Abdominal Panniculectomies : High Patient Satisfaction Despite Significant Complication Rates

We reviewed our experience with 3 operative techniques for abdominal panniculectomies to determine differences in complication rates and levels of patient satisfaction. This retrospective study included 92 consecutive patients who underwent abdominal panniculectomies over a 9-year period. Patients u...

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Veröffentlicht in:Annals of plastic surgery 2008-08, Vol.61 (2), p.188-196
Hauptverfasser: COOPER, Joshua M, PAIGE, Keith T, BESHLIAN, Kevin M, DOWNEY, Daniel L, THIRLBY, Richard C
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container_end_page 196
container_issue 2
container_start_page 188
container_title Annals of plastic surgery
container_volume 61
creator COOPER, Joshua M
PAIGE, Keith T
BESHLIAN, Kevin M
DOWNEY, Daniel L
THIRLBY, Richard C
description We reviewed our experience with 3 operative techniques for abdominal panniculectomies to determine differences in complication rates and levels of patient satisfaction. This retrospective study included 92 consecutive patients who underwent abdominal panniculectomies over a 9-year period. Patients underwent one of 3 panniculectomy techniques: fleur-de-lis (n = 25), transverse incisions with minimal undermining (n = 30), or transverse incisions with extensive undermining (n = 37). Postoperatively, patient satisfaction surveys were completed. Median pannus weight was 4.4 kg (range, 1.6-20.5). Sixty-eight patients (73.9%) had a previous gastric bypass. Median body mass index (BMI) was 38 kg/m2 (range, 22-66.9). Median follow-up for complications was 8.1 week (range, 1-235). Forty of 92 patients (43%) suffered wound complications. The reoperation rate was 13%. Postoperative complication rates were higher among hypertensive patients (61% vs. 36%; P = 0.04). There was a trend towards increased complications among those with higher BMI and pannus weights. There was not a significant relationship between operative technique and overall complication rate. Mean length of follow-up for patient questionnaire completion was 2 years, 11 months (range, 1-9 years). Eighty-one percent of those responding to the mailed questionnaire were satisfied with their operative results. There were no statistically significant differences between the technique used and patient satisfaction level. Concomitant hernia repair was performed in 47% of patients without increased wound complications. Patients were satisfied with the results of their panniculectomy, although complications were common. Higher BMI, larger pannus size, and hypertension were correlated with increased complication rates. The minimal undermining, extensive undermining, and the fleur-de-lis panniculectomy techniques result in similar patient satisfaction rates and complication rates.
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This retrospective study included 92 consecutive patients who underwent abdominal panniculectomies over a 9-year period. Patients underwent one of 3 panniculectomy techniques: fleur-de-lis (n = 25), transverse incisions with minimal undermining (n = 30), or transverse incisions with extensive undermining (n = 37). Postoperatively, patient satisfaction surveys were completed. Median pannus weight was 4.4 kg (range, 1.6-20.5). Sixty-eight patients (73.9%) had a previous gastric bypass. Median body mass index (BMI) was 38 kg/m2 (range, 22-66.9). Median follow-up for complications was 8.1 week (range, 1-235). Forty of 92 patients (43%) suffered wound complications. The reoperation rate was 13%. Postoperative complication rates were higher among hypertensive patients (61% vs. 36%; P = 0.04). There was a trend towards increased complications among those with higher BMI and pannus weights. There was not a significant relationship between operative technique and overall complication rate. Mean length of follow-up for patient questionnaire completion was 2 years, 11 months (range, 1-9 years). Eighty-one percent of those responding to the mailed questionnaire were satisfied with their operative results. There were no statistically significant differences between the technique used and patient satisfaction level. Concomitant hernia repair was performed in 47% of patients without increased wound complications. Patients were satisfied with the results of their panniculectomy, although complications were common. Higher BMI, larger pannus size, and hypertension were correlated with increased complication rates. 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This retrospective study included 92 consecutive patients who underwent abdominal panniculectomies over a 9-year period. Patients underwent one of 3 panniculectomy techniques: fleur-de-lis (n = 25), transverse incisions with minimal undermining (n = 30), or transverse incisions with extensive undermining (n = 37). Postoperatively, patient satisfaction surveys were completed. Median pannus weight was 4.4 kg (range, 1.6-20.5). Sixty-eight patients (73.9%) had a previous gastric bypass. Median body mass index (BMI) was 38 kg/m2 (range, 22-66.9). Median follow-up for complications was 8.1 week (range, 1-235). Forty of 92 patients (43%) suffered wound complications. The reoperation rate was 13%. Postoperative complication rates were higher among hypertensive patients (61% vs. 36%; P = 0.04). There was a trend towards increased complications among those with higher BMI and pannus weights. There was not a significant relationship between operative technique and overall complication rate. 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Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>COOPER, Joshua M</creatorcontrib><creatorcontrib>PAIGE, Keith T</creatorcontrib><creatorcontrib>BESHLIAN, Kevin M</creatorcontrib><creatorcontrib>DOWNEY, Daniel L</creatorcontrib><creatorcontrib>THIRLBY, Richard C</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of plastic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>COOPER, Joshua M</au><au>PAIGE, Keith T</au><au>BESHLIAN, Kevin M</au><au>DOWNEY, Daniel L</au><au>THIRLBY, Richard C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Abdominal Panniculectomies : High Patient Satisfaction Despite Significant Complication Rates</atitle><jtitle>Annals of plastic surgery</jtitle><addtitle>Ann Plast Surg</addtitle><date>2008-08-01</date><risdate>2008</risdate><volume>61</volume><issue>2</issue><spage>188</spage><epage>196</epage><pages>188-196</pages><issn>0148-7043</issn><eissn>1536-3708</eissn><coden>APCSD4</coden><abstract>We reviewed our experience with 3 operative techniques for abdominal panniculectomies to determine differences in complication rates and levels of patient satisfaction. 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subjects Abdomen - surgery
Adult
Aged
Biological and medical sciences
Body Mass Index
Female
Gastric Bypass - statistics & numerical data
Humans
Male
Medical sciences
Middle Aged
Obesity - surgery
Patient Satisfaction
Postoperative Complications - epidemiology
Reconstructive Surgical Procedures - methods
Reconstructive Surgical Procedures - statistics & numerical data
Retrospective Studies
Stomach, duodenum, intestine, rectum, anus
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Surveys and Questionnaires
title Abdominal Panniculectomies : High Patient Satisfaction Despite Significant Complication Rates
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