Abstract：
BACKGROUND: Increased rates of both breast cancer and obesity have resulted in more obese women seeking breast reconstruction. Studies demonstrate that these women are at increased risk for perioperative complications. A systematic review was conducted to assess the outcomes in obese women who underwent breast reconstruction following mastectomy. METHODS: Cochrane, PUBMED, and EMBASE electronic databases were screened and data were extracted from included studies. The clinical outcomes assessed were surgical complications, medical complications, length of postoperative hospital stay, reoperation rate, and patient satisfaction. RESULTS: Out of 33 studies met the inclusion criteria for the review and 29 provided enough data to be included in the meta-analysis (71,368 patients, 20,061 of whom were obese). Obese women (body mass index > 30 kg/m2) were 2.29 times more likely to experience surgical complications (95% confidence interval (CI) 2.19-2.39; p < 0.00001), 2.89 times more likely to have medical complications (95% CI 2.50-3.35; p < 0.00001), and had a 1.91 times higher risk of reoperation (95% CI 1.75-2.07; p < 0.00001). The most common complication, wound dehiscence, was 2.51 times more likely in obese women (95% CI 1.80-3.52; p < 0.00001). Sensitivity analysis confirmed that obese women were more likely to experience surgical complications (risk ratio 2.36, 95% CI 2.22-2.52; p < 0.00001). CONCLUSIONS: This study provides evidence that obesity increases the risk of complications in both implant-based and autologous reconstruction. Additional prospective and observational studies are needed to determine if the weight reduction prior to reconstruction reduces the perioperative risks associated with obesity.
journal_name
J Reconstr Microsurgjournal_title
Journal of reconstructive microsurgeryauthors
Panayi AC,Agha RA,Sieber BA,Orgill DPdoi
10.1055/s-0038-1627449subject
Has Abstractpub_date
2018-06-01 00:00:00pages
363-375issue
5eissn
0743-684Xissn
1098-8947journal_volume
34pub_type
杂志文章,meta分析,评审abstract：BACKGROUND: As deep inferior epigastric artery perforator (DIEP) flaps have gained popularity in breast reconstruction, the postoperative care of these patients, including the appropriate hospital length-of-stay and the need for intensive care unit (ICU) admission, has become a topic of debate. At our institution, we h...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-0040-1701698
更新日期：2020-06-01 00:00:00
abstract：:As reimbursement for free-tissue transfer decreases, the authors find an increase in the number of free flaps performed at their county facility. Over 60 percent of the free flaps performed during the past 10 years were completed within the last 4 years. This influx of patients prompted a review of their experience wi...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2001-16357
更新日期：2001-08-01 00:00:00
abstract：:Twenty patients with methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis and bone infection were treated with vascularized fibular grafts. There were 16 males and four females, and the patient ages at operation ranged from 17 to 73 years. Nine of the lesions affected the femur, eight the tibia, and there ...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2004-818044
更新日期：2004-01-01 00:00:00
abstract：:Reinnervation of composite-tissue allografts was examined in a rat hind-limb transplant model under Cyclosporin A (CyA) immunosuppression. Two groups of animals were studied. Group 1 consisted of 10 composite-tissue allografts using inbred Fisher rats (F344) as recipients and inbred Lewis rats (LEW) as donors. Recipie...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2007-1006787
更新日期：1991-10-01 00:00:00
abstract：:Multilayered tubes fabricated from human amnion were placed subcutaneously and/or longitudinally in contact with an axial artery and vein in rats. Histologic evaluation at the third postoperative week showed that the tubes had incorporated with the surrounding fibrovascular tissue. New capillary formation within the t...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2007-1006749
更新日期：1993-11-01 00:00:00
abstract：:The tremendous variability of the inferior epigastric arterial system makes accurate imaging of the vasculature of the anterior abdominal wall an essential component of optimal perforator selection. Preoperative imaging of the abdominal vasculature allows for preoperative perforator selection, resulting in improved op...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-0029-1220862
更新日期：2010-01-01 00:00:00
abstract：:A transverse rectus abdominis musculocutaneous free flap was electively performed for reconstructing the cutaneous cover in a patient during the early puerperium (12 hr after delivery). This flap was chosen because of the natural expansion achieved by pregnancy, and because it would cover the entire area to be reconst...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2007-1006478
