title: Extensive adipose tissue necrosis following pfannenstiel incision for endometrial cancer.
abstract: BACKGROUND
  Hematomas are potential postoperative complications that may arise from Pfannenstiel incisions. They usually either resolve spontaneously or are drained depending on their extent. Major risk factors such as obesity and diabetes may lead to superimposed complications and further worsen the outcome.
  
  
  METHODS
  A 73-year-old woman presented with a large subcutaneous hematoma 10 days after total abdominal hysterectomy done through a Pfannenstiel incision for endometrial cancer. The hematoma progressed and led to extensive subcutaneous fat necrosis. Extensive debridement was required, and negative pressure wound therapy with gauze was used to allow second intention closure. Satisfactory healing was achieved after 82 days of treatment without skin grafting.
  
  
  CONCLUSIONS
  This case highlights the usefulness of gauze-based negative pressure wound therapy, as well as the need for a multidisciplinary approach in taking care of such complex wound complication.
authors.affiliation: Gynecologic Oncology Division, Hôtel-Dieu de Québec, Centre hospitalier universitaire de Québec, Quebec City QC.
authors.forename: Maryse Céline
authors.initials: MC
authors.lastname: Lavoie
authors.affiliation: Gynecologic Oncology Division, Hôtel-Dieu de Québec, Centre hospitalier universitaire de Québec, Quebec City QC.
authors.forename: Marie
authors.initials: M
authors.lastname: Plante
authors.affiliation: Enterostomal care, Hôtel-Dieu de Québec, Centre hospitalier universitaire de Québec, Quebec City QC.
authors.forename: Marie-Carine
authors.initials: MC
authors.lastname: Lemieux
authors.affiliation: Plastic Surgery Division, Hôtel-Dieu de Québec, Centre hospitalier universitaire de Québec, Quebec City QC.
authors.forename: Céline
authors.initials: C
authors.lastname: Roberge
authors.affiliation: Gynecologic Oncology Division, Hôtel-Dieu de Québec, Centre hospitalier universitaire de Québec, Quebec City QC.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Renaud
authors.affiliation: Gynecologic Oncology Division, Hôtel-Dieu de Québec, Centre hospitalier universitaire de Québec, Quebec City QC.
authors.forename: Jean
authors.initials: J
authors.lastname: Grégoire
authors.affiliation: Gynecologic Oncology Division, Hôtel-Dieu de Québec, Centre hospitalier universitaire de Québec, Quebec City QC.
authors.forename: Michel
authors.initials: M
authors.lastname: Roy
authors.affiliation: Gynecologic Oncology Division, Hôtel-Dieu de Québec, Centre hospitalier universitaire de Québec, Quebec City QC.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Sebastianelli
mesh_terms: D050153:Abdominal Fat / Q000473:pathology*; D000368:Aged; D003646:Debridement; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods*; D009336:Necrosis; D054843:Negative-Pressure Wound Therapy
keywords: Pfannenstiel incision; fat necrosis; hematoma; low transverse laparotomy; morbid obesity; negative-pressure wound therapy