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    Overview

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    Coroner – regulation 28 letter

    NICE received a regulation 28 letter from a Coroner in February 2020 highlighting the absence of UK guidance relating to indications for safe practice for lipoedema-related liposuction. The coroner's letter triggered the development of IP1843 – liposuction for chronic lipoedema, and an update of IP409/3 (IPG588) – liposuction for chronic lymphoedema.

    The coroner specifically suggested guidance would be helpful in respect of:

    1. the frequency of procedures on a single patient.

    2. the amount of fluid to put into the patient during the procedure.

    3. the amount of fluid to remove from the patient during the procedure.

    4. the post procedure patient recovery plan.

    A summary of the literature relevant to these 4 points is provided in the Coroner-Regulation 28 letter findings summary in the Safety summary.