Background: The global rise in obesity rates has led to an increase in bariatric procedures, resulting in more patients needing relief from excess skin through body contouring surgeries (BCS), such as abdominoplasty. Although these procedures are generally considered safe, they can be associated with notable perioperative complications, including increased Hb-loss (hemoglobin loss) and drainage fluid volumes. Thus, this study analyzed risk factors for prolonged fluid secretion after abdominoplasty. Methods: We retrospectively analyzed 505 body contouring procedures performed between January 2018 and December 2023 at the Department of Plastic Surgery at the University Clinic of St. Poelten. The investigation focused on postoperative Hb-loss, drainage fluid volumes and hemoglobin levels in patients, comparing those with and without prior bariatric surgery. Statistical analyses utilized the t-test for Equality of Means, while correlation analyses were conducted using Spearman Rho and the Mann–Whitney U test. Results: Bariatric patients demonstrated markedly reduced hemoglobin levels both preoperatively (13.24 g/dL) and postoperatively (10.68 g/dL) compared to their non-bariatric counterparts (14.02 g/dL preoperatively and 11.71 g/dL postoperatively; p < 0.001). The prevalence of anemia was likewise substantially higher in the bariatric cohort, rising from 14.52% preoperatively to 82.48% postoperatively, versus 6.25% and 61.25%, respectively, in the non-bariatric group (p = 0.001). Moreover, prior bariatric surgery was significantly associated with increased postoperative drainage volume (p = 0.009) and prolonged operative time (p = 0.002). Notably, extended hospital stays exhibited a strong correlation with postoperative anemia (p = 0.005). Conclusions: Collectively, our findings underscore the potential risk of increased hemoglobin loss at BCS after bariatric weight loss. Tailored hemoglobin management and nutritional strategies are essential to improve the outcomes and safety of post-bariatric BCS. Meticulous preoperative identification of hematological discrepancies and adequate patient preparation are imperative for positive postoperative patient safety.

Background: Women undergoing a mastectomy often suffer severely from the sequelae of losing one or both breasts. Implant-based breast reconstruction restores female body integrity but can result in significant postoperative pain. The use of paravertebral catheters has been shown to aid significantly in pain management during the postoperative recovery. However, the vasodilation that is induced by paravertebral blocks may lead to prolonged drainage fluid secretion, blood loss and increased likelihood of revision surgery. Therefore, we analyzed the effects of paravertebral blocks after combined mastectomy and immediate breast reconstruction. Methods: We analyzed 115 breast surgeries at the department of Plastic Surgery at the University clinic of St. Poelten between 1 August 2018 and 31 December 2022. Patients were analyzed regarding postoperative hemoglobin loss and drainage fluid volumes and their correlation with paravertebral blocks. Statistical analyses were performed using Levene’s Test for Equality of Variances within our cohort. Results: The postoperative hemoglobin loss did not differ significantly between our groups (p = 0.295). Furthermore, a paravertebral block did not increase the amount of postoperative drainage fluid volumes (p = 0.508). Women receiving paravertebral blocks also did not stay longer in hospitals (p = 0.276). No paravertebral block-associated complication was seen. Conclusions: In this study, we demonstrated paravertebral blocks to be safe adjuncts in breast reconstruction to minimize pain without leading to increased blood loss or seroma formation. This indicated that vasodilatation induced by paravertebral blocks did not negatively influence the postoperative recovery. In conclusion, postoperative pain management using paravertebral blocks can be a beneficial therapeutic adjunct in surgical management of breast cancer patients.

Background: COVID-19 presented many challenges for our health system, one being a suspected change in the epidemiology of severe hand trauma modalities. These complex injuries are traditionally treated at specialized hand trauma centers, but COVID-19 has in many ways disturbed these established pathways and presented new challenges. Methods: We retrospectively analyzed finger amputation injuries treated at the University Hospital of St. Poelten between 2018 and 2022 to examine differences in the management of micro amputation injuries before and during the COVID-19 pandemic. Further challenges in the treatment of hand trauma patients were analyzed and solutions were developed. Results: Overall, the number of occupational finger amputation injuries in Lower Austria declined during the COVID-19 pandemic. Contrarily, more private accidents were treated in the same period, suggesting a lockdown specific change in injury characteristics. Throughout the entire examined period, a total of 130 injured fingers, including 29 thumbs, were treated. In 67 cases, a reconstruction attempt was feasible and successful in 59 cases. Specific challenges were fewer active hand trauma centers, subsequent long transport times, specific COVID-19 prevention measures, and limited postoperative rehabilitation resources. Conclusions: Despite many challenges overall affecting the time to revascularization, good results were achieved by small but meaningful modifications. These included well-established principles such as back table preparation and strengthening novel concepts such as tele-medicine for patient selection. Overall, the reconstruction of severe hand injuries is often challenging, especially during a world-wide health crisis, but with adequate solutions, good results can be readily achieved.