Risk Factors for Wound Complications Following Abdominoplasty

Problem Statement: Abdominoplasty has become an increasingly popular procedure. Risk factors affecting wound complications of abdominoplasty are not adequately defined in literature. Identification of these risk factors is crucial for better patient’s selection and counseling. The objectives of this study were to determine wound complication rate following abdominoplasty and to examine the relationship of a set of possible risk factors with the incidence of complications. Approach: We studied 116 patients (107 women and 9 men) who underwent abdominoplasty at Jordan University Hospital, between June 1997 and June 2007. Data were collected from patients’ medical records and analyzed to determine types and rates of surgical wound complications. Fourteen possible risk factors were investigated using logistic regression analysis to evaluate their relationship with the occurrence of wound complications. Risk factors examined were: age, sex, body mass index, parity number, smoking history, history of diabetes mellitus, previous gastroplasty for morbid obesity, previous abdominal surgical scars, type of abdominoplasty, plication of recti, hernia repair, operative time and operative blood loss. Results: A total of 29 patients (two males and 27 females) (25%) had wound complications. The most common complication was seroma. It was encountered in 15 cases (12.9%). Six patients (5.2%) had wound infection. Partial skin necrosis was encountered in four cases (3.4 %). Two patients (1.7%) developed wound dehiscence and two patients (1.7%) had hematoma. The only factors significantly increased the complication rate were: increased body mass index (p = 0.002) and history of smoking (p = 0.004). Conclusions and Recommendations: This study confirms the adverse effect of overweight and cigarette smoking on the incidence of wound complication rate following abdominoplasty. We recommend that overweight patients and smokers undergoing abdominoplasty should be adequately counseled and informed about the increased risks. In addition, prophylactic measures should be properly taken to decrease wound complication rate in these groups of patients.