Original ArticlePanniculectomy as an Adjuvant to Bariatric SurgeryAcarturk, T Oguz MD*; Wachtman, Galen BS*; Heil, Brian MD*; Landecker, Alan MD*; Courcoulas, Anita P. MD†; Manders, Ernest K. MD* Author Information From the *Division of Plastic and Reconstructive Surgery and †Department of Surgery, University of Pittsburgh Medical Center Pittsburgh, PA. Received January 9, 2004 and accepted for publication, after revision, February 10, 2004. Reprints: T. Oguz Acarturk, MD, Division of Plastic and Reconstructive Surgery, University of Pittsburgh Medical Center, 6B Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261. E-mail: [email protected] Annals of Plastic Surgery: October 2004 - Volume 53 - Issue 4 - p 360-366 doi: 10.1097/01.sap.0000135139.33683.2f Buy Metrics AbstractIn Brief A large hanging panniculus can cause problems such as intertrigo, chronic infection, and immobility. Many patients undergoing weight reduction surgery can benefit from panniculectomy either done concomitantly with bariatric surgery or later after significant weight reduction. Over the last 5 years we performed 123 panniculectomies on patients (34 males, 89 females; mean age 44.5 ± 10.3 years) undergoing bariatric surgery. The panniculectomy was either done at the same time as the bariatric surgery in 21 patients or after a time period of 17 ± 11 months in 102 patients. The prebariatric surgery weight ranged from 107 to 341 kg (mean: 168.6 ± 47.2 kg) with a mean body mass index (BMI) of 59 ± 14 kg/m2. After the bariatric surgery the patients had an average weight loss of 57.6 ± 27 kg. The prepanniculectomy weight was 121.9 ± 39.3 kg (BMI = 43.1 ± 12.4 kg/m2) for the patients who had the panniculectomy after the bariatric surgery. Ninety-two percent of the patients had multiple comorbidities. The weight of the panniculectomy specimen ranged from 4 to 54 kg. Any abdominal wall hernias (35.4% incisional and 8.9% umbilical) were fixed during the panniculectomy. Overall, patients who had panniculectomy simultaneously with the bariatric surgery had more complications than patients who had panniculectomy after their bariatric surgery. The wound infections were 48% versus16% and respiratory distress was 24% versus 0%, respectively. The skin necrosis was 10% versus 6%, dehiscence was 33% versus 13%, and hematoma formation was 10% versus 2%, respectively. Overall, the patients had good outcomes, with 3 postoperative deaths in the group with panniculectomy at the same time of bariatric surgery. An interval of weight loss prior to the procedure makes this procedure safer and more effective. Panniculectomy was performed at the time of bariatric surgery in 21 patients and on a delayed basis in 102. Complications were higher in those with simultaneous procedures, including wound infection (48% vs 16%), respiratory distress (42% vs 0%), dehiscence (33% vs 13%), and hematoma (10% vs 2%). © 2004 Lippincott Williams & Wilkins, Inc.