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Fleur-De-Lis Versus Standard Panniculectomy in Massive Weight loss Patients: A Comparison of Outcomes
Halka, JT, Lamb, P, Harron, R, Beddell, G
Summa Health
2021-01-31
Presenter: Patrick Lamb
Affidavit:
This project is 100% the original work of the residents listed as authors. This work has not been presented in any other forums.
Director Name: Ananth Murthy
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background:
The United States of America has one of the highest obesity rates in the World. In recent decades, surgical treatment of obesity with bariatric surgery procedures have allowed obese patients to lose a large portion of their excess adipose tissue, but they are often left with excess skin. The plastic surgeon is often tasked with the resection of this excess skin via standard panniculectomy or Fleur-De-Lis panniculectomy (FDL). The FDL may yield improved body contour in this patient population but is hypothesized to have increased risk for complications.
Methods:
To compare outcomes in post-bariatric surgery patients, we performed a retrospective review looking at patients who underwent panniculectomy based on the CPT code 15830. Patients were then sub-divided based on whether they underwent FDL or standard panniculectomy without a vertical incision. Patient demographics, co-morbidities, and complications were gathered from the electronic medical record.
Results:
Patients who underwent FDL were more likely to be obese (95 vs 64%) but were less likely to have co-morbidities such as HTN (21 vs 52%), DM (5 vs 20%), HLD (15 vs 31%). Complication rates were similar between groups (31 vs 36%). FLD had a higher rate of minor dehiscence (21 vs 9%) and minor tissue necrosis (15 vs 0%).
Conclusion:
Post-Bariatric surgery patients undergoing resection of excess abdominal skin are a patient population that may benefit from fleur-de-lis panniculectomy. Plastic surgeons should be aware of the potential risks and benefits of this procedure when compared to a standard panniculectomy in this population.
