Obesity in breast reduction and abdominoplasty surgery

S16 Aim: A 10 minutes telephone questionnaire was used to evaluate one-year functional outcome after treatment for peripheral nerve injury in the upper extremity. Methods: Minimally one year after surgery 206 patients, who underwent peripheral nerve repair of the upper extremity, were contacted to assess their functional outcome and pain levels. Results: Of the 206 patients, 132 (64.1%) could be reached by telephone and all completed the questionnaire. Of these latter patients 86 (65.2%) reported a good, 37 (28.0%) a fair, and 9 (6.8%) a poor sensory recovery. Good motor function recovery was reported by 65 patients (49.2%), fair by 63 (47.8%) and poor by 4 (3.0%) patients. Pain as a complication was reported by 34 (25.8%) patients. Conclusion: A brief telephone screening of the functional results and complications postsurgery could serve as a discriminative test to decide on patient selection for future clinical evaluation. Significance: As, in current medical practice, it is impossible to screen large groups of patients for physical examination for longterm follow up, we compiled a compact telephone questionnaire, which we consider very useful for a first screening for functional outcome. Patients with problems can be identified this way and called into the outpatient clinic. P5. Obesity in breast reduction and abdominoplasty surgery R. Shah, B. Sivakumar, N. Kang Mount Vernon Hospital, Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK Access to effective surgical treatments such as breast reduction and abdominoplasty is often restricted by healthcare purchasing authorities on the grounds of patient obesity. In addition, some surgeons refuse to operate on obese candidates for fear of increased complication rates. However, review of the literature reveals a lack of unambiguous data on the surgical risks of obesity in patients undergoing such ‘‘cosmetic’’ procedures. The aim of this study was to assess the relationship between patient obesity, as determined by the body mass index (BMI), and surgical outcome following breast reduction or abdominoplasty. A retrospective review of case notes was performed on 385 patients who underwent breast reduction and 73 patients who underwent abdominoplasty in our unit over a 5-year period. BMI was calculated for each patient. Complications were sub-divided into operative (haemorrhage, nipple loss, infection, wound dehiscence and scar problems), anaesthetic and medical complications. Outcome and patient satisfaction were determined from the clinic notes as well as by revision surgery requirement. Complication rates were studied in relation to BMI, volume of resection and smoking habits. Statistical analysis demonstrated a significant increase in nipple complications, such as nipple necrosis, associated with BMI greater than 30. There was also a strong correlation between volume of tissue resected and complication rates. Crucially, the statistically significant increase in nipple complication rates also exists when

ECSAPS 2006 Abstracts allowing for volume of tissue resected. We found no difference among the BMI groups in terms of late outcome, as determined from the outpatient clinic notes. These findings have implications for withholding surgery on the basis of BMI alone and will help to form a scientific basis for rationing of breast reduction and abdominoplasty surgery.

P6. A reliable ex vivo technique to detect and to quantify small blood vessels in laboratory animals J.T. Egana a,c, A. Condurache b, S. Lavandero c, H.G. Machens a a Dept. Plastic and Hand Surgery, Burn Care Center, UKSH Campus Lu¨beck. Germany b Institute for Signal Processing, UKSH Campus Lu¨beck. Germany c FONDAP Center for Molecular Studies of the Cell, University of Chile, Santiago. Chile Introduction: Angiogenesis is described as a key process for both physiological and pathological conditions. Several protocols have been developed to detect and quantify small vessels in different animal models. Most of them involve the use of long surgical procedures and perfusion of the animal with different substances which allow visualization of the vascular network. Among the most common problems of those methods are time consuming and variable measurements due to differences in the quality of perfusion. Moreover, marker substances in the blood restrict the use of the sample for other studies such as protein or RNA analysis. Here we describe a new technique based on native transillumination of target tissue to visualize blood vessels and digital segmentation to quantify area and length of the vessels. Methods: 20 fasciocutaneous flaps, measuring 2  3 cm were harvested from the back of nu/nu mice and placed on a transilluminator. Each one standardized high quality digital picture was taken and converted into a negative to enhance contrast between blood vessels and tissue. Pictures were quantitatively analyzed by a new vessel segmentation program developed in our laboratories. Data were collected as standardized units [SU]. Results: Using the described method, even very small fasciocutaneous blood vessels can be clearly visualized. Regions of interest (ROIs) can be defined and the containing vascular network quantified. Comparable results may be obtained by calculating the microvascular area index (MAI) and the microvascular length index (MLI), related to the ROIs size. Identical ROIs reveal measured [SU] with 0.0% standard deviation. Target tissue may be used for further analysis including histology, genomics and proteonomics. Conclusion: Combined use of tissue transillumination and digital segmentation provide a very reliable and useful technique to detect and quantify small vessels in different animal models. This tool may be useful for a broad range of research proposals. P7. Withdrawn