title: Impaired abdominal skin sensory function in morbid obesity and after bariatric surgery.
abstract: BACKGROUND
  Bariatric surgery reduces body weight, but creates the need for surgical correction of the patient's body shape, especially of the abdomen. The abdominal skin of the ex-obese has a lower quantity of fibrous and non-fibrous components; however, its functional status has not yet been studied. This study quantified, at different depths, the neurological function of the abdominal skin of the obese and morbidly ex-obese.
  
  
  METHODS
  Semmes-Weinstein monofilaments were used to quantify sensory levels of abdominal skin at the supra-umbilical (SU), umbilical (U), and infra-umbilical (IU) levels in 25 currently morbidly obese, 56 post-bariatric patients (open Roux-en-Y gastric bypass), and 43 women with normal body weight and/or overweight without previous obesity (control).
  
  
  RESULTS
  Only the control group showed a positive correlation between a worsening of sensory perception and age (p = 0.02). In the morbid obesity group, sensory threshold was higher at the IU level (9.60 g/mm(2)) than at the U (5.86 g/mm(2)) and SU (5.38 g/mm(2)) levels (p < 0.05). The mean sensory threshold for morbid obesity subjects (6.95 g/mm(2)) was higher than that of the post-bariatric patients (4.44 g/mm(2)), which in turn was higher than that of the control group (3.47 g/mm(2)), p < 0.01.
  
  
  CONCLUSIONS
  Morbidly obese and post-bariatric patients have lost the normal positive correlation between age and skin sensitiveness. The IU region has sensitiveness compromised in morbid obesity. Sensory thresholds in post-bariatric patients showed improvement relative to morbidly obese, but remained worse than the control subjects.
authors.affiliation: Plastic Surgery Post-Graduation Program, Universidade Federal de São Paulo-Escola Paulista de Medicina, Rua Napoleão de Barros, 715, 4° andar, Vila Clementino, CEP (postal code): 04023-002, São Paulo, São Paulo, Brazil. rodolphoab@uol.com.br
authors.forename: Rodolpho Alberto
authors.initials: RA
authors.lastname: Bussolaro
authors.forename: Elvio Bueno
authors.initials: EB
authors.lastname: Garcia
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Zanella
authors.forename: Lydia Masako
authors.initials: LM
authors.lastname: Ferreira
mesh_terms: D034861:Abdominal Wall / Q000503:physiopathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D062109:Dermatologic Surgical Procedures; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D012684:Sensory Thresholds; D012867:Skin / Q000503:physiopathology*; D015431:Weight Loss; D055815:Young Adult