Skip to main content

Advertisement

SpringerLink
Log in

Wound Infections in Body Contouring Mastopexy with Breast Reduction After Laparoscopic Adjustable Gastric Bandings: The Role of Smoking

  • Research Article
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

We retrospectively reviewed charts of 42 postbariatric patients who underwent mastopexy and breast reduction for body contouring to determine whether a significant relationship existed between cigarette smoking and postoperative wound infections and to determine the relative risk given by cigarettes and a cut-off value to predict infections.

Methods

We excluded patients with ongoing clinical infections, recent bariatric surgery (within 1 year), recent antibiotic courses, or systemic diseases such as arteriosclerosis and diabetes mellitus.

Results

All patients underwent bariatric surgery with the laparoscopic adjustable gastric bending technique and mastopexy with breast reduction for body contouring. Postoperative infections were present in 35.7% (n = 15) of patients, and 60% of these (n = 9) were superficial. Furthermore, 66.7% of them occurred in smoker patients, and 41.7% of smokers vs. 27.8% of nonsmokers developed infections. Significant differences between infected vs. infection-free patients were present for the number of pack years (p < 0.001) and the overall estimated cigarettes smoked (p < 0.001). A cut-off value of approximately 6.85 pack years (50,000 overall estimated cigarettes) distinguished between infections vs. infections-free patients, with 25% of false positives and 8% of false negatives. Relative risk conferred by smoking was 3.8.

Conclusions

The incidence of infections in our series of postbariatric patients undergoing mastopexy and breast reduction is 35.7%. A cut-off of 6.85 pack years (50,000 estimated overall cigarettes) was determined and, according to this value, the relative risk conferred by smoking was 3.8.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kwei S, Borud LJ, Lee BT. Mastopexy with autologous augmentation after massive weight loss: the intercostal artery perforator (ICAP) flap. Ann Plast Surg. 2006;57(4):361–5.

    Article  PubMed  CAS  Google Scholar 

  2. Poucke SV, Jorens PG, Peeters R, et al. Pyoderma gangrenosum: a challenging complication of bilateral mastopexy. Int Wound J. 2004;1(3):207–13.

    Article  PubMed  Google Scholar 

  3. Beer GM, Spicher I, Cierpka KA, et al. Benefits and pitfalls of vertical scar breast reduction. Br J Plast Surg. 2004;57(1):12–9.

    Article  PubMed  CAS  Google Scholar 

  4. Platt AJ, Mohan D, Baguley P. The effect of body mass index and wound irrigation on outcome after bilateral breast reduction. Ann Plast Surg. 2003;51(6):552–5.

    Article  PubMed  Google Scholar 

  5. Deconinck C, de Greef C, Walravens C, et al. Report of 243 vertical mammoplasties for very large, heavy breasts and/or severe ptosis. Analysis of the result and technical. Ann Chir Plast Esthet. 2002;47(6):623–32.

    Article  PubMed  CAS  Google Scholar 

  6. Cunningham BL, Gear AJ, Kerrigan CL, et al. Analysis of breast reduction complications derived from the BRAVO study. Plast Reconstr Surg. 2005;115(6):1597–604.

    Article  PubMed  CAS  Google Scholar 

  7. Chan LK, Withey S, Butler PE. Smoking and wound healing problems in reduction mammaplasty: is the introduction of urine nicotine testing justified? Ann Plast Surg. 2006;56(2):111–5.

    Article  PubMed  CAS  Google Scholar 

  8. O’Grady KF, Thoma A, Dal Cin A. A comparison of complication rates in large and small inferior pedicle reduction mammaplasty. Plast Reconstr Surg. 2005;115(3):736–42.

    Article  PubMed  CAS  Google Scholar 

  9. Schumacher HH. Breast reduction and smoking. Ann Plast Surg. 2005;54(2):117–9.

    Article  PubMed  CAS  Google Scholar 

  10. Dabbah A, Lehman JA Jr, Parker MG, et al. Reduction mammaplasty: an outcome analysis. Ann Plast Surg. 1995;35(4):337–41.

    Article  PubMed  CAS  Google Scholar 

  11. Schnur PL, Schnur DP, Petty PM, et al. Reduction mammaplasty: an outcome study. Plast Reconstr Surg. 1997;100(4):875–83.

    PubMed  CAS  Google Scholar 

  12. Menke H, Eisenmann-Klein M, Olbrisch RR, et al. Continuous quality management of breast hypertrophy by the German Association of Plastic Surgeons: a preliminary report. Ann Plast Surg. 2001;46(6):594–8.

    Article  PubMed  CAS  Google Scholar 

  13. Zubowski R, Zins JE, Foray-Kaplon A, et al. Relationship of obesity and specimen weight to complications in reduction mammaplasty. Plast Reconstr Surg. 2000;106(5):998–1003.

    Article  PubMed  CAS  Google Scholar 

  14. Ahmadi AH, Cohen BE, Shayani P. A prospective study of antibiotic efficacy in preventing infection in reduction mammaplasty. Plast Reconstr Surg. 2005;116(1):126–31.

    Article  PubMed  CAS  Google Scholar 

  15. Kompatscher P, von Planta A, Spicher I, et al. Comparison of the incidence and predicted risk of early surgical site infections after breast reduction. Aesthetic Plast Surg. 2003;27(4):308–14.

    Article  PubMed  Google Scholar 

  16. Serletti JM, Davenport MS, Herrera HR, et al. Efficacy of prophylactic antibiotics in reduction mammoplasty. Ann Plast Surg. 1994;33(5):476–80.

