Avaliação histológica da pele de pacientes submetidos à cirurgia bariátrica

Abstract

Obesity is a stigmatizing disease, especially among women, who seek treatments that may alter their body's shape, in addition to causing some dermatological aberrations, affecting the skin such as sagging after rapid weight loss that usually occurs due to collagen and elastin damages. Objective: To evaluate the effects of obesity and major weight loss after bariatric surgery under the collagen and elastic fibers of the extracellular matrix of the skin. Methods: Thirty-three skin biopsies from patients collected during bariatric surgery and one year after surgery were included. Histological analyzes were performed by Weigert's Hematoxylin-Eosin and Resorcin-Fucsin techniques to verify collagen fibers, elastic and elaunin fibers, respectively. The results were expressed as mean ± standard error of the mean (SEM). After assessing the distribution of normality (by the Kolmogorov-Smirnov test) the differences between the means were submitted to Student's t-test or Mann-Whitney U test and values of p <0.05 were considered statistically significant. Results: The study demonstrated an architectural alteration of the skin after one year of bariatric surgery. In addition to the laxity, a collagen disorganization with apparent decrease in quantity and increase of elastic fibers although fragmented. Conclusion: Obesity and substantial weight loss after bariatric surgery cause disorganization of the collagen fibers and fragmentation of the elastic fibers of the extracellular matrix of the skin. Further studies will be necessary to correlate skin changes with the possible causes and outcomes of bariatric surgery, providing better clinical and surgical treatment options and reducing the complication rate of these patients