Advertisement

Aesthetic Plastic Surgery

, Volume 31, Issue 5, pp 514–518 | Cite as

Composition of Postabdominoplasty Seroma

  • Patricio AndradesEmail author
  • Arturo Prado
ORIGINAL ARTICLE

Abstract

Background

This study aimed to analyze the composition of postabdominoplasty seroma fluid at different intervals, compare it with blood and lymph, and determine whether it meets the criteria for being considered an exudate.

Methods

The study enrolled 18 female patients with postabdominoplasty seroma diagnosed by clinical and ultrasound evaluation. All the patients had a Matarasso type 4 anterior abdominal wall deformity. None of the patients were overweight, and none had comorbidities. They all underwent a classical abdominoplasty procedure. Fluid samples were taken from the drains between postoperative days 5 and 7, and from needle aspiration between postoperative days 15 and 20. The fluids were assayed in the clinical laboratory at the University of Chile Clinical Hospital for chemical and cellular composition. Blood, lymph, and seroma values were compared by independent group analysis using a Tukey multiple comparison test with an alpha error of 0.05.

Results

The total protein, lactate dehydrogenase (LDH), and cholesterol levels for the early and late seroma fluids were lower than in the blood, but higher than in the lymph. The total protein seroma-to-plasma ratio was approximately 0.5; the LDH seroma-to-plasma ratio was approximately 0.6; and the cholesterol seroma-to-plasma ratio was 0.32. The platelet level was very low in the late seroma fluid, showing no statistical differences with the lymph level. The leukocyte level was low in the seroma fluid, with a higher percentage of neutrophils than found in the blood or the lymph.

Conclusions

The serous fluid formed under the flap after an abdominoplasty seems to be an exudate. In the early postoperative period, it is an inflammatory exudate that slowly turns into an exudate with some characteristics similar to those of lymph.

