Panniculectomy after bariatric surgical weight loss: Analysis of complications and modifiable risk factors

Am J Surg. 2018 May;215(5):887-890. doi: 10.1016/j.amjsurg.2018.02.008. Epub 2018 Feb 7.

Abstract

Introduction: Bariatric surgery results in massive weight loss, leaving many patients with redundant skin that can cause significant physical and psychosocial limitations. We sought to identify variables associated with postoperative complications and adjuncts associated with the mitigation of postoperative complications.

Methods: A retrospective review was performed of all post-bariatric surgery patients who underwent panniculectomy over a 10-year period.

Results: Total 706 patients included. Overall complication rate was 56%: dehiscence (24%), surgical site infection (22%), seroma (18%), and post-operative bleeding (5%). Return to operating room rate was 12%. Significant factors were: BMI >26 (p < 0.01), fleur-de-lis panniculectomy (p < 0.01), concomitant hernia repair (p < 0.01). Multivariate regression analysis demonstrated ASA class >2 (OR 1.97, p < 0.05) and incision type (OR 1.64, p < 0.05) to be independent predictors of morbidity.

Conclusion: High morbidity for post-bariatric panniculectomy is primarily local wound complications. Potentially modifiable factors that increase the complication risk profile include higher BMI, higher ASA class, and the use of fleur-de-lis incision.

MeSH terms

  • Abdominoplasty*
  • Adult
  • Bariatric Surgery*
  • Female
  • Hernia, Abdominal / surgery
  • Humans
  • Male
  • Obesity, Morbid / surgery*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / prevention & control
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Weight Loss