[Severe cutaneous necrosis after ultrasound lipolysis. Medicolegal aspects and review].
The authors report the case of a young patient who developed extensive skin necrosis after ultrasound liposuction of the medial surface of the thigh. These lesions required excision, split-skin graft and installation of an expansion prosthesis. The medicolegal aspects of this case are discussed, in particular the responsibility of the doctor who performed this damaging procedure, from three points of view: damage, fault, causality. In this case, the damage corresponded to necrosis which can be due to a chemical, infectious or thermal mechanism. It is responsible for serious damages due to the number of operations, the length of hospital stay, immobilization, rehabilitation and the time off work. The aesthetic damage, the pretium doloris, and the inconvenience are certainly considerable, but was there fault in this case? Fault by clumsiness if the equipment was used abnormally; fault by negligence or imprudence when the equipment was not approved or when the operator was not a qualified physician, submitting his patient to undue risks. The causality is envisaged in the case of chemonecrosis and burns. It would be strongly presumed in a civil procedure in case of non-approved equipment. The authors are in favour of a hypothesis of a burn and review the current state of ultrasound liposuction, which was the subject of an intense media campaign several years ago.
Service de Chirurgie Plastique Reconstructrice et Esthétique, CHU de Toulouse, Hôpital Rangueil.
J L
JL
Grolleau
D
D
Rouge
J P
JP
Chavoin
M
M
Costagliola
D000328:Adult; D062109:Dermatologic Surgical Procedures; D005602:France; D006801:Humans; D015187:Lipectomy / Q000009:adverse effects*; D009336:Necrosis; D012867:Skin / Q000473:pathology*; D013518:Surgery, Plastic / Q000331:legislation & jurisprudence*; D014465:Ultrasonics
Nécrose cutanée dramatique après lipolyse ultrasonique. Aspect médico-légal et mise au point.