Fat necrosis and why the classic abdominoplasty should be avoided in obese patients

Major fat necrosis [more than 5 cm] is a complication rarely reported following abdominoplasty though it may be frequently seen in patients with wound dehiscence and cutaneous necrosis. In this paper, the authors report 12 cases of abdominoplasty with post-operative wound dehiscence who needed secondary skin grafting to close the wound. A review of these cases showed that extensive subcutaneous fat necrosis was a prominent feature and all the patients were obese. It appears that obese individuals are prone to develop fat necrosis postoperatively in cases where the classic abdominoplasty is used. It is important that patients reduce their weight preoperatively and avoid considering abdominoplasty as a form of weight reduction. Fat necrosis, its occurrence and the various factors that could have contributed to major wound dehiscence in these patients are discussed. The authors caution surgeons against the use of the classic abdominoplasty procedure in obese patients and s t ress minimal undermining and the use of limited dermolipectomy or apronectomy along with judicious liposuction to avoid this complication of fat necrosis

Burn septicaemia in Kuwait: associated demographic and clinical factors

To study the demographic and clinical factors associated with burn septicaemia patients in Kuwait. Materials and All burn in-patients, who developed septicaemia at the Burns Unit, Al-Babtain Centre for Burns and Plastic Surgery, Kuwait, during a 9-year period [June 1992 to May 2001] were included in the study. The data were recorded for age, sex, nationality, cause and percentage of burns, inhalation injury, resuscitation, number of episodes, septicaemia on post-burn day, the microorganisms responsible in each episode, treatment and outcome for statistical analysis. Using SPSS [PC version 11.0] software, a probability level of p < 0.05 was considered significant. Of the 2,082 patients treated in the Burns Unit, 166 [8%; 99 [60%] males and 67 [40%] females] with a mean age of 26 years [range 1-70] had septicaemia. Significantly higher [p < 0.001] cases were recorded among Kuwaiti children [