Complications in post-bariatric body contouring surgery using a practical treatment regime to optimise the nutritional state.

Autor:	Makarawung DJS; Department of Plastic, Reconstructive and Hand Surgery, St. Antonius hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, the Netherlands., Al Nawas M; Department of Plastic, Reconstructive and Hand Surgery, St. Antonius hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, the Netherlands., Smelt HJM; Department of General Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands., Monpellier VM; Nederlandse Obesitas Kliniek (Dutch Obesity Clinic), Huis ter Heide, the Netherlands., Wehmeijer LM; Department of Plastic, Reconstructive and Hand Surgery, Catharina hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands., van den Berg WB; Department of Plastic, Reconstructive and Hand Surgery, St. Antonius hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, the Netherlands., Hoogbergen MM; Department of Plastic, Reconstructive and Hand Surgery, Catharina hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands., Mink van der Molen AB; Department of Plastic, Reconstructive and Hand Surgery, UMC Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
Jazyk:	angličtina
Zdroj:	JPRAS open [JPRAS Open] 2022 Jun 29; Vol. 34, pp. 91-102. Date of Electronic Publication: 2022 Jun 29 (Print Publication: 2022).
DOI:	10.1016/j.jpra.2022.06.006
Abstrakt:	Background: Post-bariatric body contouring surgery (BCS) treats redundant skin after massive weight loss; however, the complication risk is relatively high (23-70%). Most complications are wound-related, which may be partly due to a poor nutritional status after bariatric surgery. The objective of this observational study was to optimise nutrition preoperatively and assess the prevalence of wound-related complications after BCS. Methods: This prospective cohort study included 140 patients. Patients were treated according to the post-bariatric BCS guideline. Nutritional parameters were collected via pre- and peri-operative blood sampling; any deficiencies were treated. A protein-enriched diet was prescribed by a dietician 4 weeks preoperatively up until closure of all wounds. Complications were recorded using the Clavien-Dindo classification. Univariate and multivariate regression analyses were performed to identify variables associated with wound-related complications. Results: The overall wound-related complication rate was 51%. Most complications were minor, with only 4.3% was considered major. No significant differences in patient characteristics were found between patients with and without complications. Variables indicating an optimised nutritional state were not significantly associated with a decreased risk of complications; the most influential factor was a sufficient post-operative protein intake (OR 0.27, 95% CI 0.07 - 1.02, p = 0.05). Conclusion: The overall wound-related complication rate was in accordance with previous literature; however, major complications were few. This study showed a weak correlation between optimising nutritional state and better outcome after BCS, especially following a protein-enriched diet post-operatively. Therefore, we recommend continuing research on nutrition and wound-related complications, using homogeneous study populations and well-defined complications. Competing Interests: “All authors declare that they have no conflict of interest”. (© 2022 The Authors.)
Databáze:	MEDLINE
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