Increased Intraoperative Bleeding in Patients Undergoing Abdominoplasty After Gastroplasty is not Due to Coagulopathy

Abstract

Abdominoplasties carried out in patients previously underwent gastroplasty present high rates of complications, including increased bleeding in the intra- and postoperative periods. This study evaluated bleeding, coagulation parameters (coagulogram, dosage of fibrinogen, FII, FV, FVII, FVIII, FIX, FX, and FXII), and thromboelastography in two groups of women who underwent abdominoplasties: a group with a history of gastroplasty by the Fobi-Capella technique (group I) and the other group without a history of obesity (group II). Analyses were performed before, during, and after each surgical procedure. Vitamins K and C were also dosed. Bleeding was measured by counting and weighing compresses at the end of each surgery, and the withdrawn surgical specimens were weighed. Statistically, group I patients had more bleeding than group II in all evaluated operative periods (p=0.007). There was no significant change in the coagulogram or decrease in coagulation factors that could be associated with increased bleeding in any of the analyzed groups. Thromboelastography, which provides a comprehensive analysis of thrombin generation and of hemostasis in real time, did not differ between groups. Vitamin K was significantly increased in group I patients (p=0.019). The weight of the surgical specimens removed was significantly higher in group I (p=0.007) and there was correlation of the weight with the degree of bleeding. The results of this study demonstrate an increase of bleeding during the intraoperative period of abdominoplasty in patients with a history of gastroplasty that it is not due to changes in hemostasis. 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 .