Winocour et al identified risk factors for complications in a patient undergoing abdominoplasty. These can help to identify a patient who may benefit from more aggressive management. The authors are from Vanderbilt University and the University of Alabama.
Patient selection: abdominoplasty
Outcome: major complication within 30 days (myocardial infarction or other cardiac complications, pulmonary dysfunction, fluid overload, venous thromboembolism, nerve injury, surgical site infection, other infection, hematoma)
Risk factors for complications by multivariate analysis:
(1) male gender
(2) age >= 55 years
(3) obesity (BMI >= 30 kg per square meter in abstract; >=25 in Table 3)
(4) multiple/combined procedures (with liposuction, with breast, with body-contouring, etc)
(5) procedure performed in surgical center or hospital (versus surgeon's office)
where:
• A procedure performed in the office may be a limited surgery.
• Performing abdominoplasty, liposuctiona nd body-contouring had a 10% complication rate vs 3% for abdominoplasty alone).
If the patient is determined to be high risk, then steps to reduce risk should be taken, such as avoiding a combined procedure.
