Severe abdominal wall necrosis after ultrasound-assisted liposuction

The complicated case of a 44-year-old white female following ultrasound-assisted liposuction of the entire abdomen is presented. In this case the postoperative course was complicated by hematoma, treated conservatively. During following weeks extensive cutaneous necrosis over the abdomen developed. After four weeks the patient presented to our institution with purulent discharge. After surgical revision, requiring excision of the abdominal wall necrosis, a significant residual abdominal wall defect remained. After three further revisions, removal of residual necrotic fat, irrigation, and temporary coverage with a synthetic dressing, infection cleared. At this point, split thickness skin grafting was possible. The healing in of the skin grafts was complete, eventually enabling wound closure and successful reconstruction of the abdominal wall.