title: The correlation of matrix metalloproteinase 9-to-albumin ratio in wound fluid with postsurgical complications after body contouring.
abstract: BACKGROUND
  The authors' earlier retrospective report of surgical complications after abdominal contouring surgery provided evidence that post-bariatric surgery patients are at increased risk of developing wound complications compared with a normal population. This prospective pilot study was designed as a comparative analysis of both surgical and wound healing characteristics between massive weight loss and normal patients who present for abdominal contouring surgery.
  
  
  METHODS
  Excisional wounds were created and polytetrafluoroethylene tubing was inserted during the preoperative period for later harvesting in patients undergoing abdominal contouring following Roux-en-Y gastric bypass for weight loss (n = 16) or abdominoplasty (n = 17). Wound fluids were sequentially collected from drains and subjected to matrix metalloproteinase (MMP) analysis. Standard postsurgical complications were documented.
  
  
  RESULTS
  Surgical complications were more common in weight loss patients (47 percent) than in control patients (25 percent). MMP analyses showed that MMP-9 levels remained significantly elevated at postoperative day 4 in patients who subsequently experienced complications in either the weight loss group (p = 0.02) or the control group (p = 0.03). Other parameters showed no significant differences between massive weight loss patients and controls.
  
  
  CONCLUSIONS
  Although many markers were examined, the ratio of MMP-9 to albumin was the only predictor of postsurgical complications in any group. This lends further support to growing evidence that MMP-9 may be a useful biomarker of postsurgical complications. This pilot work showed no causal factors that explain the higher rates of postsurgical complications in the post-bariatric surgery patient population.
  
  
  METHODS
  Risk, II.
authors.affiliation: Nashville, Tenn. From the Department of Plastic Surgery, Vanderbilt School of Medicine; and Meharry Medical College.
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Sexton
authors.forename: Marcia
authors.initials: M
authors.lastname: Spear
authors.forename: Alonda C
authors.initials: AC
authors.lastname: Pollins
authors.forename: Chenai
authors.initials: C
authors.lastname: Nettey
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Greco
authors.forename: R Bruce
authors.initials: RB
authors.lastname: Shack
authors.forename: Kevin F
authors.initials: KF
authors.lastname: Hagan
authors.forename: Lillian B
authors.initials: LB
authors.lastname: Nanney
mesh_terms: D061645:Abdominoplasty; D000328:Adult; D000418:Albumins / Q000032:analysis*; D001826:Body Fluids / Q000737:chemistry*; D015390:Gastric Bypass; D006801:Humans; D020780:Matrix Metalloproteinase 9 / Q000032:analysis*; D008875:Middle Aged; D010865:Pilot Projects; D011183:Postoperative Complications / Q000378:metabolism; D011446:Prospective Studies; D015431:Weight Loss
chemical_list: D000418:Albumins; D020780:Matrix Metalloproteinase 9