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Background: This study presents a classification system and treatment method to correct Rectus diastasis (RD) during abdominoplasty. Materials and methods: One hundred and sixty seven patients undergoing abdominoplasty were enrolled between April 2014 and January 2018. Forty-three patients did not present with RD and were excluded from the analysis. Mean age was 40.32 years, mean BMI was 23.84, and minimum follow-up was 24 months. A four-type (A: mild 2–3cm, B: moderate 3–5cm, C: severe 5–7cm, and D: very severe 7–9cm) classification system is described. A different treatment method is performed in each category using continuous and interrupted absorbable sutures. Postoperatively patients filled up a questionnaire that involved the level of pain, the postoperative day they performed specific indoor/outdoor activities, and the evaluation of the aesthetic result. Results: No statistically significant differences were observed between the four RD types regarding pain, complications, and return to specific activities. All types of RD had the same low rate complication profile. The seroma rate was 0.81%. The infection rate was 0.81%, and the thromboembolism and the pneumonic embolism rate was 0%. After 2–6 years of follow-up no clinical recurrence of rectus diastasis was observed. All reoperations (14.52%) were performed due to scar deformities. Mean pain score levels were very low (<1.5) and within a week most patients returned to specific indoor and outdoor activities. Most patients were extremely satisfied with the results. Conclusions: In this article, we present an updated classification system and treatment protocol to provide surgeons a safe and standardized method that produces high-quality aesthetic results. Level of evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Background: Due to the great impact of bariatric surgery on the overweight epidemic, the number of post-bariatric body-contouring procedures is constantly increasing worldwide. The portable incisional negative pressure wound therapy (piNPWT) is a promising medical device for accelerating wounds closure and controlling post-operative complication, which have been shown promising results in post-bariatric population. We aimed to evaluate the role of piNPWT in optimizing wound healing and controlling post-operative complications after a post-bariatric brachioplasty. Patients and Methods: 26 post-bariatric female patients who underwent a brachioplasty followed by either a piNPWT (14 cases) or a standard wound treatment (12 controls) were analyzed. The number of post-operative dressing changes, the rate of local post-operative complications (re-operation, hematoma and serosa development, dehiscence and necrosis), the time to dry as well as the scar quality and hospitalization length were evaluated. Results: None of the patients prematurely stopped treatment with piNPWT due to intolerance. The piNPWT patient group showed a significant lower healing time as well as a significant reduction of the number of post-operative dressing changes and hospital stay. Despite the scarring process was excellent from the functional point of view in the long term, we noticed a higher rate of hyperchromic scarring at 90 days after surgery. Conclusion: The piNPWT is a cost-effective and user-friendly medical tool that increase and promote wound healing. We suggest the use of this device in post-bariatric patients who undergo a brachioplasty, especially if there is the need to minimize the number of post-operative dressing changes. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Background: Over 30% of the US population is obese and nearly 300,000 patients undergo bariatric surgery every year. Patients seeking body-contouring procedures face a staggering rate of surgical complications caused by obesity-associated systemic and local factors impairing wound healing. Closed incision negative-pressure therapy (ciNPT) systems could improve surgical outcomes in these patients. Here, we tested this hypothesis in a retrospective case-control series of post-bariatric patients undergoing an abdominoplasty.Methods: We reviewed the clinical data of 11 post-bariatric patients (average BMI 34) who had undergone an abdominoplasty followed by either standard post-operative wound treatment (control) or ciNPT (at 125 mmHg for 8 days). Data (follow-up 90 days) was analyzed, measuring the time to heal of wounds (primary end-point), the rate of local surgical complications, and the quality of scars (Vancouver Scar Scale, VSS) (secondary endpoints).Results: No discomfort was associated with the use of ciNPT. Surgical wounds healed two times faster in patients treated with ciNPT compared to controls (time-to-dry: 10.8 ± 5 days vs. 23 ± 7). ciNPT was associated with a significantly lower rate of minor local complications (0%) compared to controls (80%), leading to shorter hospitalization, less dressing changes, and lower costs for the care of wounds with minor complications. One patient in the ciNPT group developed a major local complication (hematoma). The VSS demonstrated a higher quality of scars in the ciNPT group at a 90-day follow-up.Conclusions: ciNPT might reduce the rate of minor local complications in post-bariatric patients undergoing body-contouring procedures, improving surgical outcomes and treatment costs. [ABSTRACT FROM AUTHOR]

Objectives (Background): Patients are often bothered by excess skin laxity and redundancy after weight loss. Body-contouring surgery offers a solution. This study assessed the psychosocial impact of body-contouring surgery on patients after weight loss. Methods (Settings, Design): In this cross-sectional study, a specifically designed questionnaire developed in collaboration with psychiatric department for our research was used for 43 patientswho underwent body-contouring surgery. Datawere collected during single visit to the plastic surgery clinic. All the patients had lost 20 kg or less before the surgery and were interviewed at least 6 months after the surgery. The questionnaire was used to compare the psychosocial status of the patients before and after surgery. Data were analyzed appropriately using Statistical Package for the Social Sciences. Results: The participants' mean age was 34 ± 10 years; the sample included 24 (55.8%) women and 19 (44.2%) men (total N = 43). The patients' quality of life improved significantly in the areas of social life (P < .001), job performance (P < .002), and sexual activity (P < .001). Moreover, while 17 (39.5%) patients suffered symptoms of depression before surgery, only 1 (2.3%) patient suffered symptoms of depression after surgery. The overall satisfaction was found to be 62.8%, with mammoplasty being the procedure with the highest satisfaction (66.6%). Conclusion: Body-contouring surgery after weight loss has shown to improve both psychological and social aspects of the patients' lives. Recall bias is the main limitation in our study. [ABSTRACT FROM AUTHOR]