Integrated concept of treatment for reduction of morbidity after resection of panniculus morbidus associated with lymphoedema.
Identifieur interne : 002005 ( PubMed/Checkpoint ); précédent : 002004; suivant : 002006Integrated concept of treatment for reduction of morbidity after resection of panniculus morbidus associated with lymphoedema.
Auteurs : Gunther Felmerer [Allemagne] ; Wojciech Karcz ; Etelka Földi ; Dalia TobbiaSource :
- Journal of plastic surgery and hand surgery [ 2000-6764 ] ; 2012.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- Abdominal Wall (pathology), Abdominoplasty (methods), Humans, Lymphedema (complications), Lymphedema (pathology), Lymphedema (therapy), Obesity, Morbid (pathology), Obesity, Morbid (surgery), Physical Therapy Modalities, Postoperative Complications (prevention & control), Preoperative Care, Wound Healing.
- MESH :
- complications : Lymphedema.
- methods : Abdominoplasty.
- pathology : Abdominal Wall, Lymphedema, Obesity, Morbid.
- prevention & control : Postoperative Complications.
- surgery : Obesity, Morbid.
- therapy : Lymphedema.
- Humans, Physical Therapy Modalities, Preoperative Care, Wound Healing.
Abstract
A subgroup of grossly obese patients may develop a large hanging abdominal apron, panniculus morbidus, which can contain an element of lymphoedema. This hinders normal activities and prevents adequate hygiene. We reviewed published reports and found that the complications that result from resection of a panniculus had been well described, but the presence of lymphoedema and the possible benefit of appropriate physiotherapy was not addressed. Our first aim was to assess our overall morbidity. Secondly we assessed whether perioperative complex decongestive physical therapy had the potential to reduce the incidence of commonly encountered complications. We retrospectively reviewed the casenotes of all massively obese patients who had panniculectomies between 1998 and 2008. We identified two groups of patients, in the first of which were 38 patients who were given perioperative complex decongestive physical therapy (CDP). In the second group were 18 patients who had no additional treatment perioperatively. We then compared the differences between the groups in the incidence of complications, reoperation rate, duration of hospital stay, and wound complications. All the patients not given perioperative treatment developed a postoperative complication. Only 6 patients in the treated group had minor wound problems. The rates and severity of complications associated with this type of operation can be improved if the patient has access to additional care in a specialised rehabilitation centre during the perioperative period.
DOI: 10.3109/2000656X.2012.700007
PubMed: 22909237
Affiliations:
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pubmed:22909237Le document en format XML
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<term>Humans</term>
<term>Lymphedema (complications)</term>
<term>Lymphedema (pathology)</term>
<term>Lymphedema (therapy)</term>
<term>Obesity, Morbid (pathology)</term>
<term>Obesity, Morbid (surgery)</term>
<term>Physical Therapy Modalities</term>
<term>Postoperative Complications (prevention & control)</term>
<term>Preoperative Care</term>
<term>Wound Healing</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Abdominoplastie ()</term>
<term>Cicatrisation de plaie</term>
<term>Complications postopératoires ()</term>
<term>Humains</term>
<term>Lymphoedème ()</term>
<term>Lymphoedème (anatomopathologie)</term>
<term>Obésité morbide ()</term>
<term>Obésité morbide (anatomopathologie)</term>
<term>Paroi abdominale (anatomopathologie)</term>
<term>Soins préopératoires</term>
<term>Techniques de physiothérapie</term>
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<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Lymphoedème</term>
<term>Obésité morbide</term>
<term>Paroi abdominale</term>
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<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Abdominoplasty</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Abdominal Wall</term>
<term>Lymphedema</term>
<term>Obesity, Morbid</term>
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<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Obesity, Morbid</term>
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<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Lymphedema</term>
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<term>Physical Therapy Modalities</term>
<term>Preoperative Care</term>
<term>Wound Healing</term>
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<keywords scheme="MESH" xml:lang="fr"><term>Abdominoplastie</term>
<term>Cicatrisation de plaie</term>
<term>Complications postopératoires</term>
<term>Humains</term>
<term>Lymphoedème</term>
<term>Obésité morbide</term>
<term>Soins préopératoires</term>
<term>Techniques de physiothérapie</term>
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<front><div type="abstract" xml:lang="en">A subgroup of grossly obese patients may develop a large hanging abdominal apron, panniculus morbidus, which can contain an element of lymphoedema. This hinders normal activities and prevents adequate hygiene. We reviewed published reports and found that the complications that result from resection of a panniculus had been well described, but the presence of lymphoedema and the possible benefit of appropriate physiotherapy was not addressed. Our first aim was to assess our overall morbidity. Secondly we assessed whether perioperative complex decongestive physical therapy had the potential to reduce the incidence of commonly encountered complications. We retrospectively reviewed the casenotes of all massively obese patients who had panniculectomies between 1998 and 2008. We identified two groups of patients, in the first of which were 38 patients who were given perioperative complex decongestive physical therapy (CDP). In the second group were 18 patients who had no additional treatment perioperatively. We then compared the differences between the groups in the incidence of complications, reoperation rate, duration of hospital stay, and wound complications. All the patients not given perioperative treatment developed a postoperative complication. Only 6 patients in the treated group had minor wound problems. The rates and severity of complications associated with this type of operation can be improved if the patient has access to additional care in a specialised rehabilitation centre during the perioperative period.</div>
</front>
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<Title>Journal of plastic surgery and hand surgery</Title>
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<Abstract><AbstractText>A subgroup of grossly obese patients may develop a large hanging abdominal apron, panniculus morbidus, which can contain an element of lymphoedema. This hinders normal activities and prevents adequate hygiene. We reviewed published reports and found that the complications that result from resection of a panniculus had been well described, but the presence of lymphoedema and the possible benefit of appropriate physiotherapy was not addressed. Our first aim was to assess our overall morbidity. Secondly we assessed whether perioperative complex decongestive physical therapy had the potential to reduce the incidence of commonly encountered complications. We retrospectively reviewed the casenotes of all massively obese patients who had panniculectomies between 1998 and 2008. We identified two groups of patients, in the first of which were 38 patients who were given perioperative complex decongestive physical therapy (CDP). In the second group were 18 patients who had no additional treatment perioperatively. We then compared the differences between the groups in the incidence of complications, reoperation rate, duration of hospital stay, and wound complications. All the patients not given perioperative treatment developed a postoperative complication. Only 6 patients in the treated group had minor wound problems. The rates and severity of complications associated with this type of operation can be improved if the patient has access to additional care in a specialised rehabilitation centre during the perioperative period.</AbstractText>
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