更新日期：1996-05-01 00:00:00
abstract：:The authors conducted a two-part study to determine whether transcutaneous oxygen pressure (TcPO (2)) and transcutaneous carbon dioxide pressure (TcPCO (2)) can be used to monitor flap viability after transplantation. The first part was an animal study in which TcPO (2) and TcPCO (2) were measured in 10 epigastric isl...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2007-985208
更新日期：2007-07-01 00:00:00
abstract：:Background To date, only a few reports have been published on idiopathic lymphedema, and most of these are case reports. In this time, we performed a retrospective review of idiopathic lymphedema patients. Methods Forty patients presented with idiopathic lymphedema that was unrelated to surgery, injury, and medical co...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-0036-1586257
更新日期：2017-01-01 00:00:00
abstract：BACKGROUND: The distally based sural flap (DBSF) is one of the armamentarium in the lower limb reconstruction. However, the flap has not gained popularity due to concerns about its reliability and donor site morbidity. Based on the anatomy characterization, we combined and developed five modifications to improve the va...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-0040-1716744
更新日期：2020-09-17 00:00:00
abstract：BACKGROUND:Multiple studies have detailed promising smile restoration following gracilis free muscle transfer for facial reanimation but information detailing the potential complications is lacking. The aim of this study is to systematically review the literature to evaluate the reported complication rate associated wi...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章,评审
doi：10.1055/s-0035-1555139
更新日期：2015-10-01 00:00:00
abstract：:Injury to the radial nerve is not uncommonly associated with fractures of the humerus. Despite a considerable amount of information and literature regarding management of these associated injuries, a universally accepted algorithm for treatment remains elusive. This article assimilates the data and provides evidence-b...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章,评审
doi：10.1055/s-0028-1090623
更新日期：2008-11-01 00:00:00
abstract：:The eicosanoids, leukotriene B4 (LTB4) and thromboxane A2 (TXA2), contribute to neutrophil adhesion and arteriole vasoconstriction, important microcirculatory events in ischemia-reperfusion (I-R) injury. The purpose of this study was to evaluate the effect of ketorolac on I-R injury of skeletal muscle. A videomicrosco...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2007-1000170
更新日期：1998-04-01 00:00:00
abstract：:Blood flow distribution in conventional and vascularized canine nerve grafts was analyzed. Between 4 and 6 days after operation, blood flow at both the fascicular (endoneural) and the nerve-sheath (epineural) levels was significantly greater in the nonvascularized nerve grafts than in their vascularized counterparts (...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2007-1007044
更新日期：1985-10-01 00:00:00
abstract：:Although often a life-saving therapeutic maneuver, there is minimal data available that details the effects of intraoperative packed red blood cell transfusion (IOT) after microvascular free tissue transfer. The National Surgical Quality Improvement Program database was queried to identify all patients who underwent m...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章,多中心研究
doi：10.1055/s-0033-1357275
更新日期：2014-02-01 00:00:00
abstract：:This experimental study correlated varying methods of nerve repair with the degree of functional return using the rat sciatic nerve as a model. Six groups of adult male Sprague-Dawley rats (300 to 350 g) had their left sciatic nerve crushed (Group 1), transected and not repaired (Group 6), or transected and repaired u...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2007-1006804
更新日期：1990-01-01 00:00:00
abstract：:The dorsalis pedis fasciocutaneous flap has been used successfully in soft tissue reconstruction both as a pedicled and a free flap. The long-term donor site problems associated with this dorsalis pedis flap prompted us to look at the use of the dorsalis pedis fascial flap in soft tissue reconstruction. We describe th...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-0029-1215541
更新日期：2009-06-01 00:00:00
abstract：BACKGROUND:Reverse homodigital dorsoradial (RHD) flap has been developed to repair soft-tissue defects of the thumb. However, few articles have reported this flap with long-term follow-up. This retrospective study was designed to evaluate the RHD flap and investigate factors affecting sensory recovery. METHODS:From Fe...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-0035-1548743
更新日期：2015-07-01 00:00:00
abstract：:Radical resection of tongue and oropharyngeal carcinomas often results in complex defects that are challenging to reconstruct. Furthermore, remaining function should not be disturbed by the reconstruction. We introduce a new flap design and monitored swallowing and speech following reconstruction of complex oral defec...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2008-1078691
