Risks of Autologous Abdominal Free Flap Breast Reconstruction in Patients With Elevated Body Mass Index
Background:. Obesity is widely recognized as a significant risk factor for postoperative complications of breast reconstruction. Despite extensive research, there remains a lack of consensus regarding the specific complications and outcomes experienced by patients with obesity who undergo deep infer...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2025-01-01
|
| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006457 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832589637191729152 |
|---|---|
| author | Nathaniel A. Teitler, MD Courtney J. Doherty, BS Madalyn R. Adams, MD Anna A. Podber, MD Peter M. Granger, MD Kaeli K. Samson, MPH, MA Sean C. Figy, MD Shannon L. Wong, MD Heidi H. Hon, MD |
| author_facet | Nathaniel A. Teitler, MD Courtney J. Doherty, BS Madalyn R. Adams, MD Anna A. Podber, MD Peter M. Granger, MD Kaeli K. Samson, MPH, MA Sean C. Figy, MD Shannon L. Wong, MD Heidi H. Hon, MD |
| author_sort | Nathaniel A. Teitler, MD |
| collection | DOAJ |
| description | Background:. Obesity is widely recognized as a significant risk factor for postoperative complications of breast reconstruction. Despite extensive research, there remains a lack of consensus regarding the specific complications and outcomes experienced by patients with obesity who undergo deep inferior epigastric perforator (DIEP) flap reconstruction. To provide a clearer understanding of the challenges faced by patients with obesity, we present a single-center outcome analysis of individuals who underwent DIEP flap reconstruction.
Methods:. A cohort of 194 patients who underwent at least 1 DIEP flap was retrospectively analyzed at the University of Nebraska Medical Center utilizing electronic medical records. Patients who underwent DIEP flap breast reconstruction were organized into 5 categories using World Health Organization weight status by body mass index (BMI) obtained from the day of surgery. Surgical complications within 120 days and postsurgical complication-related procedural interventions were also evaluated and compared. Comparisons of variables of interest between weight groups were assessed using Mantel–Haenszel chi-square tests or Spearman correlations.
Results:. Increases in patient weight category were associated with increased length of operation (P = 0.003), increased rates of breast fat necrosis (P = 0.04), breast wound dehiscence (P = 0.01), abdominal wound dehiscence (P = 0.02), numbers of abdominal complications (P = 0.001), and rates of requiring an intervention (P = 0.03).
Conclusions:. The findings imply that higher BMI values may lead to a higher likelihood of postoperative complications and the need for intervention. It is crucial for patients with obesity to be aware of the elevated risk associated with rising BMI values. |
| format | Article |
| id | doaj-art-77752b690ed2435cafaf5373deb15847 |
| institution | Kabale University |
| issn | 2169-7574 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-77752b690ed2435cafaf5373deb158472025-01-24T09:19:58ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-01-01131e645710.1097/GOX.0000000000006457202501000-00024Risks of Autologous Abdominal Free Flap Breast Reconstruction in Patients With Elevated Body Mass IndexNathaniel A. Teitler, MD0Courtney J. Doherty, BS1Madalyn R. Adams, MD2Anna A. Podber, MD3Peter M. Granger, MD4Kaeli K. Samson, MPH, MA5Sean C. Figy, MD6Shannon L. Wong, MD7Heidi H. Hon, MD8From the * Division of Plastic and Reconstructive Surgery, University of Nebraska Medical Center, Omaha, NEFrom the * Division of Plastic and Reconstructive Surgery, University of Nebraska Medical Center, Omaha, NEFrom the * Division of Plastic and Reconstructive Surgery, University of Nebraska Medical Center, Omaha, NE† Division of Plastic and Reconstructive Surgery, Creighton University, Omaha, NE† Division of Plastic and Reconstructive Surgery, Creighton University, Omaha, NEFrom the * Division of Plastic and Reconstructive Surgery, University of Nebraska Medical Center, Omaha, NEFrom the * Division of Plastic and Reconstructive Surgery, University of Nebraska Medical Center, Omaha, NEFrom