Physical discomfort due to redundant skin in post-bariatric surgery patients
Summary Massive weight loss after bariatric surgery leads to excess skin with functional and aesthetic impairments. The aim of this study was to evaluate the prevalence of excess skin after bariatric surgery and identify any relationship with pre- and postoperative characteristics. A total of 360 pa...
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| Veröffentlicht in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2013-07, Vol.66 (7), p.950-955 |
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| description | Summary Massive weight loss after bariatric surgery leads to excess skin with functional and aesthetic impairments. The aim of this study was to evaluate the prevalence of excess skin after bariatric surgery and identify any relationship with pre- and postoperative characteristics. A total of 360 patients who had undergone bariatric surgery procedures were asked to complete a questionnaire designed by the surgical team at least 1 year after surgery. This questionnaire was planned to estimate any impairment due to redundant skin, which was graded according to a visual analogue scale (VAS, 0-–0). Mean (standard deviation, SD) age of 110 males and 250 females was 51.2 (10.8) years. Mean preoperative body mass index (BMI) was 45.7 (6.4) kg m−2 and mean postoperative BMI at follow-up was 33.6 (6.0) kg m−2 . After a mean follow-up of 56.1 (43.6) months, the mean weight loss was 35.2 (18.8) kg. Most patients (92.8%) reported problems with redundant skin, especially on the abdomen, upper arms and rear/buttocks, which impaired daily physical activity in half of them. Excess skin was associated with female gender ( β = −13.56, 95% confidence interval (CI) −16.81 to −10.32, p |
| doi_str_mv | 10.1016/j.bjps.2013.03.016 |
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The aim of this study was to evaluate the prevalence of excess skin after bariatric surgery and identify any relationship with pre- and postoperative characteristics. A total of 360 patients who had undergone bariatric surgery procedures were asked to complete a questionnaire designed by the surgical team at least 1 year after surgery. This questionnaire was planned to estimate any impairment due to redundant skin, which was graded according to a visual analogue scale (VAS, 0-–0). Mean (standard deviation, SD) age of 110 males and 250 females was 51.2 (10.8) years. Mean preoperative body mass index (BMI) was 45.7 (6.4) kg m−2 and mean postoperative BMI at follow-up was 33.6 (6.0) kg m−2 . After a mean follow-up of 56.1 (43.6) months, the mean weight loss was 35.2 (18.8) kg. Most patients (92.8%) reported problems with redundant skin, especially on the abdomen, upper arms and rear/buttocks, which impaired daily physical activity in half of them. Excess skin was associated with female gender ( β = −13.56, 95% confidence interval (CI) −16.81 to −10.32, p < 0.0001), weight loss ( β = 0.21, 95% CI 0.12–0.29, p < 0.0001) and ΔBMI ( β = 0.21, 95% CI 0.12–0.29, p < 0.0001) at multivariate analysis. Patients with a ΔBMI >20 kg m−2 showed a significantly surplus skin discomfort compared to ΔBMI ≤5 and 5 < ΔBMI ≤10 ( p < 0.001). Patients with a weight loss >50 kg showed a significantly redundant skin discomfort compared to weight loss <20 kg ( p < 0.001). Weight loss after bariatric surgery reduces the medical risks of obesity but psychosocial and functional problems often remain due to the surplus skin. Our data suggest that a ΔBMI ≤10 kg m−2 and weight loss >20 kg, not BMI alone, might be taken into consideration as cut-off values for developing score systems with the intention to apply evidence-based indications for the surgical management of post-bariatric impairments.]]></description><identifier>ISSN: 1748-6815</identifier><identifier>EISSN: 1878-0539</identifier><identifier>DOI: 10.1016/j.bjps.2013.03.016</identifier><identifier>PMID: 23578737</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adaptation, Physiological ; Adaptation, Psychological ; Adult ; Bariatric Surgery - adverse effects ; Bariatric Surgery - methods ; Body Mass Index ; Body-contouring indications ; Confidence Intervals ; Cross-Sectional Studies ; Dermatologic Surgical Procedures - methods ; Female ; Follow-Up Studies ; Humans ; Linear Models ; Male ; Massive weight loss ; Middle Aged ; Obesity ; Obesity, Morbid - diagnosis ; Obesity, Morbid - surgery ; Plastic Surgery ; Post-bariatric surgery ; Skin excess ; Surveys and Questionnaires ; Treatment Outcome ; Weight Loss</subject><ispartof>Journal of plastic, reconstructive & aesthetic surgery, 2013-07, Vol.66 (7), p.950-955</ispartof><rights>British Association of Plastic, Reconstructive and Aesthetic