Skip to main content
Log in

Plastische Körperkorrektur im Gesamtkonzept der Adipositastherapie

Evidenzbasierter Therapiealgorithmus

Concept of reconstructive body shaping in obesity

Evidence-based therapy algorithm

  • Übersichten
  • Published:
Der Chirurg Aims and scope Submit manuscript

Zusammenfassung

Die medizinische Notwendigkeit interdisziplinärer Adipositaszentren zur Behandlung von Adipositaspatienten ist medizinischer Konsens. Betrachtet man insbesondere den weltweiten rasanten Anstieg der behandlungsbedürftigen Adipositaspatienten, so erscheint es sinnvoll, die komplexen interdisziplinären Therapieansätze auf einem möglichst evidenzbasierten klinischen und wissenschaftlichen Fundament zu gründen. Im Rahmen der bestehenden S3-Leitlinie „Chirurgie der Adipositas“ wurde erstmals ein solches Fundament geschaffen. In diesem Gesamtkonzept wurde auch die postbariatrische plastische Chirurgie integriert. Im Rahmen dieser Arbeit soll ein evidenzbasierter Therapiealgorithmus dargestellt werden.

Abstract

Interdisciplinary obesity centers are medically required for the successful treatment of obese patients. Due to the dramatic increase in the number of obese patients needing treatment, it is important to develop interdisciplinary therapy approaches based on clinically and scientifically based knowledge with high levels of evidence. The recent S3 guideline “Surgery of the obese” represents such an evidence-based interdisciplinary approach. In this concept, postbariatric plastic surgery has also been integrated. This article presents an evidence-based therapy algorithm that was developed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1
Abb. 2
Abb. 3
Abb. 4

Literatur

  1. Abela C, Sharma R, Soldin M (2009) Surgery for obesity. Role of plastic surgery. BMJ 339:b4283

    Article  PubMed  Google Scholar 

  2. Albino FP, Koltz PF, Gusenoff JA (2009) A comparative analysis and systematic review of the wound-healing milieu: implications for body contouring after massive weight loss. Plast Reconstr Surg 124:1675–1682

    Article  CAS  PubMed  Google Scholar 

  3. Altintas MA, Vogt PM (2013) Postbariatric plastic surgery. Chirurg 84:527–540

    Article  CAS  PubMed  Google Scholar 

  4. Berrington de Gonzalez A, Hartge P, Cerhan JR et al (2010) Body-mass index and mortality among 1.46 million white adults. N Engl J Med 363:2211–2219

    Article  Google Scholar 

  5. Chandawarkar RY (2006) Body contouring following massive weight loss resulting from bariatric surgery. Adv Psychosom Med 27:61–72

    Article  PubMed  Google Scholar 

  6. Clavijo-Alvarez JA, Pannucci CJ, Oppenheimer AJ et al (2011) Prevention of venous thromboembolism in body contouring surgery: a national survey of 596 ASPS surgeons. Ann Plast Surg 66:228–232

    Article  CAS  PubMed  Google Scholar 

  7. Coon D, Gusenoff JA, Kannan N et al (2009) Body mass and surgical complications in the postbariatric reconstructive patient: analysis of 511 cases. Ann Surg 249:397–401

    Article  PubMed  Google Scholar 

  8. Coon D, Michaels JT, Gusenoff JA et al (2012) Hypothermia and complications in postbariatric body contouring. Plast Reconstr Surg 130:443–448

    Article  CAS  PubMed  Google Scholar 

  9. Dini M, Mori A, Cassi LC et al (2008) Circumferential abdominoplasty. Obes Surg 18:1392–1399

    Article  PubMed  Google Scholar 

  10. Dragu A, Bach AD, Polykandriotis E et al (2009) Pseudotumors after primary abdominal lipectomy as a new sequela in patients with abdominal apron. Obes Surg 19:1599–1604

    Article  PubMed  Google Scholar 

  11. Dragu A, Horbach T, Zwaan M de et al (2011) Bariatrische Chirurgie im Kindes- und Jugendalter. Chir Allg Z 12:457–458

    Google Scholar 

  12. Dragu A, Horch RE (2012) Die Rekonstruktion der Körperform nach massiver Gewichtsreduktion – Eine notwendige Spezialaufgabe der plastischen Chirugie. Chir Allg Z 13:601–607

    Google Scholar 

  13. Dragu A, Klein P, Unglaub F et al (2009) Tensiometry as a decision tool for abdominal wall reconstruction with component separation. World J Surg 33:1174–1180

    Article  PubMed  Google Scholar 

  14. Dragu A, Kneser U, Horch RE (2012) Die postbariatrische plastische Chirurgie: Eine notwendige Spezialisierung? Kongresszeitung zum 129 Kongress der Deutschen Gesellschaft für Chirurgie. 2:14–17

