{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T03:40:39Z","timestamp":1789184439630,"version":"build-2803163510"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Glucagon-like peptide-1 receptor agonists (GLP-1s) are increasingly used for glycemic control and weight loss, but their impact on surgical wound complications remains unclear. Some studies suggest GLP-1s reduce complications such as infection and dehiscence, while others report increased risk in certain procedures. This study evaluates whether preoperative GLP-1 use is associated with postoperative wound complications in free flap breast reconstruction.<\/jats:p>\n                  <jats:p>We conducted a retrospective cohort study using the TriNetX Research Network, a global database of de-identified health records. Adults (\u226518 years) undergoing free flap breast reconstruction (2012\u20132025) were identified with CPT codes. Patients were stratified into cohorts by GLP-1 use within 1 year before surgery. Prescriptions for semaglutide, liraglutide, dulaglutide, exenatide, or tirzepatide defined GLP-1 users. Cohorts underwent 1:1 propensity score matching, and matched groups were analyzed for wound outcomes. Subgroup analyses were performed by diabetes status.<\/jats:p>\n                  <jats:p>In the pooled cohort, GLP-1 users had significantly lower composite wound complication rates compared with non-users (9.0% versus 17.1%, p\u2009=\u20090.002), including reduced surgical site infections (4.1% versus 8.1%, p\u2009=\u20090.026) and wound dehiscence (3.8% versus 7.8%, p\u2009=\u20090.023). No differences were observed in debridement, seroma, or hematoma rates. In subgroup analyses, GLP-1 use was associated with significantly lower composite wound complications in the non-diabetic subgroup (7.9 versus 18.6%, p\u2009=\u20090.007), while overall complication rates in the diabetic subgroup were comparable between users and non-users.<\/jats:p>\n                  <jats:p>Preoperative GLP-1 use was not linked to increased wound complications and may confer benefit, supporting safety when used perioperatively.<\/jats:p>","DOI":"10.1055\/a-2858-3774","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T22:55:53Z","timestamp":1776812153000},"source":"Crossref","is-referenced-by-count":1,"title":["GLP-1 Receptor Agonist Use and Wound Outcomes After Free Flap Breast Reconstruction"],"prefix":"10.1055","author":[{"given":"Joy","family":"Ha","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan R.","family":"Lester","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henning","family":"De May","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6854-5053","authenticated-orcid":false,"given":"Sydney","family":"Somers","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devin","family":"Eddington","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayant P.","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvin C.","family":"Kwok","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.japh.2023.10.002","article-title":"Trends in glucagon-like peptide 1 receptor agonist use, 2014 to 2022","volume":"64","author":"J H Watanabe","year":"2024","journal-title":"J Am Pharm Assoc (Wash DC)"},{"issue":"S 01","key":"ref2","doi-asserted-by":"crossref","first-page":"ehab724.2957","DOI":"10.1093\/eurheartj\/ehab724.2957","article-title":"Trends in initiation of GLP-1 RA in patients with type 2 diabetes during 2014\u20132019: a US database study","volume":"42","author":"M Kosiborod","year":"2021","journal-title":"Eur Heart J"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"100640","DOI":"10.1016\/j.obmed.2025.100640","article-title":"Global trends and focuses of GLP-1RA in obesity: a bibliometric analysis and visualization from 2014 to 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Impact of GLP-1 agonist weight loss drugs on surgical wound complications following plastic surgery procedures","volume":"13","author":"C C Lee","year":"2025","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"04","key":"ref18","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1097\/PRS.0000000000012405","article-title":"Perioperative GLP-1 Receptor Agonist Use and Surgical Outcomes in Nonbariatric Abdominal Panniculectomy: A 10-Year Retrospective Analysis","volume":"157","author":"Z A Koenig","year":"2026","journal-title":"Plast Reconstr Surg"},{"issue":"15","key":"ref19","doi-asserted-by":"crossref","first-page":"4527","DOI":"10.1007\/s00266-025-04703-4","article-title":"GLP-1 agonists in plastic surgery: impact on aesthetic outcomes\u2014two case reports","volume":"49","author":"F Taraschi","year":"2025","journal-title":"Aesthetic Plast Surg"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.bjps.2025.09.028","article-title":"Breast implant explantation with mastopexy in patients using GLP-1 receptor agonizts: a retrospective comparative analysis","volume":"111","author":"O