TummyTuck During Cesarean Section—A Prospective Nonrandomized Study [12E

Abstract

INTRODUCTION: Large pannus remains a significant risk factor for abdominal surgery including cesarean section. Upon patients request, panniculectomy or “tummytuck,” is becoming an accepted procedure as a part of abdominal and gynecological surgeries. Research on panniculectomy at the time of cesarean section remains sparse. We present our data dealing with the postoperative course in patients who underwent panniculectomy as a part of cesarean section. METHODS: Sixty four patients with large pannuses were included into the study conducted at NY Downtown Hospital and Moscow University Hospital between Dec 1, 2008 and July 30, 2013. Twenty-six patients were subjected to panniculectomy (study group), and thirty eight had served as controls. Panniculectomy was performed upon patients request. All procedures were performed by an obstetrician as a part of cesarean section. The abdominal flap was tailored to remove the excess skin and underlying fat. The weight of the specimen varied from 800 g to 8.5 kg. The closure of the incision was performed in multiple layers. Subcuticular layer was closed with monofilament nonpermanent sutures. Drains and compression garments were sued in all cases. RESULTS: Postpartum fever 6 (23%) 4 (11%) Seroma 1 (3.8%) 5 (13%) Hematoma 1 (3.8%) 2 (5.2%) Wound dehiscence 2 (7.3%) 5 (13%) Mean EBL was 860 cc in the control group versus 1100 cc in the study group. None required blood transfusion. CONCLUSION: Panniculectomy during cesarean section is associated with increased incidence of post-surgical fever and decreased incidence of other wound complications, especially seromas and wound dehiscence. Removal of the pannus during cesarean section was associated with increased blood loss not requiring transfusions.