Evaluating The Impact Of Diabetes And Risk Factors For Adverse Events Following Abdominal Panniculectomy: Analysis Of 7,035 Patients
Rami S. Kantar, MD, William J. Rifkin, BA, Stelios C. Wilson, MD, Joshua A. David, BS, Michael J. Cammarata, BS, J. Rodrigo Diaz-Siso, MD, Alyssa R. Golas, MD, Jamie P. Levine, MD, Daniel J. Ceradini, MD.
NYU Langone Health, New York, NY, USA.
PURPOSE: The prevalence of obesity is increasing in the United States with an associated increase in bariatric surgery as a treatment option, and panniculectomy following massive weight loss. The effect of Diabetes Mellitus (DM) on outcomes following panniculectomy remains poorly defined despite its prevalence. Our study aims to evaluate the impact of DM on complications following panniculectomy and determine risk factors for adverse events.
METHODS: The American College of Surgeons National Surgical Quality Improvement (ACS NSQIP) database was used to identify patients undergoing panniculectomy between 2010 and 2015. Patients were stratified based on diabetic status. Multivariate regression was performed to control for confounders.
RESULTS: Review of the database identified 7,035 eligible patients who underwent panniculectomy, out of which 770 (10.9%) were diabetic. Multivariate regression showed that DM was a significant risk factor for wound dehiscence (OR = 1.92; 95% CI: 1.41-3.15; p=0.02). Obesity was a significant risk factor for superficial (OR = 2.78; 95% CI: 1.53 - 3.69; p<0.001) and deep (OR = 1.52; 95% CI: 1.38 - 3.97; p=0.01) incisional surgical site infection (SSI). Smokers were also at an increased risk for superficial (OR = 1.42; 95% CI: 1.19 - 1.75; p=0.03) and deep (OR = 1.63; 95% CI: 1.31 - 2.22; p=0.02) incisional SSI.
CONCLUSION: Our analysis shows that DM is an independent risk factor for wound dehiscence following panniculectomy. Obesity and smoking were significant risk factors for superficial and deep incisional SSI. These results underscore the importance of preoperative risk factor evaluation in patients undergoing panniculectomy for safe outcomes.
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