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Debra Jackson RN PhD FACN Marie Hutchinson RN PhD Susan Barnason RN PhD APRN‐CNS FAEN FAHA FAAN William Li RN PhD Judy Mannix RN PhD MACN Stephen Neville RN PhD FCNA Donella Piper LLB PhD Tamara Power RN BN PhD Graeme D. Smith RN PhD Kim Usher RN PhD FACN FACMHN 《Journal of nursing management》2016,24(7):902-914
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Background: Dermolipectomies play a major role in the functional and esthetic deformities which result from massive weight
loss. Methods: From June 1994 to June 2000, 148 morbidly obese patients underwent various bariatric surgical procedures. After
at least 1 year, 33 patients underwent 51 regional dermolipectomies performed by the same plastic surgeon. Results: All 33
patients underwent abdominal dermolipectomy. The average operative time was 194.2 min (110-420 min). The average amount of
tissue excised was 2948.6 g (850-7525 g). 4 patients (12.1%) required blood transfusion. 6 patients (18.1%) developed complications,
which included 1 case of post-operative bleeding, 3 wound infections and 2 skin dehiscences. Average length of hospital stay
was 9.5 days (5-22 days). 15 of these patients (45.4%) simultaneously underwent abdominal incisional hernia repair; in 9 (24.2%),
a Gore-Tex? mesh was used. In 2 patients the procedure was performed under emergency conditions due to small bowel obstruction.
In 2 patients, simultaneous cholecystectomy was also performed. In 1 patient, a suction-assisted lipectomy of both thighs
was necessary. 7 patients (21.2%) had mammaplasty, with average operative time 175.7 min (140-210 min). In 1 of them, breast
implants were placed. There was no morbidity, and the average hospitalization was 6 days (4-9 days). Flankplasty was done
in 4 patients (12.1%), thigh reduction plasty in 4 patients (12.1%), and arm reduction plasty in 3 patients (9%). The average
operative time was 302.5 min (160-420), 246.2 min (230-280) and 203.3 min (180-240) respectively. Average tissue excised was
1503 g (725-2400 g), 1342.5 g (1050-1550 g), and 572.6 g (400-848 g), respectively. Morbidity was related to wound infection
in 1 patient, and persistent edema of the left lower extremity in another. 4 of these 18 patients required blood transfusion.
Average hospitalization was 8.2 days (6-11), 8 days (7-9) and 6 days (5-7) respectively. Conclusions: Regional dermolipectomies
constitute the only available treatment for deformities following massive weight loss after bariatric surgery. Based on our
experience, these procedures are safe, without serious complications and with good functional and esthetic results. 相似文献
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