Publication:

The correlation of histopathological subcutaneous adipose tissue changes with post bariatric wound healing complications

Background This study aimed at assessing the histopathological changes in the subcutaneous layer as a trigger of wound healing complications.

Methods This prospective study included 45 post bariatric consecutive patients from March 2012 to May 2015. We presented demographic data of investigated patients, operative procedures, wound complications and revision surgeries and histopathological examination of excised wound edges.

Results Wound healing complications occurred in 14/40 abdominoplasty patients, surgical revision was necessary in 11 of them. In the 5 lower body lift group, 3 patients suffered from wound healing complications and 3 patients needed revision surgery. These problems in our cases were associated with histopathological changes in the subcutaneous tissue characterized by degenerated collagen (thickened and hyperosinophilic) fibers and collapsed fat with evidence of fat necrosis.

Conclusions Surgeons operating on post bariatric patients should be concerned that they are not handling healthy structures manifested by degenerated collagen; therefore, accurate knowledge of microscopic changes in these patients is necessary for a better choice of reconstructive procedure and adequate management of complications.