Surgeons</rights><rights>2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons</rights><rights>Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-2c2d1d4fb7aff3fa554846f070de6b65a62e8b7176b17259fc596b90f2e6e4213</citedby><cites>FETCH-LOGICAL-c411t-2c2d1d4fb7aff3fa554846f070de6b65a62e8b7176b17259fc596b90f2e6e4213</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.bjps.2013.03.016$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23578737$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Giordano, Salvatore</creatorcontrib><creatorcontrib>Victorzon, Mikael</creatorcontrib><creatorcontrib>Koskivuo, Ilkka</creatorcontrib><creatorcontrib>Suominen, Erkki</creatorcontrib><title>Physical discomfort due to redundant skin in post-bariatric surgery patients</title><title>Journal of plastic, reconstructive & aesthetic surgery</title><addtitle>J Plast Reconstr Aesthet Surg</addtitle><description><![CDATA[Summary Massive weight loss after bariatric surgery leads to excess skin with functional and aesthetic impairments. The aim of this study was to evaluate the prevalence of excess skin after bariatric surgery and identify any relationship with pre- and postoperative characteristics. A total of 360 patients who had undergone bariatric surgery procedures were asked to complete a questionnaire designed by the surgical team at least 1 year after surgery. This questionnaire was planned to estimate any impairment due to redundant skin, which was graded according to a visual analogue scale (VAS, 0-–0). Mean (standard deviation, SD) age of 110 males and 250 females was 51.2 (10.8) years. Mean preoperative body mass index (BMI) was 45.7 (6.4) kg m−2 and mean postoperative BMI at follow-up was 33.6 (6.0) kg m−2 . After a mean follow-up of 56.1 (43.6) months, the mean weight loss was 35.2 (18.8) kg. Most patients (92.8%) reported problems with redundant skin, especially on the abdomen, upper arms and rear/buttocks, which impaired daily physical activity in half of them. Excess skin was associated with female gender ( β = −13.56, 95% confidence interval (CI) −16.81 to −10.32, p < 0.0001), weight loss ( β = 0.21, 95% CI 0.12–0.29, p < 0.0001) and ΔBMI ( β = 0.21, 95% CI 0.12–0.29, p < 0.0001) at multivariate analysis. Patients with a ΔBMI >20 kg m−2 showed a significantly surplus skin discomfort compared to ΔBMI ≤5 and 5 < ΔBMI ≤10 ( p < 0.001). Patients with a weight loss >50 kg showed a significantly redundant skin discomfort compared to weight loss <20 kg ( p < 0.001). Weight loss after bariatric surgery reduces the medical risks of obesity but psychosocial and functional problems often remain due to the surplus skin. Our data suggest that a ΔBMI ≤10 kg m−2 and weight loss >20 kg, not BMI alone, might be taken into consideration as cut-off values for developing score systems with the intention to apply evidence-based indications for the surgical management of post-bariatric impairments.]]></description><subject>Adaptation, Physiological</subject><subject>Adaptation, Psychological</subject><subject>Adult</subject><subject>Bariatric Surgery - adverse effects</subject><subject>Bariatric Surgery - methods</subject><subject>Body Mass Index</subject><subject>Body-contouring indications</subject><subject>Confidence Intervals</subject><subject>Cross-Sectional Studies</subject><subject>Dermatologic Surgical Procedures - methods</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Linear Models</subject><subject>Male</subject><subject>Massive weight loss</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity, Morbid - diagnosis</subject><subject>Obesity, Morbid - surgery</subject><subject>Plastic Surgery</subject><subject>Post-bariatric surgery</subject><subject>Skin excess</subject><subject>Surveys and Questionnaires</subject><subject>Treatment Outcome</subject><subject>Weight Loss</subject><issn>1748-6815</issn><issn>1878-0539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kdFr1TAYxYM4tjn3D_ggffSl13xJk7Qgggx1gwsT1OeQJl80XW9bk3Rw_3tT7vTBB-FA8nDOIfkdQl4B3QEF-XbY9cOSdowC39EikM_IJbSqrang3fNyV01byxbEBXmR0kBpw6ER5-SCcaFaxdUl2X_5eUzBmrFyIdn54OeYK7dilecqolsnZ6ZcpYcwVUXLnHLdmxhMjsFWaY0_MB6rxeSAU04vyZk3Y8Lrp_OKfP_08dvNbb2__3x382Ff2wYg18wyB67xvTLec2-EaNpGeqqoQ9lLYSTDtlegZA-Kic5b0cm-o56hxIYBvyJvTr1LnH-tmLI-lMfjOJoJ5zVp4LJRtGuFKlZ2sto4pxTR6yWGg4lHDVRvFPWgN4p6o6hpEcgSev3Uv_YHdH8jf7AVw7uTAcsvHwNGnWwhYNGFiDZrN4f_97__J27HMG0rPOAR0zCvcSr8NOjENNVftx23GYFTCoIy_huPt5iw</recordid><startdate>20130701</startdate><enddate>20130701</enddate><creator>Giordano, Salvatore</creator><creator>Victorzon, Mikael</creator><creator>Koskivuo, Ilkka</creator><creator>Suominen, Erkki</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130701</creationdate><title>Physical discomfort due to redundant skin in post-bariatric surgery patients</title><author>Giordano, Salvatore ; Victorzon, Mikael ; Koskivuo, Ilkka ; Suominen, Erkki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-2c2d1d4fb7aff3fa554846f070de6b65a62e8b7176b17259fc596b90f2e6e4213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adaptation, Physiological</topic><topic>Adaptation, Psychological</topic><topic>Adult</topic><topic>Bariatric Surgery - adverse effects</topic><topic>Bariatric Surgery - methods</topic><topic>Body Mass Index</topic><topic>Body-contouring indications</topic><topic>Confidence Intervals</topic><topic>Cross-Sectional Studies</topic><topic>Dermatologic Surgical Procedures - methods</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Linear Models</topic><topic>Male</topic><topic>Massive weight loss</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obesity, Morbid - diagnosis</topic><topic>Obesity, Morbid - surgery</topic><topic>Plastic Surgery</topic><topic>Post-bariatric surgery</topic><topic>Skin excess</topic><topic>Surveys and Questionnaires</topic><topic>Treatment Outcome</topic><topic>Weight Loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Giordano, Salvatore</creatorcontrib><creatorcontrib>Victorzon, Mikael</creatorcontrib><creatorcontrib>Koskivuo, Ilkka</creatorcontrib><creatorcontrib>Suominen, Erkki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Giordano, Salvatore</au><au>Victorzon, Mikael</au><au>Koskivuo, Ilkka</au><au>Suominen, Erkki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Physical discomfort due to redundant skin in post-bariatric surgery patients</atitle><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle><addtitle>J Plast Reconstr Aesthet Surg</addtitle><date>2013-07-01</date><risdate>2013</risdate><volume>66</volume><issue>7</issue><spage>950</spage><epage>955</epage><pages>950-955</pages><issn>1748-6815</issn><eissn>1878-0539</eissn><abstract><![CDATA[Summary Massive weight loss after bariatric surgery leads to excess skin with functional and aesthetic impairments. The aim of this study was to evaluate the prevalence of excess skin after bariatric surgery and identify any relationship with pre- and postoperative characteristics. A total of 360 patients who had undergone bariatric surgery procedures were asked to complete a questionnaire designed by the surgical team at least 1 year after surgery. This questionnaire was planned to estimate any impairment due to redundant skin, which was graded according to a visual analogue scale (VAS, 0-–0). Mean (standard deviation, SD) age of 110 males and 250 females was 51.2 (10.8) years. Mean preoperative body mass index (BMI) was 45.7 (6.4) kg m−2 and mean postoperative BMI at follow-up was 33.6 (6.0) kg m−2 . After a mean follow-up of 56.1 (43.6) months, the mean weight loss was 35.2 (18.8) kg. Most patients (92.8%) reported problems with redundant skin, especially on the abdomen, upper arms and rear/buttocks, which impaired daily physical activity in half of them. Excess skin was associated with female gender ( β = −13.56, 95% confidence interval (CI) −16.81 to −10.32, p < 0.0001), weight loss ( β = 0.21, 95% CI 0.12–0.29, p < 0.0001) and ΔBMI ( β = 0.21, 95% CI 0.12–0.29, p < 0.0001) at multivariate analysis. Patients with a ΔBMI >20 kg m−2 showed a significantly surplus skin discomfort compared to ΔBMI ≤5 and 5 < ΔBMI ≤10 ( p < 0.001). Patients with a weight loss >50 kg showed a significantly redundant skin discomfort compared to weight loss <20 kg ( p < 0.001). Weight loss after bariatric surgery reduces the medical risks of obesity but psychosocial and functional problems often remain due to the surplus skin. Our data suggest that a ΔBMI ≤10 kg m−2 and weight loss >20 kg, not BMI alone, might be taken into consideration as cut-off values for developing score systems with the intention to apply evidence-based indications for the surgical management of post-bariatric impairments.]]></abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>23578737</pmid><doi>10.1016/j.bjps.2013.03.016</doi><tpages>6</tpages></addata></record> |
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| ispartof | Journal of plastic, reconstructive & aesthetic surgery, 2013-07, Vol.66 (7), p.950-955 |
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| subjects | Adaptation, Physiological Adaptation, Psychological Adult Bariatric Surgery - adverse effects Bariatric Surgery - methods Body Mass Index Body-contouring indications Confidence Intervals Cross-Sectional Studies Dermatologic Surgical Procedures - methods Female Follow-Up Studies Humans Linear Models Male Massive weight loss Middle Aged Obesity Obesity, Morbid - diagnosis Obesity, Morbid - surgery Plastic Surgery Post-bariatric surgery Skin excess Surveys and Questionnaires Treatment Outcome Weight Loss |
| title | Physical discomfort due to redundant skin in post-bariatric surgery patients |
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