RESUMO
BACKGROUND: Abdominoplasty, the treatment for abdominal wall deformity stemming from weight loss after bariatric surgery, can cause postoperative anemia. Moreover, bariatric surgery has been associated with iron deficiency, which by itself can compromise erythropoiesis. The objective of this research is to describe the development of anemia after postbariatric abdominoplasty. METHODS: The study group consisted of 32 adult women who had received bariatric surgery. Treatment group included 20 patients who were undergoing postbariatric abdominoplasty. Control group included 12 patients waiting for abdominoplasty. Values of hemoglobin, reticulocytes, iron, ferritin, and the transferrin saturation were obtained on the evening before abdominoplasty and during the first, fourth, and eighth postoperative weeks. Hemoglobin was measured at 48 h. RESULTS: Mean hemoglobin levels for treatment group decreased from 12.98 to 10.8 g/dL after 48 h, increased on day 7 to 11.53 g/dL, but did not increase further after day 7. The reticulocyte number increased in the first week. Serum iron and transferrin saturation index fell during the first week and remained low. Ferritin levels increased non-significantly from 29.77 to 37.24 ng/mL at week 1, then fell until they were decreased (16.44 ng/mL) by day 56. CONCLUSIONS: As expected, hemoglobin fell after abdominoplasty. However, after a one-third recovery of hemoglobin concentrations by week 1 postoperative, they failed to return to preoperative levels by the eighth week. Additionally, by the eighth postoperative week, 45 % of abdominoplasty patients had developed an iron deficiency and hemoglobin deficit that was higher than that of patients who maintained normal iron stocks.
Assuntos
Abdominoplastia/efeitos adversos , Anemia/sangue , Ferritinas/sangue , Derivação Gástrica/efeitos adversos , Ferro/sangue , Obesidade Mórbida/sangue , Abdominoplastia/métodos , Adulto , Analgésicos/uso terapêutico , Antibacterianos/uso terapêutico , Biomarcadores/sangue , Celecoxib , Inibidores de Ciclo-Oxigenase 2/uso terapêutico , Feminino , Seguimentos , Derivação Gástrica/métodos , Hemoglobinas/metabolismo , Humanos , Deficiências de Ferro , Obesidade Mórbida/tratamento farmacológico , Obesidade Mórbida/cirurgia , Estudos Prospectivos , Pirazóis/uso terapêutico , Reticulócitos/metabolismo , Sulfonamidas/uso terapêuticoRESUMO
BACKGROUND: The number of bariatric surgeries is progressively increasing in the USA and in Brazil. The number of post-bariatric plastic surgeries also increases as a response to this phenomenon. Abdominoplasties performed in former morbidly obese patients present a larger number of postoperative complications. Studies show that abdominoplasty caused postoperative skin hypesthesia. This study aims at evaluating skin sensibility/sensation in post-bariatric patients submitted to anchor-line abdominoplasty with clinical, qualitative, reliable and reproductive methods. METHODS: Thirty-nine former morbidly obese women after open Roux-en-Y Gastric Bypass were evaluated for skin tactile pain, touch in movement, noxious and innocuous thermal sensibility and vibration. Fifteen patients composed the Control group (which did not undergo abdominoplasty) and 24 patients composed the Study group (which was submitted to anchor-line abdominoplasty without flap undermining). The sensations were evaluated before and after the abdominoplasty. RESULTS: The Control group which did not undergo abdominoplasty showed nearly 100% of positivity to all sensory modalities exception made to vibration which was 56.4-62.2-64.9%. Surprisingly, the Study group showed the same sensation maintenance after the abdominoplasty for nearly all modalities, vibration showed improvement (56.7-71.1-78.3%) without statistical value (p = 0.67). CONCLUSION: There was skin sensation maintenance after anchor-line post-bariatric abdominoplasty. Non-undermining of xipho-pubic flap is a possible reason for this discovery.