For patients with excessive pannus, whereby the skin on the lower abdomen hangs down due to rapid weight loss, there are multiple complications that can arise. The condition increases the risk for excessive external hip rotation contracture, skin breakdown due to trapped moisture and decreased lower-extremity strength and range of motion.
Patients with no medical complications might choose to have the excess skin surgically removed. However, for some patients, such as Patient G.D. at Wellington Place Living & Rehab, surgery is not an option and we must find alternative treatments.
G.D. is an older woman who had lost a significant amount of weight, resulting in a pannus that would sit in between her legs. She was scheduled to have surgery to have the pannus removed, but due to some co-morbidities, she was unable to proceed with the surgical procedure. The patient’s health declined, and she was no longer able to transfer herself. That’s when she joined us at Wellington.
We initially used a sheet to address G.D.’s pannus complications, which included rashes and candidiasis, but the sheet was quite cumbersome, and the patient was unable to self-release from it quickly. The sheet also made G.D. overly warm, thus increasing the moisture to her perennial area and the top of her thighs.
Next, we tried a wheelchair security belt with a padded area meant for the stomach. We secured the belt to her bed rails with cable ties, which we then used as positioning devices for bed mobility. The quick-release button made it easy for G.D. to release from the belt, and the padded belt was smaller, cooler and more comfortable for her.
By consulting with our PM&R physician, DOR, Physical Therapy and Nursing, we created a treatment plan for G.D. that addressed her various needs. As a result of our collaborative efforts, G.D. is now able to complete a HEP to maintain strength and range of motion in both lower extremities. She also has increased leg adduction, is able to keep neutral hip positioning while at rest in her bed, and is no longer experiencing rashes or discomfort due to excess moisture. Most importantly, G.D. is happier and healthier now that we’ve found a solution that works for her particular needs.