{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:57:26Z","timestamp":1790740646388,"version":"4.1.0"},"reference-count":39,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jprasurg.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Plastic, Reconstructive & Aesthetic Surgery"],"published-print":{"date-parts":[[2023,5]]},"DOI":"10.1016\/j.bjps.2023.01.042","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T13:08:15Z","timestamp":1676034495000},"page":"115-125","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":14,"special_numbering":"C","title":["Risk stratification of surgical-site outcomes by BMI and flap type in autologous breast reconstruction"],"prefix":"10.1016","volume":"80","author":[{"given":"Susan M.","family":"Taghioff","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin R.","family":"Slavin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shefali","family":"Mehra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tripp","family":"Holton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devinder","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.bjps.2023.01.042_bib1","doi-asserted-by":"crossref","first-page":"7S","DOI":"10.1097\/PRS.0000000000003941","article-title":"Current trends in postmastectomy breast reconstruction","volume":"140","author":"Panchal","year":"2017","journal-title":"Plast Reconstr Surg"},{"issue":"6","key":"10.1016\/j.bjps.2023.01.042_bib2","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1097\/SAP.0000000000002122","article-title":"Impact of obesity on quality of life after breast reconstruction","volume":"83","author":"Koh","year":"2019","journal-title":"Ann Plast Surg"},{"issue":"5","key":"10.1016\/j.bjps.2023.01.042_bib3","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1097\/PRS.0b013e318267efc5","article-title":"The advantages of free abdominal-based flaps over implants for breast reconstruction in obese patients","volume":"130","author":"Garvey","year":"2012","journal-title":"Plast Reconstr Surg"},{"issue":"1","key":"10.1016\/j.bjps.2023.01.042_bib4","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jamcollsurg.2006.09.022","article-title":"Does patient satisfaction with breast reconstruction change over time? Two-year results of the Michigan Breast Reconstruction Outcomes Study","volume":"204","author":"Alderman","year":"2007","journal-title":"J Am Coll Surg"},{"key":"10.1016\/j.bjps.2023.01.042_bib5","unstructured":"CDC n. National health and nutrition examination survey. Healthy weight, overweight, and obesity among U.S. adults. \u3008https:\/\/www.cdc.gov\/nchs\/data\/nhanes\/databriefs\/adultweight.pdf\u3009."},{"issue":"5","key":"10.1016\/j.bjps.2023.01.042_bib6","doi-asserted-by":"crossref","first-page":"681e","DOI":"10.1097\/PRS.0b013e31828e2159","article-title":"Free tissue transfer in the obese patient: an outcome and cost analysis in 1258 consecutive abdominally based reconstructions","volume":"131","author":"Fischer","year":"2013","journal-title":"Plast Reconstr Surg"},{"issue":"3","key":"10.1016\/j.bjps.2023.01.042_bib7","doi-asserted-by":"crossref","first-page":"481e","DOI":"10.1097\/PRS.0000000000006543","article-title":"Obesity and breast reconstruction: complications and patient-reported outcomes in a multicenter, prospective study","volume":"145","author":"Srinivasa","year":"2020","journal-title":"Plast Reconstr Surg"},{"issue":"8","key":"10.1016\/j.bjps.2023.01.042_bib9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0255541","article-title":"Examining the potential benefits of the influenza vaccine against SARS-CoV-2: a retrospective cohort analysis of 74,754 patients","volume":"16","author":"Taghioff","year":"2021","journal-title":"PLoS One"},{"issue":"1","key":"10.1016\/j.bjps.2023.01.042_bib10","article-title":"Comparing surgical site occurrences in 1 versus 2-stage breast reconstruction via federated EMR network","volume":"9","author":"Singh","year":"2021","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"3","key":"10.1016\/j.bjps.2023.01.042_bib11","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1038\/ijo.2012.62","article-title":"Obesity and the risk and outcome of infection","volume":"37","author":"Huttunen","year":"2013","journal-title":"Int J Obes"},{"issue":"10","key":"10.1016\/j.bjps.2023.01.042_bib12","doi-asserted-by":"crossref","DOI":"10.3390\/cells8101134","article-title":"Potential roles of adiponectin isoforms in human obesity with delayed wound healing","volume":"8","author":"Ryu","year":"2019","journal-title":"Cells"},{"issue":"2","key":"10.1016\/j.bjps.2023.01.042_bib13","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1046\/j.1467-789x.2001.00025.x","article-title":"Obesity and immune function relationships","volume":"2","author":"Marti","year":"2001","journal-title":"Obes Rev"},{"issue":"11","key":"10.1016\/j.bjps.2023.01.042_bib14","doi-asserted-by":"crossref","first-page":"1008 e1","DOI":"10.1016\/j.cmi.2015.07.003","article-title":"Impact of obesity on the