Eight patients with large panniculi are described where severe problems with hygiene, immobility, and chronic infection were caused by the lymphedematous, chronically infected pannus. Protracted nonsurgical management of the infected panniculus had failed in all 8 patients. Wedge resection without fat undermining removed diseased tissue. Infection and sepsis were eliminated and ambulation was restored in all patients. Formerly immobile patients were returned to normal activity. Significant self-induced weight loss was not observed in a 2-year follow-up period; weight gain, however, was not experienced. The primary anesthetic method was thoracic epidural reducing the requirements for general endotracheal anesthesia. The chronically infected pannus is a surgical problem deserving earlier recognition and resection.
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