kg/m.

摘要

背景

缩乳术是一种常见的手术,其实施既出于美学原因,也为了改善生活质量。该手术主要是帮助患者实现与自身身体类型相称的乳房大小,目标是恢复解剖学比例并改善心理健康,同时减轻慢性颈部、背部和肩部疼痛。缩乳术的常见风险包括出血、瘢痕形成、感染、伤口愈合不良、脂肪坏死、乳头坏死和/或血清肿。本研究旨在表明,体重指数(BMI)>30.0 kg/m² 的患者发生所有并发症的风险更高。

方法

这项回顾性研究分析了 2015 年 1 月至 2022 年 2 月期间在单一机构由一名外科医生实施缩乳术的 236 例患者的病历。根据 BMI 将患者分为两组:BMI≤29.9 kg/m² 的非肥胖组和 BMI≥30.0 kg/m² 及以上的肥胖组。本研究比较了与患者 BMI 相关的术后结果和并发症。

结果

在 236 例患者中,104 例(44%)出现了符合预定标准的并发症。在这 104 例有并发症的患者中,94 例(90.38%)的 BMI≥30.0 kg/m²。预定的并发症如下:24 例患者(23.08%)出现伤口裂开,其中 23 例的 BMI≥30.0 kg/m²;9 例患者(8.65%)出现血肿,所有患者的 BMI≥30.0 kg/m²;37 例患者(35.58%)有浅表伤口,其中 32 例的 BMI≥30.0 kg/m²;39 例(37.5%)有血清肿,其中 35 例患者的 BMI≥30.0 kg/m²;25 例患者(24.04%)出现脂肪坏死,其中 24 例的 BMI≥30.0 kg/m²;3 例患者(2.88%)出现乳头坏死,所有患者的 BMI≥30.0 kg/m²;20 例患者(19.23%)出现感染,其中 19 例的 BMI≥30.0 kg/m²。

结论

根据收集的数据和进行的统计,BMI≥30.0 kg/m² 的患者术后发生并发症的可能性是 BMI<30.0 kg/m² 患者的 4.86 倍。

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