Combined plastic and gynecological surgical procedures.
The purpose of the present study was to determine the extent to which the planned combination of one of several major plastic and gynecological surgical procedures may alter patient morbidity and postoperative hospitalization when compared with similar procedures carried out separately. A review of 10 consecutive years of operative procedures produced 63 patients who underwent combined gynecological and plastic surgical procedures. Thirty-three of the combined-surgery patients could be suitably matched with 2 control patients each to compare complications and length of hospital stay. The requirement for transfusion was significantly greater (p = 0.01) in the combined-surgery versus the paired-control groups. No other complications, however, were increased in the combined-surgery patients. There was a significant reduction (p = 0.005) in hospital stay of 1.92 postoperative days for two groups of combined-surgery patients versus the control groups. In all combined-surgery patients, patient response was favorable. Recommendations on preoperative planning and intraoperative and postoperative management are discussed. There is a perception in the surgical community that combining procedures unacceptably increases morbidity. For the past 12 years plastic and gynecological surgeons in our institution have offered combined procedures to our patients, with positive results and favorable patient response. A search of recent medical literature demonstrated several references to the planned combination of plastic and gynecological or general surgical procedures [2, 4, 5]. However, the only study with matched control patients dealt exclusively with abdominoplasty in association with one of five major gynecological procedures.
Shull
B L
BL
Department of Obstetrics and Gynecology, Scott and White Memorial Hospital and Clinic, Temple, TX.
Verheyden
C N
CN
D001803:Blood Transfusion; D001940:Breast / Q000601:surgery; D005260:Female; D005836:Genitalia, Female / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy; D007430:Intraoperative Care; D010535:Laparoscopy; D007902:Length of Stay; D008408:Mastectomy; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D013518:Surgery, Plastic; D013997:Time Factors