[hermantheshocker]

In May 2014, a 51-year-old morbidly obese woman (BMI 48), suffering from non-insulin-dependent diabetes, presented at the emergency department with a 20-year-old incisional hernia that had become incarcerated. At admittance, the abdomen was described with horizontal and vertical scars from former surgery and a discolored midline hernia measuring 30 × 50 cm.


Fig.1 Perioperative photograph with three pieces of synthetic mesh sewn together and to the facial edges (shown with peans) to substitute the abdominal wall.


Fig.2 After eight months of VAC treatment and just prior to split-skin transplantation. Note the mesh is almost invisible and the abdominal skin has reattached to the lateral aspects of the truncus.

Acute CT of the abdomen demonstrated small bowel obstruction, and an immediate explorative laparotomy was performed via the vertical scar. Perioperatively, the abdominal wall defect measured 15 × 10 cm, and the ventricle, colon, and small intestine were encapsulated in a subcutaneous cavity. The lower 150 cm of the small intestine was cyanotic and torqued around the mesentery; detorquing resulted in revitalization.


Fig.3 One week after split-skin transplantation. Note good graft take, folding of the mesh in the upper aspect of the defect and yellow secretion from what turned out to be a high small bowel fistula with low output.


Fig.4 Two months after split-skin transplantation. The inset photograph six weeks after transplantation. Huge amount of mesh eroded through the transplanted skin and cut off successively.

The intra-abdominal cavity was found shrunken and too small to contain the intestinal organs. Consequently, the fascia was split proximally and distally of the hernia port; however, the abdominal wall could not be closed without the use of three pieces of nonabsorbable mesh each measuring 35 × 35 cm (Fig. 1). The intra-abdominal organs were enclosed in the new cavity, and the skin was closed above the cavity.


Fig.5 Nine months after skin transplantation. The patient is almost healed. Inset: 28 months after the hernia operation and 20 months after the skin transplantation. A chronic skin defect in the right lateral groove, presumably due to the heavy weight of the lateral role and mechanical collision.

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[ride]

Michelin Man's mother.

[Karma]

Geez. No other words.

[Lil_Lisa]

Our bodies are not meant to be that obese. This whole situation is just wrong.

[ChristySD]

She needs to go fucking exercise…..or get her feet out from under the dining table.

[ScottUK]

She suffered from an over active knife and fork

[jesuswept]

Fat Cunt!! Yuck!! Like come on, lady, stop being such a disgusting glutton!!

[Karma]

Originally Posted by Lil_Lisa ↗

Our bodies are not meant to be that obese. This whole situation is just wrong.

THIS.

I work in a hospital and we have to hoist these people and roll them, etc. Takes 6 nursing staff sometimes. And UK isn’t quite as obese as USA. Yet.

[deiatetofulfill]

Originally Posted by Karma ↗

THIS.

I work in a hospital and we have to hoist these people and roll them, etc. Takes 6 nursing staff sometimes. And UK isn’t quite as obese as USA. Yet.

You get 6 staff and a hoist??? Lucky bugger.

[Faust]

Originally Posted by Lil_Lisa ↗

Our bodies are not meant to be that obese. This whole situation is just wrong.

stop fat shaming. BMI is just a construct made up by gym companies