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The Influence of Preexisting Lower Extremity Edema and Venous Stasis Disease on Body Contouring Outcomes
- Source :
- Annals of Plastic Surgery. 73:365-370
- Publication Year :
- 2014
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2014.
-
Abstract
- BACKGROUND While a cause and effect relationship is traditionally thought to exist between thigh surgery and postoperative lymphedema, the link between obesity-related lymphatic and/or venous disease and post-body contouring lower extremity edema has not been investigated. We hypothesize that patients who experience prolonged lower extremity edema following thigh surgery are predisposed to developing this complication due to unrecognized preoperative lymphovascular disease. METHODS Fifty-five patients who had undergone body contouring surgery were identified from our prospective registry. Twenty-eight patients completed the Venous Clinical Severity Score (VCSS), a validated outcome measure of venous disease. Three time points were assessed: pre-weight loss (T1), post-weight loss but pre-body contouring (T2), and post-body contouring (T3). Based on T3 VCSS, patients were divided into 2 groups-a T3 VCSS ≤3 (group 1; N = 13) and a T3 VCSS ≥4 (group 2; N = 15). RESULTS VCSS for group 1 at T1, T2, and T3 were 3.31 ± 0.55, 1.85 ± 0.27, and 1.54 ± 0.35 (mean ± SEM), respectively, versus 6.3 ± 1.10, 4.33 ± 0.8, and 6.8 ± 0.63 for group 2 (P < 0.05, P < 0.05, and P < 0.0001). Pain scores at T1 was 0.46 ± 0.21 for group 1 versus 1.1 ± 0.24 for group 2 (P < 0.05). Edema scores for group 1 at T1, T2, and T3 were 0.69 ± 0.29, 0.08 ± 0.08, and 0.15 ± 0.10 versus 1.87 ± 0.35, 1.13 ± 0.31, and 2.13 ± 0.24 for group 2 (P < 0.05, P < 0.001, and P < 0.0001, respectively). CONCLUSIONS Using VCSS, post-bariatric patients with prolonged lower extremity edema experienced clinically identifiable signs of disease prior to weight loss and body contouring surgery. Thus, careful preoperative evaluation may help identify at-risk patients and aid in managing postoperative expectations.
- Subjects :
- Adult
Male
medicine.medical_specialty
Cosmetic Techniques
Risk Assessment
Severity of Illness Index
Venous stasis
Postoperative Complications
Risk Factors
Weight loss
Edema
Outcome Assessment, Health Care
Weight Loss
Severity of illness
medicine
Humans
Lymphedema
Obesity
Retrospective Studies
business.industry
Retrospective cohort study
Middle Aged
medicine.disease
Surgery
Lower Extremity
Thigh
Venous Insufficiency
Preoperative Period
Body contouring
Female
medicine.symptom
Complication
business
Subjects
Details
- ISSN :
- 01487043
- Volume :
- 73
- Database :
- OpenAIRE
- Journal :
- Annals of Plastic Surgery
- Accession number :
- edsair.doi.dedup.....c3d7af19ed1e9a30ab1bd4936a8cb707