D29. Post-bariatric Panniculectomy: Postoperative Complications by Weight Loss Surgery Type

PURPOSE: Over 250,000 patients undergo bariatric surgery each year in the United States. Panniculectomy is among the most popular post-bariatric body contouring surgery following massive weight loss. Previous studies have demonstrated that post-bariatric surgery patients are at a greater risk for complications relative to the general population. However, it is unknown if bariatric surgery type, restrictive or malabsorptive, poses a differential complication risk after panniculectomy. METHODS: A retrospective chart review of post-bariatric patients who underwent abdominal panniculectomy at a single large quaternary hospital was performed. Multivariable logistic regression evaluated differences in postoperative complications, as graded by the Clavien-Dindo classification, between restrictive and malabsorptive bariatric patients. RESULTS: Of 261 post-bariatric patients, 136 (52.1%) had a history of restrictive and 125 (47.9%) of malabsorptive surgery. The overall rate of complications was 36.8%, with similar incidence between groups (p=0.25). Wound complications were observed in 26.8% (n=70) of patients. Systemic complications occurred in 17.6% of patients overall, with similar rates in the restrictive and malabsorptive surgery groups (12.5 vs. 12.0%). After adjusting for age, sex, race and ethnicity, body mass index, serum albumin, and smoking status, no significant difference in total (OR=1.26, 95%CI:0.64-2.48, p=0.50), wound-related (OR=1.79, 95%CI:0.83-3.86, p=0.14), or systemic complications (OR=0.68, 95%CI:0.24-1.91, p=0.47) was observed. CONCLUSION: Complications following panniculectomy in bariatric surgery patients are high and predominantly related to wound healing. No significant difference between type of bariatric surgery and complication risk was found. Techniques such as negative pressure wound therapy and use of advanced energy devices may reduce complication risk.