Outcome Study of the Surgical Management of Panniculitis

Abstract

Patients with panniculus morbidus have an abdominal panniculus that becomes a pathologic entity, associated with the development of candidal intertrigo, dermatitis, lymphedema, and ischemic panniculitis. Panniculectomy is a standard treatment for this problem. The objective of this study was to determine risk factors for complications associated with panniculectomy surgery to lower the complication rate. We performed a retrospective chart review of patients who underwent panniculectomy between 1999 and 2007 by looking at data related to surgical complications, comorbidities, age, and gender. In 563 patients, we recorded the incidence of the following complications: wound-related (infection, dehiscence, and/or necrosis), hematoma/seroma, respiratory distress, blood transfusions, deep venous thrombosis or pulmonary embolism, and death. Overall, 34.3% of patients suffered at least 1 complication. In patients with wound complications specifically, there was a significantly higher body mass index versus those with no wound complications (43.7% vs. 30.7%, P < 0.0001). Smokers also had a higher rate of wound complications (40.5% vs. 19.5%, P < 0.0001).

Massive Panniculectomy in the Super Obese and Super-Super Obese

“…Those with a body mass index greater than 60 were 15.5 times more likely to have a wound complication. 9 Panniculectomy combined with other operations has shown increased complication rates, similar to those reported in various studies. [10][11][12][13] The wound complications in our patients presented in various forms, including seroma, fat necrosis, and primary dehiscence, and some of these had an associated infection or bacterial growth.…”

Impact of panniculectomy on transplant candidacy of obese patients with chronic kidney disease declined for kidney transplantation because of a high-risk abdominal panniculus: A pilot study

“…In those studies, complication rates ranged from 33 to greater than 45%, and operative reintervention rates from 11 to 20%. [13][14][15] Importantly, the perioperative risk profile of our patient cohort---compared with all of the aforementioned studies' cohorts---appears to differ substantially: for instance, the proportion of diabetic patients in these studies was less than 20% (vs 70% in the present study), and the incidence of CKD V was not reported (and is therefore assumed to be very low or even close to 0% [vs 100% in our study]). [10][11][12][13][14][15] Hence, a direct comparison of our outcomes with these previous reports is difficult, because diabetes and CKD stage have a substantial adverse impact on wound and other complication rates after abdominal operative procedures.…”

Paniculectomía masiva en lipodistrofia abdominal gigante: cuando el beneficio supera los riesgos

“…demuestran una correlación estadísticamente significativa entre el tamaño del faldón abdominal o tener un IMC mayor de 39 kg/m 2 con las complicaciones de la herida 9,10 . Por otro lado, se producen alteraciones hidroelectrolíticas y pérdidas sanguíneas que incrementan las necesidades de transfusión, y hay descritos casos de muerte por tromboembolismo, sepsis o infarto agudo de miocardio 3 .…”