OBJECTIVE

To identify possible predictors of slowing down the wound healing in overweight individuals seeking for aesthetic plastic surgery.

MATERIAL AND METHODS

The study included female patients who applied for contour plastic surgery of the mammary glands and anterior abdominal wall for aesthetic indications. We identified 3 groups of patients in postoperative period depending on wound healing process: group 1 — complicated wound process (skin healing for more than 21 days, ligature-related fistula, seroma) (n=21; 42.86%); group 2 — delayed wound healing (skin healing for 14-21 days) (n=16; 32.65%); group 3 — standard wound healing (skin healing up to 14 days) (n=12; 24.49%). We analyzed 23 factors regarding the effect on wound healing: pro-inflammatory interleukins including tumor necrosis factor α (TNF-α), IL-1β, IL-6, IL-8 (pg/ml); markers of inflammation including C-reactive protein (CRP) (mg/l), leukocytes (10⁹/l); fat-soluble vitamins E, A, D, K (mcg/ml); indicators of carbohydrate metabolism including insulin (mME/l), glucose (mmol/l), HOMA-IR insulin resistance index; absolute number (10⁹) of rod-shaped and segmented neutrophils, lymphocytes, monocytes, eosinophils, basophils.

RESULTS

Predictors of complicated wound healing in overweight patients undergoing plastic surgery for aesthetic indications are HOMA-IR insulin resistance index ≥3.1, serum insulin ≥14.0 mMU/l and IL-1ß (spontaneous release) ≥45.0 pg/ml.

CONCLUSION

Identification of these factors in preoperative period will make it possible to predict unfavorable course of wound process and determine treatment strategy.