Keywords

Abdominoplasty Composition Exudate Seroma Transudate 

References

  1. 1.
    Matarasso A (1995) Liposuction as an adjunct to a full abdominoplasty. Plast Reconstr Surg 95:829–836CrossRefPubMedGoogle Scholar
  2. 2.
    Kim J, Stevenson TR (2006) Abdominoplasty, liposuction of the flanks, and obesity: Analyzing risk factors for seroma formation. Plast Reconstr Surg 117:773–779, discussion 80–81CrossRefPubMedGoogle Scholar
  3. 3.
    Pitanguy I (1975) Abdominal lipectomy. Clin Plast Surg 2:401–410PubMedGoogle Scholar
  4. 4.
    Grazer FM, Goldwyn RM (1977) Abdominoplasty assessed by survey, with emphasis on complications. Plast Reconstr Surg 59:513–517CrossRefPubMedGoogle Scholar
  5. 5.
    Avelar JM (1983) Abdominoplasty: Technical refinement and analysis of 130 cases in 8 years’ follow-up. Aesth Plast Surg 7:205–212CrossRefGoogle Scholar
  6. 6.
    Hester TR Jr, Baird W, Bostwick J III, Nahai F, Cukic J (1989) Abdominoplasty combined with other major surgical procedures: Safe or sorry? Plast Reconstr Surg 83:997–1004CrossRefPubMedGoogle Scholar
  7. 7.
    Teimourian B, Rogers WB III (1989) A national survey of complications associated with suction lipectomy: A comparative study. Plast Reconstr Surg 84:628–631CrossRefPubMedGoogle Scholar
  8. 8.
    Dillerud E (1990) Complications of suction-assisted abdominoplasty combined with other surgical procedures. Plast Reconstr Surg 85:994–995CrossRefPubMedGoogle Scholar
  9. 9.
    Floros C, Davis PK (1991) Complications and long-term results following abdominoplasty: A retrospective study. Br J Plast Surg 44:190–194CrossRefPubMedGoogle Scholar
  10. 10.
    Chaouat M, Levan P, Lalanne B, et al (2000) Abdominal dermolipectomies: Early postoperative complications and long-term unfavorable results. Plast Reconstr Surg 106:1614–1618, discussion 19–23,CrossRefPubMedGoogle Scholar
  11. 11.
    Prado A, Andrades PR, Benitez S (2004) Abdominoplasty: The use of polypropylene mesh to correct myoaponeurotic-layer deformity. Aesth Plast Surg 28:144–147CrossRefGoogle Scholar
  12. 12.
    Zimman OA, Butto CD, Ahualli PE (2001) Frequency of seroma in abdominal lipectomies. Plast Reconstr Surg 108:1449–1451CrossRefPubMedGoogle Scholar
  13. 13.
    Zecha PJ, Missotten FE (1999) Pseudocyst formation after abdominoplasty: Extravasations of Morel-Lavallee. Br J Plast Surg 52:500–502CrossRefPubMedGoogle Scholar
  14. 14.
    Kargi E, Akduman D, Dokuzoguz B, et al (2003) Late complication of abdominoplasty in an obese patient: Systemic inflammatory response syndrome and seroma. Plast Reconstr Surg 111:1568–1571CrossRefPubMedGoogle Scholar
  15. 15.
    Kulber DA, Bacilious N, Peters ED, Gayle LB, Hoffman L (1997) The use of fibrin sealant in the prevention of seromas. Plast Reconstr Surg 99:842–849, discussion 50–51CrossRefPubMedGoogle Scholar
  16. 16.
    Matarasso A (1991) Abdominolipoplasty: A system of classification and treatment for combined abdominoplasty and suction-assisted lipectomy. Aesth Plast Surg 15:111–121CrossRefGoogle Scholar
  17. 17.
    Drinker C, Field M, Heim W, Leight O (1934) The composition of edema fluid and lymph in edema and elephantiasis resulting from lymphatic obstruction. Am J Physiol 109:572–586Google Scholar
  18. 18.
    Weech A, Goettsch E, Reeves E (1934) The flow and composition of lymph in relation to the formation of edema. JEM 60:63–84CrossRefGoogle Scholar
  19. 19.
    Freitas R (1999) Lymphatic System. In: Freitas R (ed) Nanomedicine: Basic capabilities. Lands Bioscience, Austin, pp. 213–221Google Scholar
  20. 20.
    Olszewski WL (2003) Pathophysiological aspects of lymphedema of human limbs: I. Lymph protein composition. Lymphat Res Biol 1:235–243CrossRefPubMedGoogle Scholar
  21. 21.
    Olszewski WL (2003) The lymphatic system in body homeostasis: Physiological conditions. Lymphat Res Biol 1:11–21, discussion 21–24CrossRefPubMedGoogle Scholar
  22. 22.
    Paramothayan NS, Barron J (2002) New criteria for the differentiation between transudates and exudates. J Clin Pathol 55:69–71CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Light RW, Macgregor MI, Luchsinger PC, Ball WC Jr, (1972) Pleural effusions: The diagnostic separation of transudates and exudates. Ann Intern Med 77:507–513CrossRefPubMedGoogle Scholar
  24. 24.
    Light RW (2002) Clinical practice: Pleural effusion. N Engl J Med 346:1971–1977CrossRefPubMedGoogle Scholar
  25. 25.
    Hamm H, Brohan U, Bohmer R, Missmahl HP (1987) Cholesterol in pleural effusions: A diagnostic aid. Chest 92:296–302CrossRefPubMedGoogle Scholar
  26. 26.
    Abdullah S, Youngmin SA, Hudson SJ, et al. (2007) Gross synovial fluid analysis in the differential diagnosis of joint effusions. J Clin Pathol, published online 26 January 2007Google Scholar
  27. 27.
    Lindquist L, Linne T, Hansson LO, Kalin M, Axelsson G (1988) Value of cerebrospinal fluid analysis in the differential diagnosis of meningitis: A study in 710 patients with suspected central nervous system infection. Eur J Clin Microbiol Infect Dis 7:374–380CrossRefGoogle Scholar
  28. 28.
    Ghilain JM, Henrion J, Schapira M, et al. (1990) Ascitic fluid: The value of various biological tests in the differential diagnosis between cirrhotic and neoplastic ascites. Acta Gastroenterol Belg 53:168–179PubMedGoogle Scholar
  29. 29.
    Bonnema J, Ligtenstein DA, Wiggers T, van Geel AN (1999) The composition of serous fluid after axillary dissection. Eur J Surg 165:9–13CrossRefPubMedGoogle Scholar
  30. 30.
    McCaul JA, Aslaam A, Spooner RJ, et al. (2000) Aetiology of seroma formation in patients undergoing surgery for breast cancer. Breast 9:144–148CrossRefPubMedGoogle Scholar
  31. 31.
    Kuroi K, Shimozuma K, Taguchi T, et al. (2005) Pathophysiology of seroma in breast cancer. Breast Cancer 12:288–293CrossRefPubMedGoogle Scholar
  32. 32.
    Moretti E, Gomez Garcia F, Monti J, Vazquez G (2006) Investigation about seromas in liposuction and abdominal dermolipectomy. Cir Plast Iberolatinoam 32:151–160Google Scholar
  33. 33.
    Saldanha OR, De Souza Pinto EB, Mattos WN Jr, et al. (2003) Lipoabdominoplasty with selective and safe undermining. Aesth Plast Surg 27:322–327CrossRefGoogle Scholar
  34. 34.
    Baroudi R, Ferreira C (1998) Seroma: How to avoid it and how to treat it. Aesth Surg J 18:439–445CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Division of Plastic Surgery, Department of SurgeryUniversity of Chile School of MedicineSantiagoChile

Personalised recommendations