Plastic Surgery After Massive Weight Loss Flashcards
. Massive weight Joss (MWL), commonly defined as a loss of
greater than 50% ofexcess weight above ideal body weight (IBW)
T
Weight loss by pharmacologic methods can be risky and unpredictable given the lack oflong-term data
T
complications from body
contouring in this population are similar independent ofweight loss
method.’
T
MWL patients have an almost
three-fold increased risk of wound healing complications compared
to non-MWL patients, and the risk is highest in those who have lost
over 100 pounds
T
Before enlisting a patient for body contouring after weight loss,
weight should remain stable-within 5 kg-for at least 1 months
F stable-within 5 kg-for at least 3 months
stress of surgery can increase energy expenditure
up to 25%,
T
increase their daily protein consumption to 75 to 100 g in the perioperative period. This increased protein intake should be maintained for at least 2 weeks preoperatively and 4 weeks postoperatively
T
The three most common diseases patients present with after MWL
depression (53%), arthritis
(41%), and anxiety (27%)
BMI should
be under or as close to 30 kg/m2 preoperatively, because there is an
increased risk of complications in patients who have a BMI above
this threshold. Specifically, in the body contouring population
T
Risk of VTE in the post-MWL patient is around
3%, and the risk in those with a BMI over 35 kg/m2 triples to approximately 9%
T
Seroma one of the complication of the MWL surgery hoe you can treat it ?
can be decreased with drain use. If drain output
continues to preclude removal of drains, chemical sclerosis can be
performed. If drains were not used or a seroma appears after drain
removal, percutaneous needle aspiration can be done up to three
times, after which time placement of a seroma catheter is recommended
Rarely, the patient may require reoperation to excise the
seroma cavity
T
Urine cotinine tests can take
up to 10 days to get the results, so it should not be used close to
the surgical date.
t
