Impact of diabetes medications and HbA1c levels on abdominoplasty and panniculectomy outcomes

Obesity is a risk factor for diabetes mellitus (DM), which is associated with impaired wound healing and increased surgical site infections (SSI) due to poor vascularity. Patients who undergo abdominoplasties or panniculectomies often have multiple comorbidities, including DM and obesity. Previous research has demonstrated that adequate perioperative glycemic control is crucial to decreasing the risk of postoperative wound complications; however, the impact of diabetic pharmacology and HbA1c levels on postoperative outcomes in patients who undergo abdominoplasties or panniculectomies has not been studied. We conducted a retrospective cohort study on patients aged 18-85 who underwent abdominoplasty or panniculectomy at our institution from July 2014 to April 2023. Patients were stratified by HbA1c levels into four categories: Normal (<5.7), Prediabetic (5.7-6.4), Diabetic (6.5-6.9), and Diabetic with uncontrolled hyperglycemia (7.0-8.9). Diabetic patients were also categorized based on their diabetic medication use. Postoperative outcomes, including SSI, seroma, hematoma, readmission, and reoperation, were analyzed. Among the 594 patients, 16.3 % had DM, and 6.6 % were on anti-diabetic medications. SSIs occurred in 24.2 % of patients, with no significant differences between groups (p = 0.28). This study did not establish a clear relationship between diabetes medication regimens and poor postoperative outcomes; however, it highlights the medical complexity of patients who undergo abdominoplasty or panniculectomy and the perioperative glycemic management. Further research is needed to investigate how to better optimize diabetes management for improved surgical outcomes.