the * Division of Plastic and Reconstructive Surgery, University of Nebraska Medical Center, Omaha, NEFrom the * Division of Plastic and Reconstructive Surgery, University of Nebraska Medical Center, Omaha, NEBackground:. Obesity is widely recognized as a significant risk factor for postoperative complications of breast reconstruction. Despite extensive research, there remains a lack of consensus regarding the specific complications and outcomes experienced by patients with obesity who undergo deep inferior epigastric perforator (DIEP) flap reconstruction. To provide a clearer understanding of the challenges faced by patients with obesity, we present a single-center outcome analysis of individuals who underwent DIEP flap reconstruction. Methods:. A cohort of 194 patients who underwent at least 1 DIEP flap was retrospectively analyzed at the University of Nebraska Medical Center utilizing electronic medical records. Patients who underwent DIEP flap breast reconstruction were organized into 5 categories using World Health Organization weight status by body mass index (BMI) obtained from the day of surgery. Surgical complications within 120 days and postsurgical complication-related procedural interventions were also evaluated and compared. Comparisons of variables of interest between weight groups were assessed using Mantel–Haenszel chi-square tests or Spearman correlations. Results:. Increases in patient weight category were associated with increased length of operation (P = 0.003), increased rates of breast fat necrosis (P = 0.04), breast wound dehiscence (P = 0.01), abdominal wound dehiscence (P = 0.02), numbers of abdominal complications (P = 0.001), and rates of requiring an intervention (P = 0.03). Conclusions:. The findings imply that higher BMI values may lead to a higher likelihood of postoperative complications and the need for intervention. It is crucial for patients with obesity to be aware of the elevated risk associated with rising BMI values.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006457 |
| spellingShingle | Nathaniel A. Teitler, MD Courtney J. Doherty, BS Madalyn R. Adams, MD Anna A. Podber, MD Peter M. Granger, MD Kaeli K. Samson, MPH, MA Sean C. Figy, MD Shannon L. Wong, MD Heidi H. Hon, MD Risks of Autologous Abdominal Free Flap Breast Reconstruction in Patients With Elevated Body Mass Index Plastic and Reconstructive Surgery, Global Open |
| title | Risks of Autologous Abdominal Free Flap Breast Reconstruction in Patients With Elevated Body Mass Index |
| title_full | Risks of Autologous Abdominal Free Flap Breast Reconstruction in Patients With Elevated Body Mass Index |
| title_fullStr | Risks of Autologous Abdominal Free Flap Breast Reconstruction in Patients With Elevated Body Mass Index |
| title_full_unstemmed | Risks of Autologous Abdominal Free Flap Breast Reconstruction in Patients With Elevated Body Mass Index |
| title_short | Risks of Autologous Abdominal Free Flap Breast Reconstruction in Patients With Elevated Body Mass Index |
| title_sort | risks of autologous abdominal free flap breast reconstruction in patients with elevated body mass index |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006457 |
| work_keys_str_mv | AT nathanielateitlermd risksofautologousabdominalfreeflapbreastreconstructioninpatientswithelevatedbodymassindex AT courtneyjdohertybs risksofautologousabdominalfreeflapbreastreconstructioninpatientswithelevatedbodymassindex AT madalynradamsmd risksofautologousabdominalfreeflapbreastreconstructioninpatientswithelevatedbodymassindex AT annaapodbermd risksofautologousabdominalfreeflapbreastreconstructioninpatientswithelevatedbodymassindex AT petermgrangermd risksofautologousabdominalfreeflapbreastreconstructioninpatientswithelevatedbodymassindex AT kaeliksamsonmphma risksofautologousabdominalfreeflapbreastreconstructioninpatientswithelevatedbodymassindex AT seancfigymd risksofautologousabdominalfreeflapbreastreconstructioninpatientswithelevatedbodymassindex AT shannonlwongmd risksofautologousabdominalfreeflapbreastreconstructioninpatientswithelevatedbodymassindex AT heidihhonmd risksofautologousabdominalfreeflapbreastreconstructioninpatientswithelevatedbodymassindex |