LAUSR

BACKGROUND Currently there are no known structural parameters of the integument that can be measured noninvasively which are used in the planning of body contouring surgery. OBJECTIVES To see if Mean Gray Value (MGV), when taken into account preoperatively, can reduce wound-related morbidity. METHODS This project was a prospective cohort study. Ultrasound imaging of the subcutaneous tissue was performed prospectively on patients undergoing body contouring surgery to quantify the superficial fascial system (SFS) so that average MGV could be calculated over the proposed surgical sites. Patients with average to poor MGV (0.127 or less) were identified preoperatively for tension-reducing procedures. Wound complication rates were compared to a retrospective cohort which did not have preoperative imaging. RESULTS There were 115 patients in each of the two cohorts. There were 3 exclusions due to loss of ultrasound images, leaving 112 patients available for analysis in the prospective cohort. The cohorts were similar except for a higher incidence of patients with diabetes in the retrospective group (1 v 9, p=0.026). The wound complication rate was significantly reduced in the prospective group (5/112, 4.4%) when compared to the retrospective group (20/115, 17%, p=0.0062). The revision and infection rates were also significantly reduced in the prospective group (1/112, 0.9%; 3/112, 2.6%) when compared to the retrospective group (8/115, 7%, 10/115 8.6%, p=0.019, p=0.051). CONCLUSIONS MGV is a unique, patient- and area-specific structural parameter of the integument that may be useful in reducing wound-related morbidity in body contouring surgery.