Abstract

PORTES-CASTRO, Alejandro et al. Interdisciplinary clinical guidelines for massive weight loss patients during plastic reconstructive surgery. Cir. plást. iberolatinoam. [online]. 2016, vol.42, n.1, pp.77-91. ISSN 1989-2055.

Background and Objectives. Obesity is now considered a pandemic problem. México occupies one of the highest places in the world with adults and children with obesity or overweight. In 2008 multiple Bariatric Surgery Centers were created in the country. Therefore, the massive weight loss reconstruction started to be performed by Plastic Surgery Services. They lack of clinical practice guidelines. Our objective is to create an interdisciplinary clinical practice guidelines for the massive weight loss patient reconstruction, based on the results and experience of a Postbariatric Reconstruction Center. Methods. A highly specialized interdisciplinary team was created in order to perform a complete clinical evaluation before the patients was operated by Plastic Surgery. All the perioperative management was standarized by every clinical area and we described the guidelines based on the final results. Results. A total of 314 reconstruction procedures were performed in 144 postbariatric patients. The 93% of the population were female. Average age was 37.2 years old. The procedures performed were: abdominoplasty in 39.17%; mastope; and rhytidectomy in 2.54%. Average surgical time were 221.2 minutes. Intraoperative haemorrage was 275 ml as an average. Complications were developed in the 4.77% of the procedures with a mortality rate of 0%. The recomendations emitted by every clinical expert, awolled to obtain a good outcome concerning about the low rate of morbility and mortality, even better than other international series described. Conclusions. The application of clinical guidelines in the management of massive weight patient sustained in a 314 postbariatric Plastic Surgery procedure in a standarized population allows to perform an effective and safe surgery.

Keywords : Weight loss; Bariatric surgery; Clinical practice guideline; Obesity.

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