Elicit the patient’s specific concerns regarding the appearance of her abdomen

Concomitant medical issues

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  General risk factors for surgery and wound healing

  
  
  
  
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    Cardiac disease, pulmonary disease, diabetes, obesity, connective tissue disease, and steroid use

  
  
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  Risk factors for thrombotic event

  
  
  
  
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    History of deep venous thrombosis, pulmonary emboli, multiple miscarriages, or known genetic hypercoagulable state

Obstetric history: Number of previous pregnancies and plans for future pregnancies

Surgical history: Previous abdominal surgery

Goal weight and weight stability

History of smoking

Calculate body mass index (BMI): Higher incidence of wound complications, deep vein thrombosis (DVT)/pulmonary embolism (PE) in obese patients

Examine excess skin and subcutaneous tissue

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  Skin pinch to assess subcutaneous adiposity

  
  
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  Note any striae and chest/abdominal scars

Examine for hernias or rectus diastasis

Complete blood count (CBC), basal metabolic profile (BMP), prothrombin time (PT)/international normalized ratio (INR), and activated partial thromboplastin time (aPTT) may be considered depending on medical comorbidities

Hematologic testing may be considered if history is consistent with hypercoagulable process

Fingerstick glucose on the day of surgery, if diabetic

Urine beta human chorionic gonadotropin level on the day of surgery

Nutrition labs may be considered for post bariatric surgery patients

Urine cotinine level 10 days prior to surgery (to confirm compliance with smoking cessation)

Computed tomography (CT) of abdomen/pelvis if there is a questionable hernia that is difficult to characterize on examination