Friedman","year":"2025","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"06","key":"ref21","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1007\/s00266-015-0575-8","article-title":"Flap failure and wound complications in autologous breast reconstruction: a national perspective","volume":"39","author":"B B Massenburg","year":"2015","journal-title":"Aesthetic Plast Surg"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"100746","DOI":"10.1016\/j.jhsg.2025.100746","article-title":"Impact of perioperative glucagon-like peptide-1 receptor agonists on postoperative outcomes following carpal tunnel release","volume":"7","author":"N C Bank","year":"2025","journal-title":"J Hand Surg Glob Online"},{"issue":"S 02","key":"ref23","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1097\/01.GOX.0001114996.48306.e9","article-title":"D126. Do GLP-1 medications influence lower extremity free tissue transfer outcomes in diabetic limb salvage patients? A 13-year retrospective review","volume":"13","author":"R N Rohrich","year":"2025","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"03","key":"ref24","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1177\/0022034509359125","article-title":"Factors affecting wound healing","volume":"89","author":"S Guo","year":"2010","journal-title":"J Dent Res"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1055\/a-2737-6539","article-title":"Complication burden and demographic trends in autologous breast reconstruction outcomes: insights from the NIH All of Us Program","author":"H N Parekh","year":"2025","journal-title":"J Reconstr Microsurg"},{"issue":"09","key":"ref26","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1055\/s-0044-1787266","article-title":"Microsurgical breast reconstruction can be performed safely in patients with obesity","volume":"40","author":"M L Silverstein","year":"2024","journal-title":"J Reconstr Microsurg"},{"issue":"09","key":"ref27","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1055\/a-2506-1763","article-title":"Effect of enhanced recovery after surgery in morbidly obese patients undergoing free flap breast reconstruction","volume":"41","author":"K L Stephens","year":"2025","journal-title":"J Reconstr Microsurg"},{"issue":"08","key":"ref28","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1055\/s-0044-1780518","article-title":"The effects of body mass index on postoperative complications in patients undergoing autologous free flap breast reconstruction","volume":"40","author":"K Garoosi","year":"2024","journal-title":"J Reconstr Microsurg"},{"issue":"01","key":"ref29","doi-asserted-by":"crossref","first-page":"86898","DOI":"10.5493\/wjem.v14.i1.86898","article-title":"Understanding wound healing in obesity","volume":"14","author":"A Cotterell","year":"2024","journal-title":"World J Exp Med"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.ejphar.2018.10.053","article-title":"Anti-inflammatory and pro-healing impacts of exendin-4 treatment in Zucker diabetic rats: effects on skin wound fibroblasts","volume":"842","author":"M Wolak","year":"2019","journal-title":"Eur J Pharmacol"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"1148209","DOI":"10.3389\/fimmu.2023.1148209","article-title":"Glucagon-like peptide-1: a multi-faceted anti-inflammatory agent","volume":"14","author":"S F Mehdi","year":"2023","journal-title":"Front Immunol"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.diabres.2018.10.013","article-title":"Glucagon-like peptide-1 analogue liraglutide facilitates wound healing by activating PI3K\/Akt pathway in keratinocytes","volume":"146","author":"K Nagae","year":"2018","journal-title":"Diabetes Res Clin Pract"},{"issue":"04","key":"ref33","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.jdiacomp.2012.12.007","article-title":"Increased ratio of serum matrix metalloproteinase-9 against TIMP-1 predicts poor wound healing in diabetic foot ulcers","volume":"27","author":"Z Li","year":"2013","journal-title":"J Diabetes Complications"},{"issue":"06","key":"ref34","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1161\/ATVBAHA.115.305447","article-title":"GLP-1 receptor agonist exenatide increases capillary perfusion independent of nitric oxide in healthy overweight men","volume":"35","author":"M M Smits","year":"2015","journal-title":"Arterioscler Thromb Vasc Biol"}],"container-title":["Journal of Reconstructive Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2858-3774.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T23:00:49Z","timestamp":1778022049000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2858-3774"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,21]]},"references-count":32,"URL":"https:\/\/doi.org\/10.1055\/a-2858-3774","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0743-684X","1098-8947"],"issn-type":[{"value":"0743-684X","type":"print"},{"value":"1098-8947","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4,21]]},"published":{"date-parts":[[2026,4,21]]}}}