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Post-operative complications in the massive weight loss patient: discrepancies of perception
Guest RA, Gusenoff JA
University of Pittsburgh
2017-01-26
Presenter: Rachel Guest
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published or presented at a major meeting. This project represents the original work of Rachel Guest.
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction:
Informed consent is a time-consuming process, and for massive weight loss patients there is a long list of potential complications. Patients are often overwhelmed by the amount of information provided, and may be compelled to sign without understanding important concepts, such as risk of post-operative complications. By determining where discrepancies lie between physician and patient understanding of post-operative complications, and by determining patient risk factors which predispose to suboptimal understanding of complication risk, we can diminish this gap.
Methods:
40 massive weight loss patients completed a complication survey pre-operatively and at 1-month and 3-months post-operatively. 22 medical professionals evaluated the complications for comparison.
Results:
Physicians perceived most complications as significantly less severe compared to patients. At the pre-operative visit, patients, compared to physicians, perceived delayed wound healing (p=7E-10), suture extrusion (p=.00001), infection (p=.0001), necrosis (p=.0001), dehiscence (p=.001), and hematoma (p=.007), as more severe. Perception of death, DVT/PE, and re-operation did not vary significantly. Age did not impact complication perception. Patients with a primary goal of improved aesthetics viewed hematoma and dehiscence as more severe. Weight loss method impacted perception of dehiscence, hematoma, and infection. Patient perception of complication severity was similar post-operatively.
Discussion/Conclusion:
A discrepancy exists between what surgeons and patients perceive as significant complications in body contouring surgery. Age and motivation for surgery did not reliably predict complication perception, while complication perception could be predicted by weight loss method. Patients feared the worst regarding post-operative complications, emphasizing the need for detailed counseling and education prior to surgery.
