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Erschienen in: European Surgery 4/2013

01.08.2013 | Case Report

Massive panniculectomy and hernioplasty as a salvage procedure

verfasst von: R. Matasa, C. Zirak, P. M. da Costa, A. De Mey, W. Boeckx

Erschienen in: European Surgery | Ausgabe 4/2013

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Summary

Background

Salvage panniculectomy is sometimes the only solution to remove a massive pannus or abdominal apron, which is the source of many physical, social, and emotional problems for the patient. Often, the panniculus morbidus prevents weight loss, as the patient cannot exercise and can lead to hygiene and chronic pain issues, including intertrigo, chronic infections, ulcerations, and low-back pains. The heavier the panniculus, the more marked the symptoms.

Case report

Here, we present a case of a severely obese patient, with a large panniculus extending below the knees, accompanied by a large abdominal incisional hernia containing intestines. Recently, the patient’s lower abdomen became ischemic and infected, making the patient’s diabetes mellitus difficult to control. After a long ineffective period of local care and antibiotic therapy, the surgical removal was attempted. Surgery consisted resection of a 16-kg panniculus and incisional hernia repair with a resorbable mesh.

Results

Postoperative recovery was relatively simple. Patient’s quality of life showed a dramatic improvement, as well as the hygiene, toilet habits, and mobility.

Conclusion

In this kind of patients, surgery can be technically difficult and carries significant postoperative risks, but it remains the only viable option for long-term survival.
Literatur
1.
Zurück zum Zitat Knight RJ, Rtshiladze MA, Reddy C, Knox A. Looking at the bariatric surgery with a different frame of mind. Eur J Plast Surg. 2009;32:115–7.CrossRef Knight RJ, Rtshiladze MA, Reddy C, Knox A. Looking at the bariatric surgery with a different frame of mind. Eur J Plast Surg. 2009;32:115–7.CrossRef
2.
Zurück zum Zitat Aston SJ. Abdominoplasty. Aesthetic plastic surgery. Philadelphia: WB Saunders; 1980. pp. 1007–38. Aston SJ. Abdominoplasty. Aesthetic plastic surgery. Philadelphia: WB Saunders; 1980. pp. 1007–38.
3.
Zurück zum Zitat Kelly HA. Report of gynecological cases. Johns Hopkins Med J. 1899;10:197. Kelly HA. Report of gynecological cases. Johns Hopkins Med J. 1899;10:197.
4.
Zurück zum Zitat Reichenberger MA, Stoff A, Richter DF. Dealing with the mass: a new approach to facilitate panniculectomy in patients with very large abdominal aprons. Obes Surg. 2008;18:1605–10.PubMedCrossRef Reichenberger MA, Stoff A, Richter DF. Dealing with the mass: a new approach to facilitate panniculectomy in patients with very large abdominal aprons. Obes Surg. 2008;18:1605–10.PubMedCrossRef
5.
Zurück zum Zitat Manahan MA, Shermak MA. Massive panniculectomy after massive weight loss. Plast Reconstr Surg. 2006;117:2191–7.PubMedCrossRef Manahan MA, Shermak MA. Massive panniculectomy after massive weight loss. Plast Reconstr Surg. 2006;117:2191–7.PubMedCrossRef
6.
Zurück zum Zitat Petty P, Manson PN, Black R, Romano JJ, Sitzman J, Vogel J. Panniculus morbidus. Ann Plast Surg. 1992;28:442–52.PubMedCrossRef Petty P, Manson PN, Black R, Romano JJ, Sitzman J, Vogel J. Panniculus morbidus. Ann Plast Surg. 1992;28:442–52.PubMedCrossRef
7.
Zurück zum Zitat Igwe D Jr, Stanczyk M, Lee H, et al. Panniculectomy adjuvant to obesity surgery. Obes Surg. 2000;10:530–9.PubMedCrossRef Igwe D Jr, Stanczyk M, Lee H, et al. Panniculectomy adjuvant to obesity surgery. Obes Surg. 2000;10:530–9.PubMedCrossRef
8.
Zurück zum Zitat Friedrich JB, Petrov RV, Askay SA, et al. Resection of panniculus morbidus: a salvage procedure with a steep learning curve. Plast Reconstr Surg. 2008;121:108–14.PubMedCrossRef Friedrich JB, Petrov RV, Askay SA, et al. Resection of panniculus morbidus: a salvage procedure with a steep learning curve. Plast Reconstr Surg. 2008;121:108–14.PubMedCrossRef
9.
Zurück zum Zitat Grazer FM, Goldwyn RM. Abdominoplasty assed by survey, with emphasize on complications. Plast Reconstr Surg. 1977;59(4):513–7.PubMed Grazer FM, Goldwyn RM. Abdominoplasty assed by survey, with emphasize on complications. Plast Reconstr Surg. 1977;59(4):513–7.PubMed
10.
Zurück zum Zitat Matory WE Jr, O’Sullivan J, Fudem G, Dunn R. Abdominal surgery in patients with severe morbid obesity. Plast Reconstr Surg. 1994;94:976–87.PubMedCrossRef Matory WE Jr, O’Sullivan J, Fudem G, Dunn R. Abdominal surgery in patients with severe morbid obesity. Plast Reconstr Surg. 1994;94:976–87.PubMedCrossRef
11.
Zurück zum Zitat Vastine VL, Morgan RF, Williams GS, et al. Wound complications of abdominoplasty in obese patients. Ann Plast Surg. 1999;42:34–9.PubMedCrossRef Vastine VL, Morgan RF, Williams GS, et al. Wound complications of abdominoplasty in obese patients. Ann Plast Surg. 1999;42:34–9.PubMedCrossRef
Metadaten
Titel
Massive panniculectomy and hernioplasty as a salvage procedure
verfasst von
R. Matasa
C. Zirak
P. M. da Costa
A. De Mey
W. Boeckx
Publikationsdatum
01.08.2013
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 4/2013
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-013-0194-z

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