First, prolonged OAM beyond 8 days has been associated with a significantly increased risk of SSI and intra-abdominal contamination due to sustained exposure of dissected tissue surfaces and delayed fascial closure.18) Second, component separation techniques and fascial dissection inherently generate wide raw surfaces, which pose risks for both infection and microvascular bleeding.14) Third, hepatic dysfunction, demonstrated by hypoalbuminemia (1.5 g/dL) and markedly decreased cholinesterase levels (82 U/L), may have impaired both coagulation and innate immunity. The gene discussed is BCHE; the disease is infection.