Smoking as a risk factor for Panniculectomy: An analysis of 7,650 cases

Publication date: Available online 13 December 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Carolina Puyana Barcha, Matthew Ranzer
BackgroundPanniculectomy is performed to remove a symptomatic abdominal pannus. Successful surgery can improve quality of life and alleviate numerous health concerns including intertrigo, chronic infection, lumbago, and immobility. This study is aimed to examine smoking as risk factor for post-operative complications in panniculectomy patients. It is the first study to date on this topic.MethodsA retrospective study on 7,650 panniculectomy patients was performed utilizing data from the American College of Surgeons National Surgical Quality Improvement Program, collected from 2005-2015. Patients were identified by Current Procedural Terminology code 15830 and separated into two cohorts based on current smoking status. Cohorts were compared in terms of demographics, preoperative health, operation variables, and 30-day complications. Univariate analysis utilized χ2 or Fisher's exact tests and Wilcoxon rank sum tests. Multivariate logistic regression models were fitted to evaluate the association between smoking and development of wound complications or any complication. Odds ratios were computed at the 95% confidence interval.ResultsThe rate of complications for smokers vs. non-smokers were: deep incisional surgical site infections (2.4 vs. 1.3%; p=0.0162), organ/space surgical site infections (0.8% vs. 0.3%; p=0.026), and return to operating room (4.9% vs. 3.3%; p=0.0185). After adjusting for confounders, smokers had a higher likelihood of developing wound complications (OR 1.332; p=0.0085) or any complications (OR 1.379; p=0.0220) following panniculectomy compared to non-smokers.ConclusionsSmoking confers an increased risk of developing wound complications or any complication for patients undergoing panniculectomy. Smoking cessation should be an important part of the pre-operative workup to reduce complications.