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Thirty-Day Complication Rates After Gender-Affirming Bottom Surgery: An Analysis of the NSQIP Database From 2010 to

Jennifer Goldman¹, Anna Hu, Adam Hammer

¹From The George Washington University School of Medicine and Health Sciences, Washington, DC.

Annals of Plastic Surgery

|September 4, 2024

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Gender-affirming bottom surgeries (GABS) show increased risks for wound complications in transgender and nonbinary patients with higher BMI or diabetes. Awareness of these factors is key for better GABS outcomes.

Area of Science:

Surgical outcomes research
Transgender healthcare
Public health

Background:

Gender-affirming bottom surgeries (GABS) are crucial for treating gender dysphoria in transgender and nonbinary (TGNB) individuals.
Limited data exists on the operative risks and outcomes associated with GABS.
Identifying risk factors is essential for improving patient quality of life.

Purpose of the Study:

To identify sociodemographic and clinical risk factors for 30-day postoperative complications in patients undergoing GABS.
To analyze operative risks and outcomes in TGNB populations undergoing GABS.
To inform strategies for mitigating GABS complications.

Main Methods:

Utilized the American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) database (2010-2020).

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Identified GABS using Current Procedural Terminology (CPT) codes for transfeminine and transmasculine procedures.

Performed multivariate analysis to determine risk factors for 30-day postoperative complications, including reoperation and readmission.

Main Results:

Analyzed 1809 GABS procedures from 2010-2020, noting an upward trend.
Transmasculine patients with a BMI ≥ 29 had higher risks of wound complications (P < 0.05).
Diabetic transfeminine patients also faced increased risks of wound complications (P < 0.05).

Conclusions:

Sociodemographic and clinical factors like BMI and type 2 diabetes mellitus increase postoperative complications in GABS.
Effective wound care management and patient education are vital for preventing long-term GABS complications.
Physician awareness of risk factors and social determinants of health can enhance postoperative care and patient compliance.