更新日期：2008-04-01 00:00:00
abstract：:Two patients with scleroderma, ischemic pain, non-healing digital ulceration, and digital arterial obstruction were successfully treated with peripheral sympathectomy and digital arterial reconstruction using a reversed small-caliber vein graft. Postoperatively, digital blood flow increased and ulceration healed in bo...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2002-30181
更新日期：2002-05-01 00:00:00
abstract：:Posttraumatic infected massive bone defects in lower extremities are difficult to repair because they frequently exhibit massive bone and/or soft tissue defects, serious bone infection, and excessive scar proliferation. This study aimed to determine whether these defects could be classified and repaired at a single st...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-0033-1348064
更新日期：2013-11-01 00:00:00
abstract：:Although the effectiveness of cooling in extending tolerable ischemia time is well-established experimentally, most free-flap surgeons are still concerned about this problem and try to limit the ischemic period to less than 1 hr. Clinically, contact-surface cooling has been used empirically to prolong the limits of is...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2007-1006613
更新日期：1996-10-01 00:00:00
abstract：:Microsurgical reconstruction of the face completely destroyed after malignant skin tumor excisions in a xeroderma pigmentosum patient is reported. The patient's left cheek was reconstructed using a free latissimus dorsi flap and the nose using a free forearm flap with a base of iliac bone graft. There has been no recu...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2007-1006812
更新日期：1990-04-01 00:00:00
abstract：:Ischemia/reperfusion (I/R) injury is one of the factors determining tissue survival in replantation and transplantation surgery. However, more than 20 methods have been used to evaluate I/R injury in muscle. The aim of this study was to examine I/R injury in muscle tissue in a model of composite tissue allotransplanta...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2004-823113
更新日期：2004-04-01 00:00:00
abstract：:Tissue expansion in combination with flap transfer has been widely reported as preexpansion of flaps, but only once as expansion of a free flap after transfer. Three free flaps and one pedicled flap were expanded after transfer. Indication, timing of expander implantation and explantation, technical aspects, and compl...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2007-970184
更新日期：2007-02-01 00:00:00
abstract：BACKGROUND: In 2017, our institution initiated a cadaver laboratory-based course dedicated to teaching reconstructive microsurgery indications, preoperative planning, and flap dissection. The goals of this study are to describe the demographics and experience of participants/instructors and to evaluate the learning obj...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-0040-1716320
更新日期：2021-02-01 00:00:00
abstract：:Patient safety is defined as freedom from accidental or preventable harm produced by medical care. The identification of patient- and procedure-related risk factors enables the surgical team to carry out prophylactic measures to reduce the rate of complications and adverse events.The purpose of this review is to ident...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章,评审
doi：10.1055/s-0039-1693142
更新日期：2019-11-01 00:00:00
abstract：:Peripheral nerve injury may result in injury without gaps or injury with gaps between nerve stumps. In the presence of a nerve defect, the placement of an autologous nerve graft is the current gold standard for nerve restoration. The clinical employment of tubes as an alternative to autogenous nerve grafts is mainly j...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章,评审
doi：10.1055/s-0032-1333316
更新日期：2013-03-01 00:00:00
abstract：:The first clinical face allotransplantation was performed by Devauchelle et al in 2005, and currently 13 facial allotransplantations have been performed worldwide. Reports on almost half of the cases were published in the literature, focusing on technical details of facial allograft inset to the recipient face. There ...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章,评审
doi：10.1055/s-0031-1272963
更新日期：2012-01-01 00:00:00
abstract：:A modified, two-stage arteriovenous flow-through venous flap was designed to repair skin defects due to third-degree burns on the dorsum of the hand in four patients. Two weeks after plasty of an arteriovenous (A-V) shunt between the greater saphenous vein and dorsalis pedis artery, the arterialized flow-through venou...
journal_title：Journal of reconstructive microsurgery
pub_type： 杂志文章
doi：10.1055/s-2007-1006429
更新日期：1997-10-01 00:00:00
