Patients with inflammatory bowel disease (IBD) present unique challenges in reconstructive plastic surgery due to chronic systemic inflammation, altered immune response, nutritional deficiencies, and long-term use of immunosuppressive therapies. These factors can adversely affect wound healing, increase the risk of surgical site infection, and compromise flap and graft survival. Reconstructive procedures in patients with IBD are frequently required following abdominal surgeries, fistula formation, perineal and abdominal wall defects, and complex soft tissue loss. Disease activity, nutritional status, and ongoing medical therapies such as corticosteroids, immunomodulators, and biologic agents play a critical role in determining surgical timing and outcomes. Additionally, chronic inflammation and impaired tissue perfusion may influence reconstructive strategy selection, including the choice between local, regional, or free tissue transfer. This review summarizes current concepts regarding the impact of inflammatory bowel disease on wound healing and reconstructive outcomes, with an emphasis on perioperative risk assessment and multidisciplinary collaboration between plastic surgeons and gastroenterologists. Understanding the interaction between IBD-related systemic factors and reconstructive techniques is essential for optimizing surgical planning, minimizing complications, and improving functional and aesthetic outcomes in this complex patient population.
Keywords: Inflammatory bowel disease (IBD), Surgical Site Infection, Flap, Plastic Surgery.
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