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Panniculus morbidus
1Division of Plastic Surgery, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
Abstract:
Eight patients with large panniculi are described where severe problems with hygiene, immobility, and chronic infection were caused by the lymphedematous, chronically infected pannus. Protracted nonsurgical management of the infected panniculus had failed in all 8 patients. Wedge resection without fat undermining removed diseased tissue. Infection and sepsis were eliminated and ambulation was restored in all patients. Formerly immobile patients were returned to normal activity. Significant self-induced weight loss was not observed in a 2-year follow-up period; weight gain, however, was not experienced. The primary anesthetic method was thoracic epidural reducing the requirements for general endotracheal anesthesia. The chronically infected pannus is a surgical problem deserving earlier recognition and resection.
Insights
Surgical resection of chronically infected pannus effectively resolved hygiene, immobility, and infection issues in eight patients. This intervention restored mobility and normal activity, highlighting its value in managing severe panniculus complications.
Area of Science:
- Plastic Surgery
- Infectious Disease Management
Background:
- Large panniculi can cause severe hygiene issues, immobility, and chronic infections.
- Nonsurgical management often fails for infected panniculus complications.
Observation:
- Eight patients with lymphedematous, chronically infected pannus experienced significant health problems.
- Previous non-surgical treatments were unsuccessful for these patients.
Findings:
- Wedge resection without fat undermining successfully removed diseased tissue.
- All patients were cured of infection and sepsis, regaining ambulation and normal activity.
- No significant weight loss or gain was observed during a 2-year follow-up.
Implications:
- Early surgical recognition and resection of chronically infected pannus is recommended.
- Thoracic epidural anesthesia can reduce the need for general endotracheal anesthesia in these procedures.