title: Extending the Limits of Microsurgical Reconstruction in Patients with Moderate to Very Severe Obesity: Single-Center 6-Year Experiences.
abstract: BackgroundWorldwide obesity has more than doubled since 1980. Given this epidemic change, surgical and medical care has become more complex as obesity is a known risk factor for complications. Consequently, one could expect a higher prevalence of medical and surgical complications in an obese patient collective in the setting of free tissue transfer. Goal of this study was to evaluate whether this assumption holds true.Material and MethodsBetween January 2009 and June 2015, 838 patients underwent free tissue transfers at a single institution. The cases were divided into three groups using the World Health Organization body mass index (BMI) criteria into a nonobese (n= 751), a moderately obese (n= 59), and a severely to very severely obese group (n= 28). The series was retrospectively analyzed and the groups were compared regarding the potential influence of BMI in respect to surgical complications and outcomes.ResultsOverall, there was no significant difference in morbidity between the groups of patients regarding the rate of surgical complications during our 3-month follow-up period.ConclusionThis study analyzed a large series of microsurgical reconstructions, with a focus on the impact of patient obesity on outcomes. Our findings suggest that despite higher rates of patient comorbidities, successful free tissue transfer can be achieved in this population with acceptable risk for complications.
authors: Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM - Klinikum Bogenhausen, Academic Teaching, Academic Teaching Hospital Technical University, Munich, Germany.
authors: Paul I
authors: PI
authors: Heidekrueger
authors: Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM - Klinikum Bogenhausen, Academic Teaching, Academic Teaching Hospital Technical University, Munich, Germany.
authors: Albrecht
authors: A
authors: Heine-Geldern
authors: Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM - Klinikum Bogenhausen, Academic Teaching, Academic Teaching Hospital Technical University, Munich, Germany.
authors: Milomir
authors: M
authors: Ninkovic
authors: Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM - Klinikum Bogenhausen, Academic Teaching, Academic Teaching Hospital Technical University, Munich, Germany.
authors: Frank
authors: F
authors: Herter
authors: Department for Plastic and Hand Surgery, CHUV Cenrte de la Main, Lausanne, Switzerland.
authors: Camillo
authors: C
authors: Mueller
authors: Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM - Klinikum Bogenhausen, Academic Teaching, Academic Teaching Hospital Technical University, Munich, Germany.
authors: P Niclas
authors: PN
authors: Broer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D061214:Patient Safety; D018579:Patient Selection; D011183:Postoperative Complications / Q000503:physiopathology* / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014947:Wounds and Injuries / Q000601:surgery*; D055815:Young Adult