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Breast Reconstruction with Free Tissue Transfer from the Abdomen in the Morbidly Obese

Saad, Adam M.D.; Dupin, Charles L. M.D.

Plastic and Reconstructive Surgery: February 2012 - Volume 129 - Issue 2 - p 366e
doi: 10.1097/PRS.0b013e31823aef45

Louisiana State University Health Sciences Center, New Orleans, La.

Correspondence to Dr. Saad, Department of Plastic Surgery, Louisiana State University Health Sciences Center, 1542 Tulane Avenue, Room 734, New Orleans, La. 70112

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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.

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