This study evaluated the risk factors for postoperative
SSI after hepatic resection for liver
disease. The current study reveals four independent
risk factors for postoperative SSI after liver
resection. Previous studies report that obese
patients with BMI >25e30 kg/m2 were at risk of
developing postoperative SSI.25e27 Body habitus
in Japan is significantly different from that of
a Western population, and the significance of BMI
of 25.4 vs 22.7 kg/m2 may not translate to the
European population. In the present study,
multivariate analysis revealed that BMI >23.6 kg/m2
significantly influenced postoperative SSI complications
by ROC curve analysis. All patients
received prophylaxis for three days after hepatic
surgery. It is important to consider adjustments
to the level of administered antibiotic agents
according to a patient’s body weight. Obesity is
common in the West and it is a recent concern
in Japan. The increased surgical risks associated
with obesity highlight the importance for patients
confronting body-contouring procedures to understand
and consider these risks preoperatively. On
the other hand, from the viewpoint of BMI, it
should be considered that a significant proportion
of patients having liver resection due to carcinoma,
either primary or metastatic, would have
an element of malnutrition. Perioperative supplementation
with branched amino acid (BCAA)-rich
soft-powder nutrient-mixture was introduced in
our department for patients with low BMI who
did not have an adequate diet. Our previous study
suggested that the administration of BCAA-rich
soft-powder nutrient-mixture was of great help
to improve not only the nutritional status but
also whole-body kinetics.28 Therefore, in this
study, low BMI was not specifically linked to the
development of postoperative SSI
This study evaluated the risk factors for postoperative
SSI after hepatic resection for liver
disease. The current study reveals four independent
risk factors for postoperative SSI after liver
resection. Previous studies report that obese
patients with BMI >25e30 kg/m2 were at risk of
developing postoperative SSI.25e27 Body habitus
in Japan is significantly different from that of
a Western population, and the significance of BMI
of 25.4 vs 22.7 kg/m2 may not translate to the
European population. In the present study,
multivariate analysis revealed that BMI >23.6 kg/m2
significantly influenced postoperative SSI complications
by ROC curve analysis. All patients
received prophylaxis for three days after hepatic
surgery. It is important to consider adjustments
to the level of administered antibiotic agents
according to a patient’s body weight. Obesity is
common in the West and it is a recent concern
in Japan. The increased surgical risks associated
with obesity highlight the importance for patients
confronting body-contouring procedures to understand
and consider these risks preoperatively. On
the other hand, from the viewpoint of BMI, it
should be considered that a significant proportion
of patients having liver resection due to carcinoma,
either primary or metastatic, would have
an element of malnutrition. Perioperative supplementation
with branched amino acid (BCAA)-rich
soft-powder nutrient-mixture was introduced in
our department for patients with low BMI who
did not have an adequate diet. Our previous study
suggested that the administration of BCAA-rich
soft-powder nutrient-mixture was of great help
to improve not only the nutritional status but
also whole-body kinetics.28 Therefore, in this
study, low BMI was not specifically linked to the
development of postoperative SSI
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