DOI: 10.1093/bjs/znad258.478 ISSN:

675 Are Postoperative Outcomes in Flap Operations Affected by Obesity?

A Meenu, V Karanth, N C S Kumar, A Acharya
  • Surgery



To explore the outcomes of flap surgeries and how obesity affects them. To find if there is a correlation between CBC indices (also inflammatory markers) with flap survival.


All flap surgeries on adults in the collaborating departments in an Indian tertiary care hospital from 2021-2022 excluding finger flaps were prospectively analyzed. Data of 90 patients including postoperative complications, preoperative Neutrophil-Lymphocyte Ratio (NLR) were recorded.BMI is calculated to classify patients based on Asia-Pacific guidelines where BMI>25 is obese, 23-24.9 is overweight, <18 is underweight.Chi square tests were used to assess association between obesity, NLR and early (within 7 days of surgery) &late (beyond 7 days) postoperative complications -flap loss, wound dehiscence, surgical site infection. Multiple regression model and ANOVA test were also done with these variables.


There is significant association between patients’ obese or overweight habitus and postoperative surgical site complications. 38% early (p = 0.001) and 36% late (p = 0.044) complications happened in obese patients alone.

There is significant association between NLR and early postoperative complications (p = 0.002).60% with high NLR values had severe early postoperative complications, compared to 16.7% of patients with normal NLR and 21.1% with mildly raised NLR.

Obesity and high NLR [NLR 10-18 or moderate stress, NLR>18 or severe stress] independently have significant correlation (0.038 for obesity, 0.015 for NLR) with early postoperative complications.


Obesity combined with high preoperative NLR is a quick, inexpensive predictor of poor early postoperative flap survival.

More from our Archive