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Published on: June 17, 2018
"Supersize" panniculectomy: indications, technique, and results
Ivo A Pestana1, Douglas Campbell, Regina M Fearmonti
1From the *Department of Plastic and Reconstructive Surgery, Wake Forest Baptist University Medical Center, Winston-Salem; and †Division of Plastic and Reconstructive Surgery, Department of Surgery, Duke University Medical Center, Durham, NC.
Supersize panniculectomy, involving removal of large abdominal skin flaps (≥10 kg), can improve quality of life for severely obese patients. Major complications were infrequent, suggesting it is a justified intervention for therapy-resistant pannus.
Area of Science:
- Plastic Surgery
- Bariatric Surgery
- Obesity Medicine
Background:
- Obesity presents significant health challenges, leading to morbidity and mortality.
- Panniculectomy aims to alleviate complications from excess abdominal skin in obese individuals.
- This procedure can enhance quality of life, mobility, and prepare patients for weight management.
Purpose of the Study:
- To describe the indications and outcomes of "supersize" panniculectomy in extremely obese patients.
- To evaluate the safety and efficacy of this procedure in a specific patient cohort.
Main Methods:
- Retrospective chart review of patients undergoing "supersize" panniculectomy over six years.
- Data collected included demographics, indications, imaging, concomitant procedures, and complications.
- "Supersize" panniculectomy defined as pannus resection weight ≥10 kg, extending to mid-thigh or below.
Main Results:
- Twenty-six patients underwent "supersize" panniculectomy for immobility, panniculitis, hernia, or gynecologic tumors.
- Mean resection weight was 15.6 kg; mean follow-up was 15.7 months.
- Overall complication rate was 42.3%, but major complications (requiring reoperation) were 11.5%.
Conclusions:
- "Supersize" panniculectomy is a viable option for severely obese patients with extensive pannus.
- Despite high overall complication rates, major complications were infrequent, justifying the intervention.
- Preoperative CT imaging is recommended to identify underlying hernias.
