The Impact of the Weight of Removed Tissue on the Development of Postoperative Complications in Patients Undergoing Abdominoplasty after Gastric Bypass.

BACKGROUND: Patients who undergo Roux-en-Y gastric bypass (RYGB) have significant weight loss, and abdominoplasty is an effective corrective surgery for removing excess skin. This study aimed to evaluate the impact of the weight of removed tissue on the development of postoperative complications in patients undergoing abdominoplasty without lipoaspiration after gastric bypass at the Federal District North Wing Regional Hospital, Brasília, Brazil. METHODS: Data were analyzed from a prospective registry of patients who underwent abdominoplasty without lipoaspiration after gastric bypass from January 2011 to December 2018. The variables examined included body mass index (BMI) before RYGB and before plastic surgery, weight loss, weight of the excised abdominal flap, comorbidities, and medical complications. Analysis of the role of the weight of the removed tissue after abdominoplasty was performed to assess outcome measures. RESULTS: One hundred sixty-three patients were included. The mean age of the patients was 42 years. Their BMI at the time of abdominoplasty was 27.49 kg/m2, and the average weight loss before abdominoplasty was 47.13 kg. The preweight loss BMI was 45.27 kg/m2, and the ∆BMI was 17.78 kg/m2. The overall complication rate was 29.4%. An amount of removed tissue from the abdomen ≥ 2000 g significantly increased the rates of postoperative complications (46.7% vs. 19.4%; p = 0.002; OR = 3.13). CONCLUSIONS: Removal of ≥ 2000 g of tissue from the abdomen led to significantly more complications in patients who underwent abdominoplasty after gastric bypass. In addition, this group of patients was significantly associated with the presence of higher anthropometric variable values (BMI, weight loss, max BMI, and ∆BMI) and not associated with the presence of comorbidities.

Nosocomial infections in a Brazilian Burn Unit.

In 1-year prospective study, bacterial and fungal infections presenting in burned patients were registered. Two-hundred and seventy-eight patients were included. The median total body surface area burned was 14% (range 1-100%). The median length of hospital stay was 12 days (range 1-86 days). Eighty-six patients had in all 148 infections. Seventy-two bloodstream infections (BSI) occurred in 57 patients; most common microorganisms were coagulase-negative staphylococci and methicillin-sensitive Staphylococcus aureus. Forty-nine (17.6%) patients had burn wound infections and 18 (6.5%) had pneumonia. Antibiotics were given to only 30% of the burn patients. Overall mortality rate was 5.0% (14/278). The database can be used to evaluate the effects of changes in burn treatment, staffing and design of burn units, and antimicrobial resistance development in relation to antibiotic usage.