Prediction of flap ischemia during abdominoplasty in patients after bariatric treatment

Introduction. The number of bariatric surgeries performed is progressively increasing. However, rapid and massive weight loss leads to the same rapid formation of sagging skin folds, including in the area of the anterior abdominal wall, the complete elimination of which requires the intervention of a plastic surgeon. But dermatolipectomy after bariatric treatment has a number of significant differences from standard abdominoplasty.

The aim of the work: to search for and substantiate new methods of preventing complications after dermatolipectomy in patients with a history of metabolic surgery.

Materials and methods. The study included 10 patients aged 45 to 57 years who underwent classical abdominoplasty at Eva Clinic after previous bariatric surgery 1.5 to 2 years ago. The essence of the method is to measure the parameters of blood circulation in the epigastric arteries before and after the main stage of abdominoplasty, followed by an analysis of the data obtained to adopt an optimal suturing strategy. Ultrasound vascular doppler VD-260 was used to determine blood flow through the epigastric arteries.

Results. The only indicator that can indicate the possibility of flap ischemia after suturing is the ratio of Doppler readings before and after suturing. The before/ after ratio of 2.0 or more indicates the possibility of necrotic skin changes and requires additional mobilization of the skin flap in order to reduce tension.

Conclusion. This technique is an innovative method for predicting the healing process of postoperative wounds in plastic surgery, based on an objective assessment of microcirculation in tissues.

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