risk of wound infection following surgery: results from a nationwide prospective multicentre cohort study in England","volume":"21","author":"Thelwall","year":"2015","journal-title":"Clin Microbiol Infect"},{"key":"10.1016\/j.bjps.2023.01.042_bib15","article-title":"Obesity and surgical wound healing: a current review","volume":"2014","author":"Pierpont","year":"2014","journal-title":"ISRN Obes"},{"issue":"6","key":"10.1016\/j.bjps.2023.01.042_bib16","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.ejvs.2008.01.006","article-title":"Obesity and impaired venous function","volume":"35","author":"van Rij","year":"2008","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"10173","key":"10.1016\/j.bjps.2023.01.042_bib17","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/S0140-6736(18)32822-8","article-title":"The global syndemic of obesity, undernutrition, and climate change: the Lancet Commission report","volume":"393","author":"Swinburn","year":"2019","journal-title":"Lancet"},{"issue":"1","key":"10.1016\/j.bjps.2023.01.042_bib18","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1038\/s41395-018-0227-0","article-title":"Multiple nutritional deficiencies in a morbidly obese patient","volume":"114","author":"O'Brien","year":"2019","journal-title":"Am J Gastroenterol"},{"issue":"1","key":"10.1016\/j.bjps.2023.01.042_bib19","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/00000637-199901000-00006","article-title":"Wound complications of abdominoplasty in obese patients","volume":"42","author":"Vastine","year":"1999","journal-title":"Ann Plast Surg"},{"issue":"1","key":"10.1016\/j.bjps.2023.01.042_bib20","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1034\/j.1600-0560.2000.027001019.x","article-title":"Encapsulated fat necrosis\u2013a clinicopathological study of 8 cases and a literature review","volume":"27","author":"Kiryu","year":"2000","journal-title":"J Cutan Pathol"},{"issue":"3","key":"10.1016\/j.bjps.2023.01.042_bib21","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1007\/s10549-019-05215-x","article-title":"Body mass index impacts infection rates in immediate autogenous breast reconstruction","volume":"175","author":"Willoughby","year":"2019","journal-title":"Breast Cancer Res Treat"},{"issue":"5","key":"10.1016\/j.bjps.2023.01.042_bib22","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1055\/s-0038-1627449","article-title":"Impact of obesity on outcomes in breast reconstruction: a systematic review and meta-analysis","volume":"34","author":"Panayi","year":"2018","journal-title":"J Reconstr Microsurg"},{"issue":"2","key":"10.1016\/j.bjps.2023.01.042_bib23","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/SAP.0000000000001284","article-title":"How big is too big: pushing the obesity limits in microsurgical breast reconstruction","volume":"80","author":"Spitz","year":"2018","journal-title":"Ann Plast Surg"},{"issue":"1","key":"10.1016\/j.bjps.2023.01.042_bib24","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.bjps.2015.08.036","article-title":"Are overweight and obese patients who receive autologous free-flap breast reconstruction satisfied with their postoperative outcome? A single-centre study","volume":"69","author":"Sinha","year":"2016","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"4","key":"10.1016\/j.bjps.2023.01.042_bib25","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/j.jamcollsurg.2013.03.031","article-title":"Impact of obesity on outcomes in breast reconstruction: analysis of 15,937 patients from the ACS-NSQIP datasets","volume":"217","author":"Fischer","year":"2013","journal-title":"J Am Coll Surg"},{"issue":"5","key":"10.1016\/j.bjps.2023.01.042_bib26","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1016\/j.breast.2013.05.009","article-title":"The differential effect of BMI on prosthetic versus autogenous breast reconstruction: a multivariate analysis of 12,986 patients","volume":"22","author":"Hanwright","year":"2013","journal-title":"Breast"},{"issue":"1","key":"10.1016\/j.bjps.2023.01.042_bib27","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/SAP.0b013e31825c07f3","article-title":"Breast reconstruction with abdominal-based free flaps in high body mass index population: postoperative complications and impact of weight loss","volume":"72","author":"Ozturk","year":"2014","journal-title":"Ann Plast Surg"},{"issue":"1","key":"10.1016\/j.bjps.2023.01.042_bib28","doi-asserted-by":"crossref","first-page":"21e","DOI":"10.1097\/PRS.0b013e3182547d09","article-title":"Abdominal wall stability and flap complications after deep inferior epigastric perforator flap breast reconstruction: does body mass index make a difference? Analysis of 418 patients and 639 flaps","volume":"130","author":"Ochoa","year":"2012","journal-title":"Plast Reconstr Surg"},{"issue":"6","key":"10.1016\/j.bjps.2023.01.042_bib29","doi-asserted-by":"crossref","first-page":"2206","DOI":"10.1097\/PRS.0b013e3182131c93","article-title":"Breast reconstruction