New method of abdominoplasty for morbidly obese patients.
BACKGROUND
We report two cases of morbidly obese patients with huge infected abdominal aprons who underwent apronectomies at Alice Springs Hospital, Northern Territory, Australia. We describe a novel technique which to date has not been described in the available literature. Patients afflicted by morbid obesity with large aprons can be incapacitated by immobility as well as suffer from recurrent infections. Apronectomy in this situation can be difficult because of the heavy weight of the apron.


METHODS
This technique involves the use of a small crane and large orthopaedic K-nails. Two K-nails were inserted into the apron and attached to a small crane. This facilitated the elevation and manipulation of the apron during surgical dissection. The abdominal tissue removed from the female and male weighed 30 kg and 64 kg, respectively. The wounds were closed primarily and drained by three large bore suction drains.


RESULTS
The female patient had a largely uneventful postoperative course with a minor wound infection that resolved with conservative treatment. The other patient required a more protracted course of antibiotics for his more severe infection. Mobility was markedly improved in both individuals.


CONCLUSIONS
This novel technique can be used successfully for severely morbidly obese individuals and can significantly reduce the surgeon's and assistants' difficulty in manipulating and handling a heavy apron during dissection.
Ollapallil
Jacob
J
Department of Surgery, Alice Springs Hospital, Alice Springs, Australia. jacoboj@ozemail.com.au
Koong
David
D
Panchacharavel
Gowrinanthanan
G
Butcher
Charles
C
Yapo
Benjamin
B
D000005:Abdomen / Q000601:surgery*; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods