Sarcopenic obesity linked to tissue expander reconstruction complications

Sarcopenic obesity may exacerbate complications after breast reconstruction using a tissue expander, a recent study has found.

Researchers conducted a nonrandomized, retrospective cohort analysis of 157 patients undergoing 169 expander indwelling surgeries. Skeletal muscle index (SMI) and total adipose tissue index (TATI) were measured and used for the calculation of sarcopenic obesity. The outcome of interest was the development of complications.

Forty cases of complications were reported, yielding a rate of 23.7 percent. These included delayed wound healing, seromas, infections, haematomas, expander ruptures, and removals of the expander. In the remaining 129 procedures, no such issues were documented.

Multivariate logistic regression analysis showed that a low SMI-to-TATI ratio, the index for sarcopenic obesity, emerged as a significant and independent risk factor for the overall development of complications (odds ratio [OR] per 10-percent decrease, 2.28; p=0.001).

This effect was driven by the strong interaction between sarcopenic index and delayed wound healing (OR per 10-percent decrease, 6.33; p=0.003). Diabetes was similarly correlated with delayed wound healing (OR, 7.36; p=0.044).

In addition, high body mass index (OR per 5-kg/m² increase, 8.00; p<0.001) and heavy blood loss (OR per 10-g increase, 1.18; p=0.003) were determined as risk factors for seroma development.

“Patients with a large adipose tissue volume and lower skeletal muscle mass (sarcopenic obesity) may have more complications after expander surgery than those with high BMI or large adipose tissue volume alone,” the researchers said.