Evaluation of intra-operative abdominal wall perfusion in post-bariatric abdominal dermolipectomy

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Adrian Dragu - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Stefan Schnürer - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Thomas Horbach - , Municipal Hospital Schwabach (Author)
  • Frank Unglaub - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Andreas Arkudas - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Justus P. Beier - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Ulrich Kneser - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Raymund E. Horch - , Friedrich-Alexander University Erlangen-Nürnberg (Author)

Abstract

Objective: Abdominal dermolipectomy after massive weight loss has become a standard procedure. However the complication rates such as wound necrosis or secondary healing complications are still high. In this context ischaemia or inadequate micro-perfusion are known as triggers of wound healing complications. Little is known about the regional perfusion patterns before and after post-bariatric abdominal dermolipectomy. This study focuses on assessment of intraoperative micro-perfusion patterns of the abdominal tissue. Methods: The perfusion of the abdominal wall flap was monitored intra-operatively in 17 patients with an average BMI of 29.2 ± 3.7 kg/m2 after bariatric surgery. All patients underwent abdominal post-bariatric dermolipectomy after massive weight loss while applying the non-invasive O2C laser-spectrophotometer. The micro-perfusion parameters oxygen saturation (SO2), relative haemoglobin content (rHB) and relative blood flow (BF) were intra-operatively measured. Results: The results of this study show that the part of the abdominal fat typically resected during dermolipectomy has the lowest SO2 before surgery. Furthermore, the results demonstrate that previously well oxygenated parts in the median line of the abdominal fat undergo a significant decrease in oxygen saturation upon mobilisation and subsequent suturing, while the caudal wound edges show an increase of micro-perfusion parameters. Conclusion: Data show that micro-perfusion is worst in the median line of the cranial wound edge and is significantly altered after mobilisation. In addition an intra-operative increase of micro-perfusion in the caudal part of the wound edge, especially in the mons pubis area, can be measured.

Details

Original languageEnglish
Pages (from-to)651-659
Number of pages9
JournalObesity Facts
Volume5
Issue number5
Publication statusPublished - Nov 2012
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 23108184
ORCID /0000-0003-4633-2695/work/145698764

Keywords

Keywords

  • Abdominal wall perfusion, Adipose tissue, Bariatric surgery, BMI, Dermolipectomy, Interdisciplinary, Microvasculature, Post-bariatric plastic surgery, Risk factors, Surgery, Tissue ischaemia