| Satisfacción con la cirugía post bariátrica y la consideración cirugía del contorno corporal después de pérdida masiva de peso |
Post-bariatric surgery satisfaction and body-contouring consideration after massive weight loss.
Aldaqal SM, Makhdoum AM, Turki AM, Awan BA, Samargandi OA, Jamjom H.
North Am J Med Sci [serial online] 2013 [cited 2013 Apr 11];5:301-5.
Background: Following a bariatric surgery and massive weight-loss, the outcome is usually sullied by consequences on the body's contour and redundant skin. Aims: We aimed to record the frequency of contour irregularities and quantify patients' satisfaction with appearance and anticipations from body contouring surgery. Materials and Methods: The ethical committee at King Abdulaziz University Hospital approved the study, and patients were consented. A cross-sectional study targeting the post-bariatric patients from May 2011 to April 2012 was conducted at our hospital. We used post-massive weight loss Satisfaction Questionnaire. Results: The total numbers of patients were 64 (51 women and 13 men), of which 57 patients (89.2%) developed sagging skin. Most patients were dissatisfied with their appearance after weight loss. The most common zones were the upper arms (50%) and abdomen (45%). Considerably more women (36.2%) than men (24%) were dissatisfied with certain body areas. The most noticeable expectation of patients from body contouring surgery was improved cosmetic appearance (65.6%) and self-confidence (64.1%). More women (70.58%) than men (46.15%) expected a better cosmetic appearance after body contouring (P = 0.003). Conclusion: After bariatric surgery, sagging excess skin is an unsatisfactory problem. Therefore, body contouring surgery must be included in morbid obesity management.
Keywords: Bariatric surgery, Body contouring surgery, Expectation, Satisfaction, Weight loss
http://www.najms.org/text.asp?2013/5/4/301/110442
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| Anestesia para procedimientos de cirugía plástica en pacientes con obesidad mórbida previa |
Anesthesia for plastic surgery procedures in previously morbidly obese patients.
Whizar-Lugo V, Cisneros-Corral R, Reyes-Aveleyra MA, Campos-León J. Domínguez J.
Anest Mex 2009;21:186-193.
Abstract
Obese patients that have undergone bariatric surgery and have lost considerable amounts of weight tend to seek the assistance of plastic surgeons for body contour surgery to improve their physical appearance as well as their self esteem. This growing patient population tends to retain a certain amount of excess weight, as well as some of the co morbidities of obesity, such as arterial hypertension, mixed cardiopathy, pulmonary hypertension and hyperglycemia, among other pathologies. They should be examined thoroughly, in search of these co morbidities, as well as to obtain a complete list of medications they take or have taken in the past. The anesthetic management plan should be contingent upon the patient's physical condition, anatomic and physiologic changes, psychological condition and the surgical plan. Anemia is a frequent complication of some bariatric procedures and should be compensated with appropriate anticipation. Preanesthetic medications may include benzodiazepines and alfa-2 agonists, as long as precautions are taken against nausea and vomiting. Droperidol is the drug of choice. Regional anesthesia should be employed whenever possible, especially subarachnoid block, since it is deeper and has fewer adverse effects. General anesthesia should be left as the last choice, and may be combined with regional techniques. It is prudent to use conscious sedation for facial and neck surgery, maintaining stringent monitoring, especially with respect to airway management. Thromboprophylaxis is mandatory in these patients, and should continue for several days postoperatively.
Key words: previously obese, plastic surgery, anesthesia
http://www.anestesiaenmexico.org/RAM9/RAM2009-21-3/007.pdf
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Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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