Plastic Surgery Research Council
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PSRC 60th Annual Meeting
Program and Abstracts

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Outcomes and Safety of Combined Abdominoplasty-Hysterectomy versus the Individual Procedures
Benjamin B. Massenburg, BA, Paymon Sanati-Mehrizy, BA, Michael J. Ingargiola, MD, Jonatan Hernandez Rosa, MD, Peter J. Taub, MD, FACS, FAAP.
Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Purpose: The combined abdominoplasty-hysterectomy is being increasingly requested by patients and has been described in the literature since 1986. However, outcomes of the combined procedure versus each operation performed separately have not been thoroughly explored. This study retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) and identified each abdominoplasty (ABP), hysterectomy (HYS), and combined abdominoplasty-hysterectomy (ABP-HYS) performed between 2005 and 2012.
Methods: There were 1325 ABP cases, 12173 HYS cases, and 143 ABP-HYS cases identified that met the inclusion criteria. The incidence of complications in each of the three procedures was calculated, and a multiplicative-risk model was used to calculate the probability of a complication for a patient undergoing distinct HYS and an ABP on different dates. One-sample binomial tests were performed to determine statistical significance.
Results: Surgical complications occurred in 7.7% of patients undergoing an ABP-HYS, while the calculated risk of a surgical complication was 12.5% (p=0.0407) for a patient undergoing separate ABP and HYS procedures. Unplanned reoperations occurred in 2.1% of patients undergoing an ABP-HYS and was calculated to be 4.6% (p=0.0776) in a patient undergoing separate ABP and HYS procedures.
The mean operative time was significantly lower for an ABP-HYS at 238 minutes versus 270 minutes for separate ABP and HYS procedures (p<0.0001). The mean time under anesthesia was also significantly lower for an ABP-HYS at 295 minutes versus 364 minutes for separate ABP and HYS procedures (p<0.0001). The mean number of days from operation to discharge was 3.94 days for an ABP-HYS and 4.44 days for separate ABP and HYS procedures (p=0.0647).
Conclusions: In an era of outcomes-driven medicine, identifying the rate of adverse outcomes is a critical quality indicator for surgeons. Data acquired from the ACS-NSQIP suggests that a combined abdominoplasty-hysterectomy has a lower incidence of surgical complications than separate abdominoplasty and hysterectomy procedures performed on different dates. For patients who wish to undergo both procedures, a combined abdominoplasty-hysterectomy is a safer option that will result in less operative time, less time under anesthesia, and a trend towards fewer days in the hospital.


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