Accelerating Fleur-de-lis Panniculectomy with the Absorbable Dermal Stapler-A Study of Efficiency, Aesthetics, and Quality-of-life
- PMID: 38769148
- DOI: 10.1007/s00266-024-04068-0
Accelerating Fleur-de-lis Panniculectomy with the Absorbable Dermal Stapler-A Study of Efficiency, Aesthetics, and Quality-of-life
Abstract
Background: Fleur-de-lis panniculectomy (FDL), a contouring technique involving vertical and horizontal tissue resections, often involves longer operative times and potential complications. This study assessed operative time, postoperative outcomes, and patient-reported quality of life (PRO) with Insorb® Absorbable Subcuticular Skin Stapler versus traditional sutures during FDL.
Methods: A retrospective review from 2015 to 2022 of FDL patients excluded those with complex concomitant procedures. Demographics, operative details, and surgical outcomes were compared between patients using the dermal stapler and those with suture-only closures.
Results: Forty subjects were identified, with 25 (62.5%) in the dermal stapler cohort. The dermal stapler significantly reduced total procedure time (66.76 vs. 125.33 min, p < 0.05). There were no significant differences in surgical site occurrences, aesthetic outcomes, readmissions, or reoperations. Multivariate regression analysis further highlighted the choice of closure technique as an independent predictor of operative time, with traditional sutures indicating a significantly increased operative time compared to using the dermal stapler (AOR 76.53, CI 38.11-114.95, p < 0.001). Regarding PROs, both groups saw improvements across multiple BODY-Q domains, but the dermal stapler group reported greater enhancements (six out of nine domains vs. three for sutures).
Conclusion: The absorbable dermal stapler significantly reduces FDL operative time without increasing wound healing or aesthetic dissatisfaction incidents and maintains comparable quality-of-life improvements to standard suture closure.
Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://link.springer.com/journal/00266 .
Keywords: Dermal stapler; Operative time; Panniculectomy; Quality of life.
© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.
References
-
- Friedman T, O’Brien Coon D, Michaels VJ, Purnell C, Hur S, Harris DN, Rubin JP (2010) Fleur-de-Lis abdominoplasty: a safe alternative to traditional abdominoplasty for the massive weight loss patient. Plast Reconstr Surg 125(5):1525–1535. https://doi.org/10.1097/PRS.0b013e3181d6e7e0 . (PubMed PMID: 20145584) - DOI - PubMed
-
- O’Brien JA, Broderick GB, Hurwitz ZM, Montilla R, Castle J, Dunn RM, Akyurek M, Lalikos JF (2012) Fleur-de-lis panniculectomy after bariatric surgery: our experience. Ann Plast Surg 68(1):74–78. https://doi.org/10.1097/SAP.0b013e31820eb92d . (PubMed PMID: 21587047) - DOI - PubMed
-
- Dellon AL (1985) Fleur-de-lis abdominoplasty. Aesthetic Plast Surg 9(1):27–32. https://doi.org/10.1007/bf01570680 . (PubMed PMID: 3158172) - DOI - PubMed
-
- Castañares S, Goethel JA (1967) Abdominal lipectomy: a modification in technique. Plast Reconstr Surg 40(4):378–383. https://doi.org/10.1097/00006534-196710000-00011 . (PubMed PMID: 4228850) - DOI - PubMed
-
- Wallach SG (2005) Abdominal contour surgery for the massive weight loss patient: the fleur-de-lis approach. Aesthet Surg J 25(5):454–465. https://doi.org/10.1016/j.asj.2005.06.001 . (PubMed PMID: 19338845) - DOI - PubMed