In reading the article entitled “Breast Reconstruction with Free Tissue Transfer from the Abdomen in the Morbidly Obese” by Jandali et al. (Plast Reconstr Surg. 2011;127:2206–2213), I noticed a key error in their statistics. They state a total flap loss rate of 8 percent in the morbidly obese compared with 0.5 percent in the control group, a statistically significant difference. Their numbers are based on two of 25 patients (8 percent) instead of two of 42 free flaps (4.7 percent). To use flap loss as a complication but not use the number of flaps seems inconsistent.
One wonders whether the correct numbers would result in a statistically significant difference. This calls into question the validity of the conclusions drawn from these numbers. Because one of the main points in the article is that flap loss is significantly higher in the morbidly obese, this error should be addressed by the authors. As America's waistline grows, so too does the desire for autologous reconstruction, and it would be of great importance to know whether the morbidly obese are indeed at higher risk for flap loss.
Adam Saad, M.D.
Charles L. Dupin, M.D.
Louisiana State University Health Sciences Center, New Orleans, La.
Letters to the Editor, discussing material recently published in the Journal, are welcome. They will have the best chance of acceptance if they are received within 8 weeks of an article's publication. Letters to the Editor may be published with a response from the authors of the article being discussed. Discussions beyond the initial letter and response will not be published. Letters submitted pertaining to published Discussions of articles will not be printed. Letters to the Editor are not usually peer reviewed, but the Journal may invite replies from the authors of the original publication. All Letters are published at the discretion of the Editor.
Letters submitted should pose a specific question that clarifies a point that either was not made in the article or was unclear, and therefore a response from the corresponding author of the article is requested.
Authors will be listed in the order in which they appear in the submission. Letters should be submitted electronically via PRS' enkwell, at www.editorialmanager.com/prs/.
We reserve the right to edit Letters to meet requirements of space and format. Any financial interests relevant to the content of the correspondence must be disclosed. Submission of a Letter constitutes permission for the American Society of Plastic Surgeons and its licensees and asignees to publish it in the Journal and in any other form or medium.
The views, opinions, and conclusions expressed in the Letters to the Editor represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the Journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such correspondence.
The Journal requests that individuals submit no more than five (5) letters to Plastic and Reconstructive Surgery in a calendar year.