Evaluating the Use of 5-Factor Modified Frailty Index to Predict Wound Healing Complications in Reduction Mammoplasty.

[BACKGROUND] Reduction mammoplasty is an established treatment for symptomatic macromastia. Understanding risk factors associated with complications is essential for counseling and patient selection. The modified frailty index (mFI-5) has been proposed as a simple tool to assess risk in surgical candidates.

[OBJECTIVES] We sought to determine if the mFI-5 can accurately predict wound healing complications following reduction mammoplasty.

[METHODS] A retrospective review was performed of primary bilateral reduction mammoplasty cases between 2017 and 2019 at one institution. MFI-5 scores were calculated for each patient. 30-day wound healing complications were defined as incisional dehiscence, T-point breakdown, nipple-areolar complex necrosis, and fat necrosis. Univariate and multivariate logistic regression were used to evaluate predictive value.

[RESULTS] 474 patients were stratified into three age groups: 15-30, 31-50, and over 51. Twenty-six percent of patients developed 1 wound healing problem. On univariate analysis, ages 31-50 and 51+ (OR 2.75 and 3.16) and mFI score of 1 (OR 2.07) were associated with an increased risk of wound healing complications. Adjusted multivariate analysis indicated that age greater than 51 years significantly predicted wound healing issues (OR 2.89; p=0.001) when controlled for American Society of Anesthesiologists (ASA) score, smoking, and body mass index (BMI). The mFI-5 did not significantly predict wound healing issues when controlled for age, ASA, BMI, or smoking.

[CONCLUSIONS] In our population, the mFI-5 was not a statistically significant predictor of wound healing complications following reduction mammoplasty. When controlling for confounders, advanced age alone seems to place patients at higher risk for wound healing complications.