Kathryn W Brown, Martin G McCandless, Hemanth Nannapaneni, Kristen Adams, Somjade Jay Songcharoen, Peter B Arnold
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Tissue to be discarded was sent to pathology for analysis of immunohistochemistry directed against endothelial cells to determine the density of the SDP. Patients with BMI <35 and ≥35 kg/m<sup>2</sup> were compared. Statistical analysis, including 2-tailed <i>t</i> test and Pearson correlation, was conducted.</p><p><strong>Results: </strong>A significant difference in SDP density (standard deviation) was identified between patients with a BMI ≥35 versus <35 kg/m<sup>2</sup> (2.65 capillaries/mm<sup>2</sup> ± 1.8 vs 1.56 capillaries/mm<sup>2</sup> ± 1.2; <i>P</i> = .033). Patients with no historical use of tobacco versus those who used tobacco showed a significantly increased SDP (2.11 capillaries/mm<sup>2</sup> ± 1.6 vs 1.20 capillaries/mm<sup>2</sup> ± 0.5; <i>P</i> = .009). A significant relationship between postoperative infection (1.00 capillaries/mm<sup>2</sup> ± 1.1; <i>P</i> = .041) and hematoma/seroma (0.788 capillaries/mm<sup>2</sup> ± 0.1; <i>P</i> = .003) was identified. No significant relationship was found between SDP and delayed wound healing, nipple-areolar complex complications, fat/flap necrosis, or symptomatic scar occurrence.</p><p><strong>Conclusions: </strong>There is a statistically significant increase in SDP seen with increasing BMI, which does not explain the higher rate of wound healing complications after reduction mammaplasty typically seen in the higher BMI patient population. The association between BMI and complications after reduction mammaplasty remains unclear.</p>","PeriodicalId":11687,"journal":{"name":"Eplasty","volume":"23 ","pages":"e36"},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10350870/pdf/eplasty-23-e36.pdf","citationCount":"0","resultStr":"{\"title\":\"Subdermal Plexus Density as It Relates to Obesity and Wound Complications in Patients Undergoing Reduction Mammaplasty.\",\"authors\":\"Kathryn W Brown, Martin G McCandless, Hemanth Nannapaneni, Kristen Adams, Somjade Jay Songcharoen, Peter B Arnold\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Reduction mammaplasty is one of the most common reconstructive procedures performed in plastic surgery. Multiple comorbidities play a role in postoperative wound healing complications; however, there are insufficient data on the subdermal plexus (SDP) as it relates to these comorbidities. The purpose of this study is to evaluate the relationship between body mass index (BMI) and SDP of the superficial breast tissues and examine the association between SDP and postoperative complications.</p><p><strong>Methods: </strong>After Institutional Review Board approval, screening, and informed consent, patients undergoing reduction mammaplasty were selected. Tissue to be discarded was sent to pathology for analysis of immunohistochemistry directed against endothelial cells to determine the density of the SDP. Patients with BMI <35 and ≥35 kg/m<sup>2</sup> were compared. Statistical analysis, including 2-tailed <i>t</i> test and Pearson correlation, was conducted.