title: Complications in body contouring procedures: an analysis of 1797 patients from the 2005 to 2010 American College of Surgeons National Surgical Quality Improvement Program databases.
abstract: BACKGROUND
  The purpose of this study was to examine the incidence and predictors of surgical and medical morbidity following body contouring procedures.
  
  
  METHODS
  The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2010 for all identifiable body contouring cases including Current Procedural Terminology codes for brachioplasty, medial thigh lift, abdominoplasty, and suction-assisted lipectomy. Independent predictors of morbidity were determined.
  
  
  RESULTS
  A total of 1797 patients underwent body contouring during the study period, and most were female (n = 1600; 89.0 percent). The average body mass index was 31.6 kg/m, and 239 were morbidly obese (body mass index ≥ 40 kg/m). The most common area of intervention was the trunk region, with 1652 patients (91.9 percent) receiving abdominal contouring and/or contouring of the hips and buttocks. Minor wound complications occurred in 114 individuals (6.3 percent), 122 patients (6.8 percent) suffered a major surgical morbidity, and 40 (2.2 percent) experienced a medical complication. Multiple comorbidities (OR, 15.87; p = 0.014), presence of bleeding disorder (OR, 20.31; p = 0.026), preoperative albumin level (OR, 0.14; p = 0.003), and malnutrition (OR, 0.19; p = 0.065) were associated with an increased odds of minor wound complications. Inpatient procedures (OR, 4.64; p = 0.06) and functional status (OR, 9.71; p = 0.011) were associated with an increased odds of major surgical morbidity.
  
  
  CONCLUSIONS
  This study characterizes the 30-day morbidity rates in patients undergoing body contouring procedures using a large, prospective, validated national data set, highlighting the critical importance of careful preoperative patient evaluation and underscoring the need for detailed preoperative counseling and risk stratification.
  
  
  METHODS
  Risk, III.
authors.affiliation: Philadelphia, Pa. From the Division of Plastic Surgery, Hospital of the University of Pennsylvania.
authors.forename: John P
authors.initials: JP
authors.lastname: Fischer
authors.forename: Ari M
authors.initials: AM
authors.lastname: Wes
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Serletti
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kovach
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015897:Comorbidity; D016208:Databases, Factual / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D015187:Lipectomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D058996:Quality Improvement; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology