D161. Effectiveness of Topical Negative Pressure Dressing on Patient Outcomes in Plastic and Reconstructive Surgery

PURPOSE: The purpose of this study was to compare the incidence of complications in patients undergoing functional panniculectomy versus cosmetic abdominoplasty. METHODS: The ACS NSQIP dataset was queried for panniculectomy procedures performed between 2015 and 2019. Excision of excessive infraumbilical tissue was defined as CPT 15830. According to ASPS guidelines, cosmetic abdominoplasty was defined as cases with the ICD-10 Z41.1 or CPT 15847 modifier, while functional panniculectomy was defined as cases without these modifiers. RESULTS: During the study interval, 11137 patients underwent excision of excessive infraumbilical tissue, including 57.4% (n=6397) functional panniculectomy and 42.6% (n=4740) cosmetic abdominoplasty. Patients undergoing functional panniculectomy had significantly higher rates of any adverse event (p<.001, 13.3% vs 8.5%), surgical complications (p<.001, 11.9% vs 6.9%), related readmission (p<.001, 6.1% vs 3.6%), and related reoperation (p<.001, 4.4% vs 2.5%). Specifically, patients undergoing functional panniculectomy had significantly higher rates of superficial incisional infections (p<.001, 5.6% vs 3.1%), deep incisional infections (p<.001, 1.7% vs 0.8%), dehiscence (p=.003, 1.4% vs 0.8%), bleeding requiring transfusion (p=.003, 3.4% vs 2.4%), sepsis (p<.001, 0.7% vs 0.2%), and myocardial infarction (p=.025, 0.1% vs 0.0%). In multivariate regression controlling for type of procedure (p<.001), patients had significantly higher rates of complications with history of diabetes (p=.002), smoking (p<.001), COPD (p=.001), steroid medications (p=.035), concurrent hernia repair (p=.026), male sex (p=.007), and increased BMI (p<.001). CONCLUSION: Several medical complications, surgical complications, readmission, and reoperation are significantly higher in patients undergoing functional panniculectomy compared to those undergoing cosmetic abdominoplasty.