A morbidly obese 51-year-old woman who was 155 cm tall and weighed 170 kg, and had functional limitation and angina due to her weight and massive pannus, underwent abdominal panniculectomy. The abdominal pannus was pierced with two, 4 mm, nonthreaded Steinmann pins (Synthes, USA) from which the pannus was elevated and suspended with rope. This elevation allowed for traction and simultaneous exposure of both the superior and inferior aspects of the pannus, assisting in surgical resection. The pannus removed weighed 25 kg. Postoperatively, the patient developed cellulitis on the inferior flap that resolved with antibiotics, and the wound healed in two weeks.
National Institute of Health, National Heart, Lung and Blood Institute.Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report.Washington: United States Department of Health and Human Services, 1998.
2.
FlegalKM, CarrolMD, KuczmarkskiRJ. Overweight and obesity trends in the United States: Prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord1998; 22: 39–47.
3.
TrakasK, LawrenceK, ShearNH. Utilization of healthcare resources by obese Canadians. CMAJ1999; 160: 1457–62.
4.
KatzmarzykPT, MalinaRM. Obesity and relative subcutaneous fat distribution among Canadians of First Nation and European ancestry. Int J Obes Relat Metab Disord1998; 22: 1127–31.
5.
JetteM, SidneyK, QuennevilleJ. Association between an excessive body mass index and coronary heart disease risk factors in military personnel. Mil Med1993; 158: 489–93.
6.
RabkinSW, ChenY, LeiterL, LiuL, ReederBA. Risk factor correlates of body mass index. CMAJ1997; 157(Suppl 1):S26–31.
7.
PettyP, MansonPN, BlackR. Panniculus morbidus. Ann Plast Surg1992; 28: 442.
8.
MeyerowitzBR, GruberRP, LaubDR. Massive abdominal panniculectomy. J Am Med Assoc1973; 225: 408.
9.
KrollSS, NetscherD. Complication of TRAM flap breast reconstruction in obese patients. Plast Reconstr Surg1989; 84: 886.
10.
Health implications of obesity: NIH consensus development conference statement. Ann Intern Med1985; 103(Pt 2):1073–77.
11.
VastineUL, MorganRF, WilliamsGS. Wound complications of abdominoplasty in obese patients. Ann Plast Surg1999; 42: 34–9.
12.
DawJL, MustoeTA. Use of a tourniquet in panniculus resection. Plast Reconstr Surg1997; 99: 2082–4.
13.
MatoryWEJr, O'SullivanJ, FudemG, DunnR. Abdominal surgery in patients with severe morbid obesity. Plast Reconstr Surg1994; 94: 976–87.