    Article  PubMed  CAS  Google Scholar 

  17. WHO. MONICA Manual: Smoking questionnaire. WHO MONICA Project (1992). http://www.ktl.fi/publications/monica/manual/part3/iii-1.htm.

  18. Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet. 2001;357:1191–4.

    Article  PubMed  CAS  Google Scholar 

  19. Kryger ZB, Fine NA, Mustoe TA. The outcome of abdominoplasty performed under conscious sedation: six-year experience in 153 consecutive cases. Plast Reconstr Surg. 2004;113(6):1807–17.

    Article  PubMed  Google Scholar 

  20. Spiegelman JI, Levine RH. Abdominoplasty: a comparison of outpatient and inpatient procedures shows that it is a safe and effective procedure for outpatients in an office-based surgery clinic. Plast Reconstr Surg. 2006;118(2):517–22.

    Article  PubMed  CAS  Google Scholar 

  21. Sanger C, David LR. Impact of significant weight loss on outcome of body-contouring surgery. Ann Plast Surg. 2006;56(1):9–13.

    Article  PubMed  CAS  Google Scholar 

  22. Rees TD, Liverett DM, Guy CL. The effect of cigarette smoking on skin-flap survival in the face lift patient. Plast Reconstr Surg. 1984;73(6):911–5.

    Article  PubMed  CAS  Google Scholar 

  23. Krueger JK, Rohrich RJ. Clearing the smoke: the scientific rationale for tobacco abstention with plastic surgery. Plast Reconstr Surg. 2001;108(4):1063–73.

    Article  PubMed  CAS  Google Scholar 

  24. Rogliani M, Labardi L, Silvi E, et al. Smokers: risks and complications in abdominal dermolipectomy. Aesthetic Plast Surg. 2006;30(4):422–4.

    Article  PubMed  CAS  Google Scholar 

  25. Chan LK, Withey S, Butler PE. Smoking and wound healing problems in reduction mammaplasty: is the introduction of urine nicotine testing justified? Ann Plast Surg. 2006;56(2):111–5.

    Article  PubMed  CAS  Google Scholar 

  26. Manassa EH, Hertl CH, Olbrisch RR. Wound healing problems in smokers and nonsmokers after 132 abdominoplasties. Plast Reconstr Surg. 2003;111(6):2082–7.

    Article  PubMed  Google Scholar 

  27. Mosely LH, Finseth F, Goody M. Nicotine and its effect on wound healing. Plast Reconstr Surg. 1978;61(4):570–5.

    Article  PubMed  CAS  Google Scholar 

  28. Kaufman T, Eichenlaub EH, Levin M, et al. Tobacco smoking: impairment of experimental flap survival. Ann Plast Surg. 1984;13(6):468–72.

    Article  PubMed  CAS  Google Scholar 

  29. Lawrence WT, Murphy RC, Robson MC, et al. The detrimental effect of cigarette smoking on flap survival: an experimental study in the rat. Br J Plast Surg. 1984;37(2):216–9.

    Article  PubMed  CAS  Google Scholar 

  30. van Adrichem LN, Hoegen R, Hovius SE, et al. The effect of cigarette smoking on the survival of free vascularized and pedicled epigastric flaps in the rat. Plast Reconstr Surg. 1996;97(1):86–96.

    Article  PubMed  Google Scholar 

  31. Chang LD, Buncke G, Slezak S, et al. Cigarette smoking, plastic surgery, and microsurgery. J Reconstr Microsurg. 1996;12(7):467–74.

    PubMed  CAS  Google Scholar 

  32. Black CE, Huang N, Neligan PC, et al. Effect of nicotine on vasoconstrictor and vasodilator responses in human skin vasculature. Am J Physiol Regul Integr Comp Physiol. 2001;281(4):R1097–104.

    PubMed  CAS  Google Scholar 

  33. Astrup P, Kjeldsen K. Carbon monoxide, smoking, and atherosclerosis. Med Clin North Am. 1974;58(2):323–50.

    PubMed  CAS  Google Scholar 

  34. Birnstingl MA, Brinson K, Chakrabarti BK. The effect of short-term exposure to carbon monoxide on platelet stickiness. Br J Surg. 1971;58(11):837–9.

    Article  PubMed  CAS  Google Scholar 

  35. Dintenfass L. Elevation of blood viscosity, aggregation of red cells, haematocrit values and fibrinogen levels with cigarette smokers. Med J Aust. 1975;1(20):617–20.

    PubMed  CAS  Google Scholar 

  36. Meade TW, Chakrabarti R, Haines AP, et al. Characteristics affecting fibrinolytic activity and plasma fibrinogen concentrations. Br Med J. 1979;1(6157):153–6.

    Article  PubMed  CAS  Google Scholar 

  37. Chaouat M, Levan P, Lalanne B, et al. Abdominal dermolipectomies: early postoperative complications and long-term unfavorable results. Plast Reconstr Surg. 2000;106(7):1614–8.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

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

    G. Gravante, R. Sorge & V. Cervelli

  2. Dolan Park Hospital, Birmingham, UK

    A. Araco & F. Araco

  3. University “La Sapienza”, Rome, Italy

    D. Delogu

Authors
  1. G. Gravante
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Araco
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Sorge
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F. Araco
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. Delogu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. V. Cervelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. Gravante.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gravante, G., Araco, A., Sorge, R. et al. Wound Infections in Body Contouring Mastopexy with Breast Reduction After Laparoscopic Adjustable Gastric Bandings: The Role of Smoking. OBES SURG 18, 721–727 (2008). https://doi.org/10.1007/s11695-007-9252-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-007-9252-6

Keywords

Search

Navigation