with free tissue transfer from the abdomen in the morbidly obese","volume":"127","author":"Jandali","year":"2011","journal-title":"Plast Reconstr Surg"},{"issue":"3","key":"10.1016\/j.bjps.2023.01.042_bib30","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1097\/01.prs.0000252003.14537.d2","article-title":"Effect of obesity on flap and donor-site complications in pedicled TRAM flap breast reconstruction","volume":"119","author":"Spear","year":"2007","journal-title":"Plast Reconstr Surg"},{"issue":"5","key":"10.1016\/j.bjps.2023.01.042_bib31","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1097\/01.prs.0000236898.87398.d6","article-title":"Complications after microvascular breast reconstruction: experience with 1195 flaps","volume":"118","author":"Mehrara","year":"2006","journal-title":"Plast Reconstr Surg"},{"issue":"5","key":"10.1016\/j.bjps.2023.01.042_bib32","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1097\/00006534-200004050-00007","article-title":"Effect of obesity on flap and donor-site complications in free transverse rectus abdominis myocutaneous flap breast reconstruction","volume":"105","author":"Chang","year":"2000","journal-title":"Plast Reconstr Surg"},{"issue":"1","key":"10.1016\/j.bjps.2023.01.042_bib33","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1002\/micr.30442","article-title":"Predictors affecting complications and aesthetic outcomes in autologous breast reconstruction with free muscle-sparing transverse rectus abdominis myocutaneous flaps","volume":"40","author":"Moon","year":"2020","journal-title":"Microsurgery"},{"issue":"5","key":"10.1016\/j.bjps.2023.01.042_bib34","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1097\/00000658-198705000-00009","article-title":"Autogenous tissue reconstruction in the mastectomy patient. A critical review of 300 patients","volume":"205","author":"Hartrampf","year":"1987","journal-title":"Ann Surg"},{"issue":"1","key":"10.1016\/j.bjps.2023.01.042_bib35","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1097\/00000637-198301000-00005","article-title":"The transverse abdominal island flap: Part I. Indications, contraindications, results, and complications","volume":"10","author":"Scheflan","year":"1983","journal-title":"Ann Plast Surg"},{"issue":"2","key":"10.1016\/j.bjps.2023.01.042_bib36","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/S0094-1298(20)31796-X","article-title":"Complications of breast reconstruction","volume":"11","author":"Scheflan","year":"1984","journal-title":"Clin Plast Surg"},{"issue":"5","key":"10.1016\/j.bjps.2023.01.042_bib37","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1055\/s-0040-1701666","article-title":"Robotic-assisted DIEP flap harvest for autologous breast reconstruction: a comparative feasibility study on a cadaveric model","volume":"36","author":"Manrique","year":"2020","journal-title":"J Reconstr Microsurg"},{"issue":"6","key":"10.1016\/j.bjps.2023.01.042_bib38","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1055\/a-1116-2102","article-title":"The DIEP flap as well-established method of choice for autologous breast reconstruction with a low complication rate \u2013 retrospective single-centre 10-year experience","volume":"80","author":"Munder","year":"2020","journal-title":"Geburtshilfe Frauenheilkd"},{"issue":"5","key":"10.1016\/j.bjps.2023.01.042_bib39","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1097\/SAP.0b013e31827a2c02","article-title":"Complications of latissimus dorsi flap breast reconstruction in overweight and obese patients","volume":"70","author":"Yezhelyev","year":"2013","journal-title":"Ann Plast Surg"},{"issue":"7","key":"10.1016\/j.bjps.2023.01.042_bib40","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1002\/micr.30346","article-title":"Waist-to-hip ratio is a better predictor than body mass index for morbidity in abdominally based breast reconstruction","volume":"38","author":"Wu","year":"2018","journal-title":"Microsurgery"}],"container-title":["Journal of Plastic, Reconstructive & Aesthetic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1748681523000517?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1748681523000517?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T20:49:43Z","timestamp":1761684583000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1748681523000517"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":39,"alternative-id":["S1748681523000517"],"URL":"https:\/\/doi.org\/10.1016\/j.bjps.2023.01.042","relation":{},"ISSN":["1748-6815"],"issn-type":[{"value":"1748-6815","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Risk stratification of surgical-site outcomes by BMI and flap type in autologous breast reconstruction","name":"articletitle","label":"Article Title"},{"value":"Journal of Plastic, Reconstructive & Aesthetic Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.bjps.2023.01.042","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.","name":"copyright","label":"Copyright"}]}}