“Perioperative GLP-1 Receptor Agonist Use & Surgical Outcomes in Non-bariatric Abdominal Panniculectomy: A 10-Year Retrospective Analysis”

Glucagon-like peptide-1 receptor agonists (GLP1ra) are increasingly used for type 2 diabetes and obesity due to metabolic benefits and potential wound-healing properties. However, their perioperative safety in acute surgical settings remains unclear. They can possibly alter tissue quality and intensify GLP1ra side effects. This study examines postoperative complications and GLP1ra -associated side effects in non-bariatric patients who underwent panniculectomy. We conducted a retrospective review of 373 panniculectomy patients (January 2013-January 2023), including 81 GLP1ra users and 292 non-users. Patients with prior bariatric surgery or concomitant hernia repair were excluded due to the added complexity of mesh placement and altered tissue planes, which could confound wound healing outcomes. 1 All had ≥1 year of follow-up. Baseline demographics, nutritional markers, and GLP1ra therapy duration were recorded. Logistic regression was performed to adjust for confounders when comparing complications and side effects. GLP1ra users had higher rates of type 2 diabetes (55.6% vs 29.5%, P=0.01), hypertension (69.1% vs 52.7%, P=0.04), and chronic obstructive pulmonary disease (17.3% vs 6.5%, P=0.02), along with elevated prealbumin (22.8±6.6 vs 20.4 ± 7.7 mg/dL, P=0.030). Analyses showed greater delayed wound healing (18.5% vs 7.5%, P=0.0066) but lower seroma incidence (4.9% vs 14.0%, P=0.032) in GLP1ra users. These differences persisted on multivariable regression. No significant differences were noted in infection, fat necrosis, hematoma, or GLP1ra-related gastrointestinal side effects. Although GLP1ra demonstrated promise in chronic wound care, their use correlated with increased delayed healing but fewer seromas in acute surgical settings. Overall, these findings support their perioperative safety, though vigilant monitoring for potential wound-healing delays is advised.