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Current Practices and Guidelines for Perioperative Blood Management in Post-Bariatric Body Contouring Surgery: A Comprehensive Review of Literature

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Abstract

With the increase in obesity prevalence, a noticeable increase in bariatric surgeries has been reported in national and international statistics. Therefore, body contouring surgeries have increased to help individuals achieve their desired body shape. Plastic surgeons need to consider potential hematologic complications that may occur in this specific group of patients before performing body contouring surgery. This review illustrates the perioperative medical, laboratory, and management strategies needed to minimize blood loss and blood transfusion requirements during body contouring. Using Google Scholar and PubMed, a comprehensive literature review was conducted to identify articles discussing post-bariatric body contouring perioperative blood management strategies, including the effects of bariatric surgery on hemostasis as well as basic hematology and coagulation. In preoperative blood management, blood investigations aid in the early detection of electrolytes, protein, and vitamin deficiencies and anemia, resulting in the early correction of nutritional deficiencies. In order to reduce postoperative complications, surgical and anesthesia techniques, as well as intraoperative pharmacological therapy, play an essential role. Postoperative blood transfusion and restrictive transfusion thresholds are tailored to the patient's needs and depend on various physiological indicators, such as heart rate, blood pressure, urine output, and laboratory findings, such as acidosis and hematocrit level. Generally, post-bariatric body contouring blood management measures are still lacking, and more research is required to develop standardized guidelines for optimizing patient safety and satisfaction.

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Acknowledgment

This work was supported by the College of Medicine Research Center, Deanship of Scientific Research, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.

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Authors and Affiliations

  1. Division of Plastic Surgery, Department of Surgery, King Saud University, Riyadh, Saudi Arabia

    Omar Fouda Neel

  2. Division Plastic Surgery, Department of Surgery, McGill University, Montreal, Canada

    Omar Fouda Neel

  3. Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia

    Hatan Mortada

  4. Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia

    Hatan Mortada

  5. College of Medicine, King Saud bin Abdulaziz University for Health and Sciences, Riyadh, Saudi Arabia

    Salman Sufian Qasim

  6. Division of Plastic Surgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia

    Salman Sufian Qasim

  7. King Abdullah International Medical Research Center, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia

    Salman Sufian Qasim

  8. Faculty of Medicine, Imam Mohammad Ibn Saud University, Riyadh, Saudi Arabia

    Taif Fawaz AlNojaidi

  9. Division of Hematology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia

    Ghazi Alotaibi

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Neel, O.F., Mortada, H., Qasim, S.S. et al. Current Practices and Guidelines for Perioperative Blood Management in Post-Bariatric Body Contouring Surgery: A Comprehensive Review of Literature. Aesth Plast Surg 47, 1462–1471 (2023). https://doi.org/10.1007/s00266-022-03192-z

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