Plastic and reconstructive surgery · 2025
Impact of GLP-1 Agonist on Surgical Wound Complications after Plastic and Reconstructive Surgery: A Propensity-Matched Cohort Large Database Analysis.
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Lee Charles C, Newland Mary, Yau Alice, Chroneos Rea, Johnson T Shane
Аннотация
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have gained Food and Drug Administration approval for management of type 2 diabetes. However, they have been increasingly used for their weight loss side effect profile. Surgical site wound complications have been observed in patients using these medications (although with a low incidence rate). Given the paucity of literature on weight loss medications and their implications in plastic surgery, this study evaluates the impact of weight loss medication use on postoperative surgical site outcomes in patients undergoing common plastic and reconstructive procedures.
METHODS: The TriNetX National Health Research database was queried to identify patients undergoing panniculectomy, abdominoplasty, or breast reduction. Patients with diabetes; peripheral vascular diseases; nutritional, metabolic, or endocrine diseases; a history of cancer; or smoking were excluded. Propensity matching analysis was performed to balance the cohorts. Postoperative outcomes, specifically surgical wound infections, breakdown, or dehiscence within 30 days after the procedure, were assessed based on GLP-1 RA use status.
RESULTS: The risk of surgical site wound healing complications in patients taking GLP-1 RAs compared with those not on these medications was statistically significantly higher before cohort matching as well as after matching. Matched cohort results were as follows: 4.7% versus 2.7% for panniculectomy ( P = 0.05), 9.8% versus 3.6% for abdominoplasty ( P = 0.001), and 2.6% versus 1.3% for breast reduction ( P = 0.035), respectively.
CONCLUSIONS: Use of GLP-1 RAs was associated with higher rates of surgical site complications across all evaluated procedures. This underscores the necessity of patient counseling regarding the implications of these weight loss medications before surgery, along with the potential need for a strategic perioperative management plan to enhance surgical outcomes.
METHODS: The TriNetX National Health Research database was queried to identify patients undergoing panniculectomy, abdominoplasty, or breast reduction. Patients with diabetes; peripheral vascular diseases; nutritional, metabolic, or endocrine diseases; a history of cancer; or smoking were excluded. Propensity matching analysis was performed to balance the cohorts. Postoperative outcomes, specifically surgical wound infections, breakdown, or dehiscence within 30 days after the procedure, were assessed based on GLP-1 RA use status.
RESULTS: The risk of surgical site wound healing complications in patients taking GLP-1 RAs compared with those not on these medications was statistically significantly higher before cohort matching as well as after matching. Matched cohort results were as follows: 4.7% versus 2.7% for panniculectomy ( P = 0.05), 9.8% versus 3.6% for abdominoplasty ( P = 0.001), and 2.6% versus 1.3% for breast reduction ( P = 0.035), respectively.
CONCLUSIONS: Use of GLP-1 RAs was associated with higher rates of surgical site complications across all evaluated procedures. This underscores the necessity of patient counseling regarding the implications of these weight loss medications before surgery, along with the potential need for a strategic perioperative management plan to enhance surgical outcomes.