Experience of excess skin after gastric bypass or duodenal switch in patients with super obesity.
BACKGROUND
There is a lack of knowledge about the patient's experience of excess skin after bariatric surgery in patients with body mass index, (BMI)>50 kg/m(2). The objective of this study was to evaluate experience of excess skin after laparoscopic biliopancreatic diversion with duodenal switch (BPD/DS) or laparoscopic Roux-en-Y gastric bypass (LRYGB) and explore possible gender differences. Another aim was to analyze possible correlation between the reported experiences of excess skin with changes in weight, BMI, and hip and waist circumference after surgery.


METHODS
One and/or 2 years after gastric bypass or duodenal switch surgery 57 patients responded to a specific questionnaire. The questionnaire included questions about the amount of excess skin and how much discomfort it caused. Furthermore, the patients were measured concerning weight and waist and hip circumference.


RESULTS
One year after surgery, a majority of the patients experienced excess skin scored as>2 ("a lot of" or "very much"). The patients in the BPD/DS group experienced significantly more excess skin compared to patients in the LRYGB group. Women experienced more excess skin and discomfort on several body parts than men. The correlations between changes in BMI and the reported experience and discomfort of excess skin were low. There was a low to moderate correlation between changes in waist and hip circumference measures and the experience of excess skin on stomach and buttocks.


CONCLUSIONS
Weight loss after LRYGB and BPD/DS in super-obese patients is associated with substantial discomfort from excess skin. Women reported more discomfort and experienced more excess skin than men. There was a low correlation between experience of excess skin and changes in weight, BMI, and circumference measures.
Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sweden. Electronic address: christina.biorserud@vgregion.se.
Christina
C
Biörserud
Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sweden.
Torsten
T
Olbers
Department of Morbid Obesity and Bariatric Surgery, Oslo University Hospital Aker, Norway.
Torgeir T
TT
Søvik
Department of Morbid Obesity and Bariatric Surgery, Oslo University Hospital Aker, Norway.
Tom
T
Mala
Department of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sweden; Department of Plastic surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Anna
A
Elander
Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sweden; Department of Neurophysiology and rehabilitation, Sahlgrenska University Hospital, Gothenburg, Sweden.
Monika Fagevik
MF
Olsén
D000328:Adult; D015904:Biliopancreatic Diversion / Q000379:methods; D015992:Body Mass Index; D001835:Body Weight; D004386:Duodenum / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology*; D012867:Skin; D049629:Waist-Hip Ratio; D055815:Young Adult
Bariatric surgery; Excess skin; Super obesity