Predictive value of biochemical and tissue modifications for wound healing in post-bariatric patients

Abstract

Background

Bariatric surgery, despite its beneficial effects, is responsible for highly frequent wound healing complications, as it has already been demonstrated in post-biliopancreatic diversion (BPD) patients.

The aim of this study was to analyze results and wound healing process in a population submitted to Roux-en-Y gastric bypass (RYGB), a procedure involving both a malabsorptive and restrictive approach.

Methods

Thirteen non-smokers and non-diabetic patients submitted to laparoscopic RYGB underwent abdominoplasty. Biochemical parameters before and after bariatric surgery were evaluated. The content of total protein and hydroxyproline (revealing collagen amount) was assessed in multiple biopsies before and after RYGB. Skin samples were subjected to macroscopic and histological evaluation, where elastic fibers content was put into evidence by a specific stain (Wigert–Van Gieson).

Results

Most of the biochemical parameters analyzed showed a mild reduction after weight loss surgery. Neither tissue proteins nor hydroxyproline were significantly reduced after RYGB. Macroscopically, equal thickness of the two adipose tissue layers (areolar and lamellar) was observed in addition to normal consistency and compactness. Histological evaluation revealed fibroblast augmentation, hypertrophic adipocytes, and augmented dimension. Results were then compared with those previously obtained in post-BPD population.

Conclusion

Despite that further elaborations are needed, RYGB, compared to BPD, seems to be associated with minor modifications of tissues and biochemical and tissue parameter values, possibly leading to a lower wound complication rate.

Level of Evidence: Level IV, prognostic study

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