[Liposuction and extensive cutaneous necrosis. Apropos of a clinical case]

The massive use of hypertonic solution in subcutaneous tissue inevitably causes a necrotic reaction whose severity is directly correlated to the extent of infiltration, involving, as in the present case, all of the abdomen and the anteromedial surface of the thighs. This infiltration was performed for ultrasound treatment as part of liposuction in which the cutaneous swelling must be particularly marked in order to obtain full benefit from this technique. The direct action of ultrasound itself cannot be incriminated in this case. The present case developed was abdominocrural necrosis requiring six weeks of hospitalisation, including twelve days in the intensive care unit and skin cover by split skin grafts after debridement. Although this complication is not specific to liposuction, the quantities of saline regularly infiltrated with this technique carry a high risk of this complication, for which the doctor is inevitable responsible, even if it is due to a confusion on the part of paramedical staff.