Preoperative prediction and surgical correction of the risk of developing local wound complications after contour plastic surgery of the trunk in overweight patients

E. P. Sukhoparova; E. V. Zhinov’ev; Е. П. Сухопарова; Е.  В. Зиновьев

doi:10.24884/0042-4625-2026-185-2-8755-7182

Preoperative prediction and surgical correction of the risk of developing local wound complications after contour plastic surgery of the trunk in overweight patients

E. P. Sukhoparova, E. V. Zhinov’ev

https://doi.org/10.24884/0042-4625-2026-185-2-8755-7182

Full Text:

PDF (Rus)

Generate QR code

Abstract

Based on a retrospective analysis, the OBJECTIVE was to develop an algorithm for predicting the risk of complications of abdominoplasty in overweight patients (BMI 25-29.9 kg/m²) using laboratory markers of carbohydrate metabolism and cytokine status, as well as to evaluate the efficacy of a modified surgical technique in high-risk patients.

METHODS AND MATERIALS. The study was conducted in two stages: 1) a retrospective analysis of 49 patients (2016-2018) who underwent standard abdominoplasty to identify predictors of complicated wound healing; 2) a prospective cohort study of 30 patients (2022-2023) with a BMI of 25-29.9 kg/m² and identified risk predictors (HOMA-IR≥3.1, insulin level>14.0 µIU/mL, interleukin-1β level (IL-1β)≥45.0 pg/ml), who underwent modified abdominoplasty with limited dissection, preservation of suprapubic tissue, Scarpa’s fascia and flap fixation. The main evaluation criteria were the duration of the operation, the frequency of seromas, hematomas, and ligature fistulas.

RESULTS. The retrospective analysis revealed three independent predictors of the development of local wound complications: HOMA-IR≥3.1, insulin level≥14.0 µIU/mL and lL-1β level≥45.0 pg/ml. The use of the modified technique in female patients with these predictors led to a statistically significant decrease in the incidence of complications compared with the retrospective group of similar risk: the incidence of seromas decreased from 43% to 3% (p=0.001), hematomas from 10% to 0% (p=0.04). The average surgery time was reduced by 40%.

CONCLUSION. The proposed algorithm, combining preoperative detection of markers of insulin resistance, carbohydrate metabolism disorders and systemic inflammation with the use of a gentle modified abdominoplasty technique, makes it possible to objectify the risk and significantly reduce the frequency of postoperative local wound complications in overweight patients, which can serve as a basis for individualizing surgical tactics.

Keywords

abdominoplasty, overweight, insulin resistance, interleukin-1β, prognosis of complications, systemic chronic inflammation

About the Authors

E. P. Sukhoparova

Pavlov University
Russian Federation

Sukhoparova Elena P., Cand. of Sci. (Med.), Associate Professor of the Department of Plastic Surgery, AuthorID: 1042578

6-8, L’va Tolstogo str., Saint Petersburg, 197022

Competing Interests:

The author declares no conflict of interest.

E. V. Zhinov’ev

Saint-Petersburg I. I. Dzhanelidze Research Institute of Emergency Medicine
Russian Federation

Zhinov’ev Evgenii V., Cand. of Sci. (Med.), Professor, Head of the Department of Thermal Lesions, AuthorID: 709654

3, lit. A, Budapeshtskaya str., Saint Petersburg, 192242

Competing Interests:

The author declares no conflict of interest.

References

1. Obydennov S. A., Frauchi I. V. Topographic-anatomical rationale for aesthetic abdominoplasty. FORCIPE. 2023;6(3S):60. (In Russ.).

2. Pshenisnov K. P., Grigoryan Z. Ts., Sedov A. V. et al. Complications of aesthetic abdominoplasty. Annals of Plastic, Reconstructive and Aesthetic Surgery. 2008;(Suppl):121. (In Russ.).

3. World Health Organization. Obesity and overweight. 2025. https://www.who.int/ru/news-room/fact-sheets/detail/obesity-and-overweight (accessed 11.09.2025). (In Russ.).

4. Dedov I. I., Mel’nichenko G. A., Shestakova M. V. et al. Nacional’nye klinicheskie rekomendacii po lecheniyu morbidnogo ozhireniya u vzroslyh. 3-ij peresmotr (lechenie morbidnogo ozhireniya u vzroslyh). Ozhirenie i metabolizm. 2018;15(1):53–70. (In Russ.). https://doi.org/10.14341/omet2018153-705.

5. RBC news portal: website. Moscow, 2025. URL: https://www.rbc.ru/rbcfreenews/685416599a794748b23d7bc (accessed: 15.05.2025). (In Russ.).

6. Sukhoparova E. P., Khrustalyova I. E., Ellinidi V. N., Abgarian A. G. The role of chron-ic inflammation in pathogenesis of complications after contour-plastic surgeries. Issues of Reconstructive and Plastic Surgery. 2025;28(3):35–41. (In Russ.). https://doi.org/10.52581/1814-1471/94/04.

7. Baugh N., Zuelzer H., Meador J., Blankenship J. Wound wise: wounds in surgical patients who are obese. Am J Nurs. 2007;107(6):40–50; quiz 51. https://doi.org/10.1097/01.NAJ.0000271848.07721.24. PMID: 17519604.

8. Donohoe C. L., Feeney C., Carey M. F., Reynolds J. V. Perioperative evaluation of the obese patient. J Clin Anesth. 2011;23(7):575–86. https://doi.org/10.1016/j.jclinane.2011.06.005. PMID: 22050805.

9. Gupta V., Winocour J., Rodriguez-Feo C. et al. Safety of Aesthetic Surgery in the Overweight Patient: Analysis of 127,961 Patients. Aesthet Surg J. 2016;36(6):718–29. https://doi.org/10.1093/asj/sjv268. PMID: 26895958.

10. Liu Q., Wu M., Orgill D. P. et al. The effect of obesity on inpatient outcomes in lower extremity trauma: A systematic review and meta-analysis. J Trauma Acute Care Surg. 2022;92(2):464–470. https://doi.org/10.1097/TA.0000000000003328. PMID: 34225344.

11. Tewari N., Awad S., Macdonald I. A., Lobo D. N. Obesity-related insulin resistance: implications for the surgical patient. Int J Obes (Lond). 2015;39(11):1575–88. https://doi.org/10.1038/ijo.2015.100.

Review

For citations:

Sukhoparova E.P., Zhinov’ev E.V. Preoperative prediction and surgical correction of the risk of developing local wound complications after contour plastic surgery of the trunk in overweight patients. Grekov's Bulletin of Surgery. 2026;185(2):65-70. (In Russ.) https://doi.org/10.24884/0042-4625-2026-185-2-8755-7182

JATS XML