ArticleThe Journal of surgical research2022
The Association Between Metabolic Derangement and Wound Complications in Elective Plastic Surgery.
Article in The Journal of surgical research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 21 citations in OpenAlex.
- Prehabilitation for Pressure Ulcer Surgery: A Practical and Evidence-based Guide.Plastic and reconstructive surgery. Global open · 2026Article
- Improving Patient Outcomes by Bridging Bariatric and Body Contouring Surgery with Comprehensive Prehabilitation.Plastic and reconstructive surgery. Global open · 2026Article
- Endoscopic Versus Open Carpal Tunnel Release in Obese and Nonobese Patients.Journal of hand surgery global online · 2026Article
- Contemporary perspectives on metabolic surgery for type 2 diabetes: surgical techniques, outcomes, and complications.Frontiers in endocrinology · 2026Review
- Article
- Complications after Oncoplastic Breast Reduction and Impact on Time to Adjuvant Therapy.Plastic and reconstructive surgery. Global open · 2024Article
- Topical lyophilized thrombin application improves wound healing for posterior spinal surgery.Heliyon · 2024Article
- A component-based analysis of metabolic syndrome's impact on 30-day outcomes after hip fracture: reduced mortality in obese patients.OTA international : the open access journal of orthopaedic trauma · 2024Article
- Access to reconstructive plastic surgery for patients undergoing bariatric surgery in the Unified Health System (SUS).Revista do Colegio Brasileiro de Cirurgioes · 2023Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
introductionThe incidence of metabolically unhealthy obesity is rising nationally. In this study, we compare wound and overall complications between metabolically unhealthy obese and healthy patients undergoing elective plastic surgery and model how operative time influences a complication risk.
methodsPatients undergoing elective breast and body plastic surgery procedures in the 2009-2019 National Surgical Quality Improvement Program (NSQIP) dataset were identified. Complications were compared between metabolically unhealthy obese (body mass index [BMI] > 30 with diabetes and/or hypertension) versus metabolically healthy obese patients (BMI > 30 without diabetes or hypertension). Logistic regression was used to model the probability of wound complications across operative times stratified by metabolic status.
resultsOf 139,352 patients, 13.4% (n = 18,663) had metabolically unhealthy obesity and 23.8% (n = 33,135) had metabolically healthy obesity. Compared to metabolically healthy patients, metabolically unhealthy patients had higher incidence of wound complications (6.9% versus 5.6%; P < 0.001) and adverse events (12.4% versus 9.6%; P < 0.001), in addition to higher 30-d readmission, returns to the operating room, and length of stay (all P < 0.001). After adjustment, BMI (Odds ratio [OR] 7.86), hypertension (OR 1.15), and diabetes (OR 1.25) were independent risk factors for wound complications (all P < 0.001). Among metabolically unhealthy patients, the operative time was log-linear with a wound complication risk (OR 1.21; P < 0.001).
conclusionsDiabetes and hypertension are additive risk factors with obesity for wound complications in elective plastic surgery. Among patients with metabolically unhealthy obesity, a risk of wound complications increases logarithmically with operative time. This distinction with regard to metabolic state might explain the unclear impact of obesity on surgical outcomes within existing surgical literature.
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