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Wound Infections in Post-bariatric Patients undergoing Body Contouring Abdominoplasty: the Role of Smoking

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Background

In this prospective study, we followed patients after laparoscopic adjustable gastric banding for morbid obesity who underwent abdominoplasty for body contouring. Our purposes were: 1) to determine if a significant relationship between cigarette smoking and postoperative wound infections existed, 2) the relative risk conferred by cigarettes and 3) a cut-off value for the increased risk.

Methods

Patients scheduled for body contouring abdominoplasty were considered eligible. We excluded those with ongoing clinical infections, recent antibiotic administration, those within 1 year from their bariatric surgery and those with systemic diseases. Smokers were asked to stop smoking at least 4 weeks before surgery.

Results

Since November 2004, we recruited 60 patients. Postoperative infections were present in 25% (n=15) of patients and 86.7% of these (n=13) were superficial. All except one occurred in smokers (P=0.0001): 47% of smokers and 3% of nonsmokers developed infections. Significant differences between infections vs infection-free patients were present for the number of cigarettes smoked per day (P<0.001), years of smoking (P<0.001), overall estimated cigarettes smoked and the number of pack years (P=0.001). A cut-off value of −62,000 overall estimated cigarettes (8.5 pack years) distinguished between infections vs infection-free patients (6.2% false positives and 7.1% false negatives). Relative risk conferred by smoking was 14 (95% confidence intervals 13.3–16.7).

Conclusions

The incidence of infections in postbariatric patients undergoing body contouring abdominoplasties is 25%. The relative risk conferred by smoking was 14 and the cut-off value was 62,000 overall cigarettes (8.5 pack years).

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Authors and Affiliations

  1. Department of General Surgery, University of Tor Vergata in Rome, Rome, Italy

    G. Gravante

  2. Dolan Park Hospital, Birmingham, United Kingdom

    A. Araco & F. Araco

  3. Department of Human Physiology, Laboratory of Biometry, University of Tor Vergata in Rome, Rome, Italy

    R. Sorge

  4. University “La Sapienza” of Rome, Rome, Italy

    D. Delogu

  5. Department of Plastic Surgery, University of Tor Vergata in Rome, Rome, Italy

    V. Cervelli

  6. via U. Maddalena 40/a, 00043, Ciampino, Roma, Italy

    G. Gravante

Authors
  1. G. Gravante
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  2. A. Araco
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  3. R. Sorge
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  4. F. Araco
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  5. D. Delogu
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  6. V. Cervelli
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Correspondence to G. Gravante.

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Gravante, G., Araco, A., Sorge, R. et al. Wound Infections in Post-bariatric Patients undergoing Body Contouring Abdominoplasty: the Role of Smoking. OBES SURG 17, 1325–1331 (2007). https://doi.org/10.1007/s11695-007-9236-6

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  • DOI: https://doi.org/10.1007/s11695-007-9236-6

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