Impact of GLP-1 Agonist on Surgical Wound Complications Following Plastic and Reconstructive Surgery: A Propensity Matched Cohort Large Database Analysis.

[PURPOSE] GLP-1 agonists have gained FDA approval for managing type 2 diabetes. However, they have been increasingly utilized for their weight loss side effect profile. Although of low incidence rate, surgical site wound complications have been observed in patients using these medications. Given the paucity of literature on weight loss medications and its implications in plastic surgery, this study aims to evaluate the impact of weight loss medication on postoperative surgical site outcomes in patients undergoing common plastic and reconstructive procedures.

[METHODS] The TriNetX National Health Research database was queried to identify patients undergoing panniculectomy, abdominoplasty, and breast reduction. Patients with diabetes, peripheral vascular diseases, nutritional/metabolic/endocrine diseases, history of cancer, and smokers were excluded. Propensity matching analysis was performed to balance the cohorts. Postoperative outcomes, specifically surgical wound infections, breakdown, or dehiscence within 30 days post-procedure were assessed based on patients' GLP-1 agonist use status.

[RESULTS] The risk of surgical site wound healing complications in patients taking GLP-1 agonists compared to those not on these medications was statistically significantly higher before cohort matching as well as after matching. Matched cohorts: 4.7% vs. 2.7% for panniculectomy (p = 0.05), 9.8% vs. 3.6% for abdominoplasty (p=0.001), and 2.6 % vs. 1.3% for breast reduction (p=.035), respectively.

[CONCLUSIONS] Patients using GLP-1 agonists were associated with higher rates of surgical site complications across all evaluated procedures. This underscores the necessity of patient counseling regarding the implications of these weight loss medications prior to surgery, along with the potential need for a strategic perioperative management plan to enhance surgical outcomes.