</p><p><strong>Results: </strong>A significant difference in SDP density (standard deviation) was identified between patients with a BMI ≥35 versus <35 kg/m<sup>2</sup> (2.65 capillaries/mm<sup>2</sup> ± 1.8 vs 1.56 capillaries/mm<sup>2</sup> ± 1.2; <i>P</i> = .033). Patients with no historical use of tobacco versus those who used tobacco showed a significantly increased SDP (2.11 capillaries/mm<sup>2</sup> ± 1.6 vs 1.20 capillaries/mm<sup>2</sup> ± 0.5; <i>P</i> = .009). A significant relationship between postoperative infection (1.00 capillaries/mm<sup>2</sup> ± 1.1; <i>P</i> = .041) and hematoma/seroma (0.788 capillaries/mm<sup>2</sup> ± 0.1; <i>P</i> = .003) was identified. No significant relationship was found between SDP and delayed wound healing, nipple-areolar complex complications, fat/flap necrosis, or symptomatic scar occurrence.</p><p><strong>Conclusions: </strong>There is a statistically significant increase in SDP seen with increasing BMI, which does not explain the higher rate of wound healing complications after reduction mammaplasty typically seen in the higher BMI patient population. 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引用次数: 0
摘要
背景:乳房缩小成形术是整形外科中最常见的重建手术之一。多种合并症在术后伤口愈合并发症中起作用;然而，关于真皮下神经丛(SDP)与这些合并症的关系的数据不足。本研究的目的是评估体重指数(BMI)与乳腺浅表组织SDP的关系，并探讨SDP与术后并发症的关系。方法:经机构审查委员会批准、筛选和知情同意后，选择接受缩小乳房成形术的患者。将丢弃的组织送到病理学处进行针对内皮细胞的免疫组织化学分析，以确定SDP的密度。比较BMI为2的患者。采用双尾t检验和Pearson相关进行统计学分析。结果:BMI≥35和2患者的SDP密度(标准差)存在显著差异(2.65毛细血管/mm2±1.8 vs 1.56毛细血管/mm2±1.2;P = .033)。无吸烟史的患者与有吸烟史的患者相比，SDP显著增加(2.11毛细血管/mm2±1.6 vs 1.20毛细血管/mm2±0.5;P = .009)。术后感染(1.00支毛细血管/mm2±1.1;P = 0.041)和血肿/血肿(0.788毛细血管/mm2±0.1;P = .003)。SDP与伤口延迟愈合、乳头-乳晕复杂并发症、脂肪/皮瓣坏死或症状性瘢痕发生之间无显著关系。结论:随着BMI的增加，SDP有统计学意义上的显著增加，这并不能解释高BMI患者群体中典型的乳房缩小成形术后伤口愈合并发症发生率较高的原因。BMI与缩乳术后并发症之间的关系尚不清楚。
Subdermal Plexus Density as It Relates to Obesity and Wound Complications in Patients Undergoing Reduction Mammaplasty.
Background: Reduction mammaplasty is one of the most common reconstructive procedures performed in plastic surgery. Multiple comorbidities play a role in postoperative wound healing complications; however, there are insufficient data on the subdermal plexus (SDP) as it relates to these comorbidities. The purpose of this study is to evaluate the relationship between body mass index (BMI) and SDP of the superficial breast tissues and examine the association between SDP and postoperative complications.
Methods: After Institutional Review Board approval, screening, and informed consent, patients undergoing reduction mammaplasty were selected. Tissue to be discarded was sent to pathology for analysis of immunohistochemistry directed against endothelial cells to determine the density of the SDP. Patients with BMI <35 and ≥35 kg/m2 were compared. Statistical analysis, including 2-tailed t test and Pearson correlation, was conducted.
Results: A significant difference in SDP density (standard deviation) was identified between patients with a BMI ≥35 versus <35 kg/m2 (2.65 capillaries/mm2 ± 1.8 vs 1.56 capillaries/mm2 ± 1.2; P = .033). Patients with no historical use of tobacco versus those who used tobacco showed a significantly increased SDP (2.11 capillaries/mm2 ± 1.6 vs 1.20 capillaries/mm2 ± 0.5; P = .009). A significant relationship between postoperative infection (1.00 capillaries/mm2 ± 1.1; P = .041) and hematoma/seroma (0.788 capillaries/mm2 ± 0.1; P = .003) was identified. No significant relationship was found between SDP and delayed wound healing, nipple-areolar complex complications, fat/flap necrosis, or symptomatic scar occurrence.
Conclusions: There is a statistically significant increase in SDP seen with increasing BMI, which does not explain the higher rate of wound healing complications after reduction mammaplasty typically seen in the higher BMI patient population. The association between BMI and complications after reduction mammaplasty remains unclear.
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