Incidence of Postoperative Venous Thromboembolism following Panniculectomy in Patients with History of COVID-19, 2025, Newland

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Incidence of Postoperative Venous Thromboembolism following Panniculectomy in Patients with History of COVID-19​

Newland, Mary BS1; Lee, Charles C. MD2; Li, Cindy MD2; Sun, Ashley BS1; Potochny, John MD2

Author Information
Plastic and Reconstructive Surgery 156(5):p 793-798, November 2025. | DOI: 10.1097/PRS.0000000000012202
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Background:​

Venous thromboembolism (VTE) is a well-documented postoperative complication and is potentially life-threatening. Recent research has elucidated that a history of COVID-19 may be a risk factor for VTE. The authors’ study aimed to assess the risk of VTE in panniculectomy patients with a history of COVID-19.

Methods:​

The TriNetX LLC National Health Research database was queried to identify patients who underwent panniculectomy in the years 2017 to 2020 (prepandemic) and 2020 to 2023 (postpandemic). Postpandemic patients were studied by querying those with and without a history of COVID-19. These cohorts were analyzed to calculate the incidence rate of VTE in the 30-day postoperative period.

Results:​

A total of 7114 patients who underwent panniculectomy on prophylactic anticoagulation were identified. There were 3015 patients in the prepandemic category and 4099 patients in the postpandemic group. Within the postpandemic classification, there were 790 patients with a history of COVID-19 and 3309 patients without. The rate of VTE was not significantly different in the prepandemic (3.2%) versus postpandemic (3.0%) cohorts (P = 0.64). However, in the postpandemic cohort, there was a significant difference in VTE rates between patients with (4.9%) and without (2.5%) a history of COVID-19 (P = 0.0002).

Conclusions:​

There was no significant increase in VTE incidence after panniculectomy during the pandemic. In the patients identified with a history of COVID-19, we observed a significantly higher rate of VTE compared with those patients without. Seeing as its long-term morbidity effects are yet to be fully understood, a history of COVID-19 should be carefully considered when determining VTE risk.

CLINICAL QUESTION/LEVEL OF EVIDENCE:​

Risk. II.
 

News Release 29-Oct-2025

COVID may increase risk of dangerous blood clots after panniculectomy​

COVID history is an 'additional risk factor' for VTE, reports Plastic and Reconstructive Surgery

Peer-Reviewed Publication
Wolters Kluwer Health



October 29, 2025Among patients undergoing panniculectomy to remove excess abdominal skin, those with previous COVID may be at higher risk of serious blood clot-related complications called venous thromboembolism (VTE), reports a study in the November issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS). The journal is published in the Lippincott portfolio by Wolters Kluwer.

"Our findings suggest that past COVID may be an additional predisposing risk factor for VTE among patients undergoing panniculectomy," comments lead author Mary Newland, BS, a medical student at Penn State College of Medicine, Hershey, Pa. "This may have implications for assessment and prevention of surgical risks of body contouring surgery after major weight loss."

New data on VTE risk after panniculectomy

Body contouring describes a range of surgical procedures to remove excess skin and soft tissue in patients with major weight loss. Panniculectomy is a specific procedure done to remove loose, hanging skin and fat from the lower abdomen. It is generally considered a "functional" rather than cosmetic procedure, with the goal of addressing skin complications (such as rashes, infections and ulcers) and mobility issues related to the overhanging skin.

Venous thromboembolism refers to potentially life-threatening blood clots known as deep vein thrombosis or pulmonary embolism. For panniculectomy and other types of major surgery, assessment of VTE risk and prevention with the use of anticoagulant medications (blood thinners) is an important part of patient management.

Recent studies have suggested that patients who have previously had COVID-19 may be more likely to develop VTE after panniculectomy. To clarify this association, the researchers analyzed national hospital data on patients who underwent panniculectomy.

'Significant increase' in VTE among patients with a history of COVID

The analysis included data on 7,114 patients who underwent functional panniculectomy between 2017 and 2023. Of these, 3,015 patients had surgery before and 4,099 after the start of the COVID-19 pandemic. All patients received preventive blood thinners, based on standard assessment of VTE risk factors (Caprini score). On initial analysis, the two groups had similar rates of VTE: 3.2% before and 3.0% after the start of the pandemic in March 2020.

Further analysis of the post-pandemic group assessed VTE risk among 790 patients with a history of COVID, compared to 3,309 patients who had not had COVID. The results showed a significantly higher risk of VTE for patients with a history of COVID: 4.9%, compared with 2.5% in those without COVID. Other potential VTE risk factors for VTE – such as heart, lung, and blood vessel disease – were similar between groups.

"Our results demonstrate a significant increase in the incidence of VTE among [panniculectomy] patients with a history of COVID-19," according to the authors. Although other factors may contribute, the increase in VTE risk is likely related to an increased tendency for blood clots to form (hypercoagulability) after COVID infection.

The study "shows the emergence of a new patient population who may be more susceptible to postoperative VTEs," Ms. Newland and coauthors conclude. They emphasize that further studies are needed to confirm the association between COVID and the risk of blood clot-related complications after panniculectomy, and to clarify the implications for risk assessment and VTE prevention.

Read Article: Incidence of Postoperative VTE following Panniculectomy in Patients with History of COVID-19

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Journal​

Plastic & Reconstructive Surgery

Article Title​

Incidence of Postoperative Venous Thromboembolism following Panniculectomy in Patients with History of COVID-19

Article Publication Date​

29-Oct-2025

 
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