Download PDF
CC BY-NC-ND 4.0 · Indian J Plast Surg 2019; 52(02): 238-241
DOI: 10.1055/s-0039-1696079
Case Report
Association of Plastic Surgeons of India

Successful Outcome of Post Liposuction Extensive Necrotizing Soft Tissue Infection of Abdomen and Concomitant Jejunal Perforation—A Case Report

Hardeep Singh
1   Division of Plastic, Reconstructive and Aesthetic Surgery, Medanta—The Medicity, Gurugram, India
,
Rakesh Kumar Khazanchi
1   Division of Plastic, Reconstructive and Aesthetic Surgery, Medanta—The Medicity, Gurugram, India
,
Sanjay Mahendru
1   Division of Plastic, Reconstructive and Aesthetic Surgery, Medanta—The Medicity, Gurugram, India
› Author Affiliations
Further Information

Publication History

Publication Date:
10 September 2019 (online)

Also available at
   Permissions and Reprints

Abstract

Introduction Liposuction is one of the common cosmetic surgery procedures performed. Although rare, the complications associated with it are necrotizing soft tissue infection and bowel perforation. We would like to share our experience of such a complication that was managed successfully.

Case Report We were referred a 65-year-old male patient with signs and symptoms of intestinal obstruction who had undergone liposuction of abdomen 1 week before and now had discoloration of the abdominal skin. The discoloration was present from just below the costal margin and was extending up to bilateral inguinal regions. Laterally the discoloration extended up to the mid axillary line on both sides. Imaging studies showed dilated small bowel. During laparotomy, he underwent debridement of all discolored skin and repair of the single jejunal perforation. Postoperatively patient was first managed on intravenous fluids, nasogastric aspiration and total parenteral nutrition for 10 days. The wound was managed with silver dressings that led to healthy granulations. The patient was at high risk for anesthesia for skin grafting; hence, he was managed with allograft for 10 days. The patient then underwent skin grafting once he was fit. The graft took up well and he resumed regular activities.

Conclusion This is unique as the patient had extensive necrotizing soft tissue infection of the abdominal skin after liposuction along with intestinal perforation and obstruction that was managed successfully due to aggressive surgical intervention, allograft, and good supportive care both in the intensive care unit and in ward.

Keywords

liposuction - necrotising soft issue infection - perforation
 

  • References

  • 1 Zakine G, Baruch J, Dardour JC, Flageul G. Perforation of viscera, a dramatic complication of liposuction: a review of 19 cases evaluated by experts in France between 2000 and 2012. Plast Reconstr Surg 2015; 135 (03) 743-750
    CrossrefPubMedGoogle Scholar
  • 2 Heitmann C, Czermak C, Germann G. Rapidly fatal necrotizing fasciitis after aesthetic liposuction. Aesthetic Plast Surg 2000; 24 (05) 344-347
    CrossrefPubMedGoogle Scholar
  • 3 Grazer FM. Suction-assisted lipectomy, suction lipectomy, lipolysis, and lipexeresis. Plast Reconstr Surg 1983; 72 (05) 620-623
    CrossrefPubMedGoogle Scholar
  • 4 Bellini E, Grieco MP, Raposio E. A journey through liposuction and liposculture: Review. Ann Med Surg (Lond) 2017; 24: 53-60
    PubMedGoogle Scholar
  • 5 Dixit VV, Wagh MS. Unfavourable outcomes of liposuction and their management. Indian J Plast Surg 2013; 46 (02) 377-392
    CrossrefPubMedGoogle Scholar
  • 6 Shiffman MA. Prevention and treatment of liposuction complications. In: Shiffman MA, Di Giuseppe A. eds. Liposuction—Principles and Practice. 1st ed.. New York, NY: Springer; 2006: 333-334
    Google Scholar
  • 7 Sharma D, Dalencourt G, Bitterly T, Benotti PN. Small intestinal perforation and necrotizing fasciitis after abdominal liposuction. Aesthetic Plast Surg 2006; 30 (06) 712-716
    CrossrefPubMedGoogle Scholar
  • 8 Igra H, Lanzer D. Avoiding complications. In: Hanke CW, Sattler G. eds. Liposuction. 1st ed.. Philadelphia, PA: Saunders; 2005: 131-134
    Google Scholar