  15. Dragu A, Schnürer S, Horbach T et al (2012) Evaluation of intra-operative abdominal wall perfusion in post-bariatric abdominal dermolipectomy. Obes Facts 5:651–659

    Article  PubMed  Google Scholar 

  16. Dragu A, Schnurer S, Unglaub F et al (2011) Wide topical negative pressure wound dressing treatment for patients undergoing abdominal dermolipectomy following massive weight loss. Obes Surg 21:1781–1786

    Article  PubMed  Google Scholar 

  17. Dragu A, Vogt PM, Weiner RA et al (2011) Die S3-Leitlinie der Adipositas – Kommentar zur Rolle der Plastischen Chirurgie. Chir Allg Z 12:449–455

    Google Scholar 

  18. Dragu A, Werner TC, Horbach T et al (2013) Kasse muss keine postbariatrisch-plastische Operation bezahlen. Chir Allg Z 14:108–112

    Google Scholar 

  19. Giordano S, Victorzon M, Koskivuo I et al (2013) Physical discomfort due to redundant skin in post-bariatric surgery patients. J Plast Reconstr Aesthet Surg 66:950–955

    Article  PubMed  Google Scholar 

  20. Goertz O, Kapalschinski N, Skorzinski T et al (2012) Wound healing complications in smokers, non-smokers and after abstinence from smoking. Chirurg 83:652–656

    Article  CAS  PubMed  Google Scholar 

  21. Hauner H (2006) Evidence based therapy of obesity. Internist (Berl) 47:159–170

    Google Scholar 

  22. Heitmann C, Germann G (2007) Body contouring surgery after massive weight loss. Part I: abdomen and extremities. Chirurg 78:273–284 (quiz 285–276)

    Article  CAS  PubMed  Google Scholar 

  23. Horch RE, Kneser U, Polykandriotis E et al (2012) Tissue engineering and regenerative medicine -where do we stand? J Cell Mol Med 16:1157–1165

    Article  CAS  PubMed  Google Scholar 

  24. Larsson I, Berteus Forslund H, Lindroos AK et al (2004) Body composition in the SOS (Swedish Obese Subjects) reference study. Int J Obes Relat Metab Disord 28:1317–1324

    Article  CAS  PubMed  Google Scholar 

  25. Michaels JT, Rubin JP (2009) Discussion. A comparative analysis and systematic review of the wound-healing milieu: implications for body contouring after massive weight loss. Plast Reconstr Surg 124:1683–1684

    Article  CAS  PubMed  Google Scholar 

  26. Mitchell JE, Crosby RD, Ertelt TW et al (2008) The desire for body contouring surgery after bariatric surgery. Obes Surg 18:1308–1312

    Article  PubMed  Google Scholar 

  27. Pecori L, Serra Cervetti GG, Marinari GM et al (2007) Attitudes of morbidly obese patients to weight loss and body image following bariatric surgery and body contouring. Obes Surg 17:68–73

    Article  PubMed  Google Scholar 

  28. Richter DF, Olivari N, Dombard LP et al (2002) Ganzkörperstraffungen nach starkem Gewichtsverlust. Chir Allg Z 3:277–281

    Google Scholar 

  29. Ruan X, Li Z, Zhang Y et al (2011) Apolipoprotein A-I possesses an anti-obesity effect associated with increase of energy expenditure and up-regulation of UCP1 in brown fat. J Cell Mol Med 15:763–772

    Article  CAS  PubMed  Google Scholar 

  30. Runkel N, Colombo-Benkmann M, Huttl TP et al (2011) Evidence-based German guidelines for surgery for obesity. Int J Colorectal Dis 26:397–404

    Article  PubMed  Google Scholar 

  31. Sarwer DB, Thompson JK, Mitchell JE et al (2008) Psychological considerations of the bariatric surgery patient undergoing body contouring surgery. Plast Reconstr Surg 121:423e–434e

    Article  PubMed  Google Scholar 

  32. Shermak MA (2006) Hernia repair and abdominoplasty in gastric bypass patients. Plast Reconstr Surg 117:1145–1150 (discussion 1151–1142)

    Article  CAS  PubMed  Google Scholar 

  33. Weiner RA (2010) Indications and principles of metabolic surgery. Chirurg 81:379–394 (quiz 395)

    Article  CAS  PubMed  Google Scholar 

  34. Weiner RA, Weiner S (2011) The 6th Frankfurt meeting for surgery of obesity and metabolic disorders. Obes Facts 4(Suppl 1):1–2

    PubMed  Google Scholar 

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt. A. Dragu und R.E. Horch geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Dragu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dragu, A., Horch, R. Plastische Körperkorrektur im Gesamtkonzept der Adipositastherapie. Chirurg 85, 37–41 (2014). https://doi.org/10.1007/s00104-013-2628-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00104-013-2628-3

Schlüsselwörter

Keywords

Navigation