In the recent May 2013 Plastic and Reconstructive Surgery Journal there were abstracts from a recent research meeting. One jumped out at me: “Resident involvement affects plastic surgery outcomes: an analysis of 10,356 patients from the nsqip database.” It was presented by doctors out of Northwestern University.
The premise:
Panniculectomies (tummy tucks to remove the apron of overhanging skin) “have been shown to improve quality of life in morbidly obese patients. However its functional benefits are counterbalanced by its relatively high complication rates.” These surgeries are done by surgeons of diverse specialties.
Their question:
Does the specialty of the surgeon impact the outcome?
Answer:
YES.
In a group of 954 surgeries, 72% were done by plastic surgeons, and 27% by non plastic surgeons
- non plastic surgeons had a statistically significant higher rate of complications (23% vs 8.6%)
- non plastic surgeons had higher wound infection rates (12.7% vs 5.3%)
- non plastic surgeons had more medical complications (13% vs. 3.3%)
- and their OR time was shorter than plastic surgeons (1.9 hours vs. 3 hours- not necessarily a good thing to go too fast in a big surgery)
Conclusion?
“Multivariate regression analysis of nsqip data showed panniculectomy performed by plastic surgeons results in lower rates of overall postoperative complications, wound infections, and reoperations compared to non plastic surgeons.”
NOTE: Tummy tucks and panniculectomies are not exactly the same. Generally panniculectomies are for people who are overweight or who have been overweight. They have a large apron of hanging skin, called a “pannus.” Muscle tightening and skin undermining can be slightly different depending on the patient. Comorbidities (like diabetes, blood pressure, etc) can also vary.