Siamak Agha-Mohammadi1, Dennis J Hurwitz. 1. Plastic Surgery Body Contouring Center, 400 Newport Center Drive, Suite 100, Newport Beach, CA 92660, USA. dragha@plasticsurgerycal.com
Abstract
BACKGROUND: Currently, many body-contouring patients are overweight or obese or recently have sustained massive weight loss. Often these patients need multiple surgical procedures with extensive incisions. The need for optimal healing in all these patient populations is, however, hampered by their existing nutritional deficiencies. METHODS: Based on the authors' previous work (Agha-Mohammadi and Hurwitz Plast Reconstr Surg 122:604-618, 2008; Agha-Mohammadi and Hurwitz Plast Reconstr Surg 122:1901-1914, 2008), three clinical studies were initiated. The first study examined the preoperative nutritional parameters of 90 body-contouring patients. Of the 48 postbariatric patients, 38% had low prealbumin (<20 mg/dl), 33% had vitamin A deficiency, 32.6% had low hemoglobin (<12 g/dl), 16.3% had iron deficiency, 9.5% had vitamin B12 deficiency, and 12% had hyperhomocystinemia. Among the 42 nonbariatric patients, only 10% had low prealbumin and 11.5% had vitamin A deficiency. Other deficiencies were less remarkable. The second study evaluated the effect of a surgical nutritional supplement on the prealbumin, vitamin A, vitamin B12, and folate levels of 13 decubitus ulcer patients. The data indicated an increase in all the measured parameters, particularly a prealbumin increase of about 0.8 mg/dl per day. The third study investigated complications experienced by 131 body-contouring patients. The patients were divided into postbariatric and nonbariatric groups, then stratified according to their body mass index (BMI). The rates of minor and major complications in obese nonbariatric and postbariatric patients (receiving the nutritional supplement) were comparable with those of normal-weight nonbariatric patients. CONCLUSION: Obese nonbariatric and postbariatric patients are at nutritional risk for many primary ingredients of wound healing and immune system competency. Appropriate nutritional supplementation is an effective means for correcting these nutritional parameters and can significantly reduce surgical complications associated with obesity and bariatric surgery.
BACKGROUND: Currently, many body-contouring patients are overweight or obese or recently have sustained massive weight loss. Often these patients need multiple surgical procedures with extensive incisions. The need for optimal healing in all these patient populations is, however, hampered by their existing nutritional deficiencies. METHODS: Based on the authors' previous work (Agha-Mohammadi and Hurwitz Plast Reconstr Surg 122:604-618, 2008; Agha-Mohammadi and Hurwitz Plast Reconstr Surg 122:1901-1914, 2008), three clinical studies were initiated. The first study examined the preoperative nutritional parameters of 90 body-contouring patients. Of the 48 postbariatric patients, 38% had low prealbumin (<20 mg/dl), 33% had vitamin A deficiency, 32.6% had low hemoglobin (<12 g/dl), 16.3% had iron deficiency, 9.5% had vitamin B12 deficiency, and 12% had hyperhomocystinemia. Among the 42 nonbariatric patients, only 10% had low prealbumin and 11.5% had vitamin A deficiency. Other deficiencies were less remarkable. The second study evaluated the effect of a surgical nutritional supplement on the prealbumin, vitamin A, vitamin B12, and folate levels of 13 decubitus ulcerpatients. The data indicated an increase in all the measured parameters, particularly a prealbumin increase of about 0.8 mg/dl per day. The third study investigated complications experienced by 131 body-contouring patients. The patients were divided into postbariatric and nonbariatric groups, then stratified according to their body mass index (BMI). The rates of minor and major complications in obese nonbariatric and postbariatric patients (receiving the nutritional supplement) were comparable with those of normal-weight nonbariatric patients. CONCLUSION:Obese nonbariatric and postbariatric patients are at nutritional risk for many primary ingredients of wound healing and immune system competency. Appropriate nutritional supplementation is an effective means for correcting these nutritional parameters and can significantly reduce surgical complications associated with obesity and bariatric surgery.
Authors: Adrian Dragu; Stefan Schnürer; Frank Unglaub; Maya B Wolf; Justus P Beier; Ulrich Kneser; Raymund E Horch Journal: Obes Surg Date: 2011-11 Impact factor: 4.129
Authors: Paolo Limongelli; Giuseppina Casalino; Salvatore Tolone; Luigi Brusciano; Giovanni Docimo; Gianmattia Del Genio; Ludovico Docimo Journal: Int Wound J Date: 2017-03-01 Impact factor: 3.315