Plastic Surgery Research Council
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Presenter: Sumanas W Jordan, MD
Co-Authors: Mioton LM, Smetona J, Aggarwal A, Wang E, Dumanian GA, Kim JY
Northwestern University Feinberg School of Medicine

Background: Panniculectomies have been shown to improve quality of life in morbidly obese patients. However, its functional benefits are counterbalanced by its relatively high complication rates. Given that panniculectomies are performed by surgeons of diverse specialties, we endeavored to determine the impact of surgeon specialty on panniculectomy outcomes.

Methods: We performed a retrospective review of the prospectively maintained American College of Surgeons National Safety and Quality Improvement Program (ACS-NSQIP) database for all patients undergoing panniculectomy from 2006-2010. For each case, patient demographic details, surgeon specialty training, and 30-day outcomes were recorded and assessed.

Results: A total of 954 panniculectomies meeting inclusion criteria were reported in the NSQIP database from 2006-2010. Within this group, 694 (72.7%) of the procedures were performed by plastic surgeons and 260 (27.3%) were performed by non-plastic surgeons. Patients with panniculectomies performed by non-plastic surgeons had a significantly higher rate of overall complications (23.08% vs 8.65%, p<.001) and wound infections (12.69% vs 5.33%, p<.001) and incurred more medical complications (13.08% vs 3.31%, p<.001) than those performed by plastic surgeons. Average operative time for plastic surgeons was significantly longer than non-plastic surgeons (3.00 1.48 hours vs 1.88 0.93 hours, p<.001). Propensity score-adjusted multivariate models used to eliminate confounding factors showed that undergoing a panniculectomy by a non-plastic surgeon was a significant predictor of overall post-operative complications (odds ratio [OR]=2.09, 95% confidence interval [CI] 1.35-3.23) and wound infection (OR=1.73, 95% CI 1.004-2.98).

Conclusion: Multivariate regression analysis of NSQIP data showed that panniculectomy performed by plastic surgeons results in lower rates of overall postoperative complications, wound infections, and reoperations compared to non-plastic surgeons.

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