乳房重建后的伤口并发症:与手术前风险评估中的体质指数相比,血红蛋白A1c的有限作用
Emily E Zona1, Doruk Orgun, Caroline C Bay1
1From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Annals of plastic surgery
|June 23, 2025
概括
较高的体重指数 (BMI) 在乳房重建患者中显著增加伤口并发症风险. 血红蛋白A1c水平与这些术后并发症没有关联.
科学领域:
- 整形外科 整形外科 整形外科
- 手术瘤学手术瘤学
- 代谢健康 代谢健康
背景情况:
- 血红蛋白A 1c (HbA 1c) 和体重指数 (BMI) 是评估乳房重建并发症风险的关键因素.
- 对于这些患者接受的HbA 1c和BMI的切断值,存在有限的基于证据的指南.
研究的目的:
- 为了调查HbA 1c水平和BMI与所有塑性和自身乳房重建后的伤口并发症之间的关联.
- 确定这些共同的术前措施的潜在风险值.
主要方法:
- 使用美国外科医生学院国家外科质量改善计划数据库 (2021-2022) 进行回顾性队列研究.
- 在2809名接受乳房重建的患者中分析了30天的伤口并发症 (衰变,手术部位感染).
- 统计分析包括基于HbA 1c和BMI四分位数的多变量考克斯回归和卡普兰-梅尔曲线.
主要成果:
- 较高的BMI四分位数与30天伤口并发症率的增加显著相关 (P < 0.001).
- 体重指数最高四分位数 (中位数为37.3kg/m2) 的患者与最低四分位数患者相比,并发症率翻了一番多.
- 在HbA 1c水平和30天的伤口并发症之间没有发现显著的关联 (日志等级P = 0.46).
结论:
- 升高的BMI是乳房重建后伤口并发症的重要预测因素.
- 较高的BMI与在全塑性和自身重建类型中显著增加的并发症风险有关.
- 在这个患者队列中,HbA 1c水平似乎与伤口并发症风险无关.
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