Abstract：
BACKGROUND: Bariatric surgery has gained popularity in recent decades as an effective treatment for obesity. Abdominoplasty is one of the most often performed aesthetic procedures all over the world. In post-bariatric patients undergoing abdominoplasty, the diameter size and number of the abdominal wall perforators increase proportionally with increased body weight. Postoperative complications that may occur are haematoma, and venous thromboembolism (VTE). In plastic surgery procedures VTE prophylaxis grades vary due to the lack of consensus and clear guidelines. The aim of this study was to explore the frequency of postoperative bleeding and VTE in patients undergoing abdominoplasty and to explore the risk factors associated with major bleeding.
METHODS: A retrospective single-centre study of adult patients who were operated on by abdominoplasty between 2011 and 2020. Chemoprophylaxis including low molecular weight heparin (LMHW) was recommended when the operating time exceeded 2 h.
RESULTS: A total of 102 patients were included. There were no patients with VTE. Eight patients were re-operated for major haematoma. The weight loss (peak weight to weight before the abdominoplasty) was 14.4 kg larger in the re-operation group (p = 0.03). Eighty-eight percent in the re-operation group and 67% in the other group were treated with LMWH (p = 0.43). Multivariable logistic regression showed that with each decrease from the peak in BMI kg/m2 the risk of re-operation for major haematoma was increased by 22% (p = 0.02).
CONCLUSIONS: Abdominoplasty in patients after massive weight loss has a higher risk of postoperative bleeding. Having a clear protocol for chemoprophylaxis should be considered.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
METHODS: A retrospective single-centre study of adult patients who were operated on by abdominoplasty between 2011 and 2020. Chemoprophylaxis including low molecular weight heparin (LMHW) was recommended when the operating time exceeded 2 h.
RESULTS: A total of 102 patients were included. There were no patients with VTE. Eight patients were re-operated for major haematoma. The weight loss (peak weight to weight before the abdominoplasty) was 14.4 kg larger in the re-operation group (p = 0.03). Eighty-eight percent in the re-operation group and 67% in the other group were treated with LMWH (p = 0.43). Multivariable logistic regression showed that with each decrease from the peak in BMI kg/m2 the risk of re-operation for major haematoma was increased by 22% (p = 0.02).
CONCLUSIONS: Abdominoplasty in patients after massive weight loss has a higher risk of postoperative bleeding. Having a clear protocol for chemoprophylaxis should be considered.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
摘要：
背景：减肥手术近几十年来作为肥胖的有效治疗方法已经越来越受欢迎。腹部成形术是全世界最经常进行的美学程序之一。在接受腹部成形术的减肥后患者中，腹壁穿孔器的直径大小和数量随着体重的增加而成比例增加。可能发生的术后并发症是血肿，静脉血栓栓塞（VTE）。在整形外科手术中，由于缺乏共识和明确的指南，VTE预防等级各不相同。本研究的目的是探讨腹部成形术患者术后出血和VTE的频率，并探讨与大出血相关的危险因素。
方法：一项回顾性单中心研究，研究对象为2011年至2020年期间接受腹部成形术的成年患者。当手术时间超过2小时时，建议进行化学预防，包括低分子量肝素（LMHW）。
结果：共纳入102例患者。无VTE患者。八名患者因严重血肿而再次手术。再次手术组的体重减轻（腹壁成形术前的体重峰值）增加了14.4kg（p=0.03）。再次手术组88%和另一组67%接受LMWH治疗(p=0.43)。多变量逻辑回归显示，随着BMIkg/m2从峰值下降，重大血肿再次手术的风险增加22％（p=0.02）。
结论：大量体重减轻后患者的腹部成形术具有更高的术后出血风险。应考虑有明确的化学预防方案。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
方法：一项回顾性单中心研究，研究对象为2011年至2020年期间接受腹部成形术的成年患者。当手术时间超过2小时时，建议进行化学预防，包括低分子量肝素（LMHW）。
结果：共纳入102例患者。无VTE患者。八名患者因严重血肿而再次手术。再次手术组的体重减轻（腹壁成形术前的体重峰值）增加了14.4kg（p=0.03）。再次手术组88%和另一组67%接受LMWH治疗(p=0.43)。多变量逻辑回归显示，随着BMIkg/m2从峰值下降，重大血肿再次手术的风险增加22％（p=0.02）。
结论：大量体重减轻后患者的腹部成形术具有更高的术后出血风险。应考虑有明确的化学预防方案。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
