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Anchor-Line Abdominoplasty with Scarpa Fascia Preservation in Postbariatric Patients: A Comparative Randomized Study

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  • Body Contouring
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Abstract

Background

The number of bariatric surgeries for the treatment of morbid obesity has increased, and there is growing demand for postbariatric abdominoplasty. The aim of this study was to evaluate the impacts of Scarpa’s fascia preservation on total drainage volume, time to drain removal, and seroma formation in anchor-line abdominoplasty.

Methods

A total of 42 postbariatric patients were randomly assigned to two groups and underwent anchor-line abdominoplasty. Scarpa’s fascia was not preserved during abdominoplasty in one group (n = 21) but was preserved in the other group (n = 21). A suction drain was left in place until the drainage volume was less than 30 ml/24 h. Seroma formation was assessed by abdominal ultrasound on the twentieth postoperative day; only fluid collections greater than 30 ml were considered seromas.

Results

The time to drain removal was shorter, and the total drainage volume was lower in the fascial preservation group than in the fascial dissection group. However, no difference in the seroma formation rate was observed between the groups.

Conclusion

Scarpa’s fascia preservation decreased the drainage volume and the time to drain removal but not the rate of seroma formation.

Level of Evidence II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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References

  1. World Health Organization (2017) Media Centre. Obesity and overweight. Fact sheet. Updated Oct 2017. Available from: https://www.who.int/mediacentre/factsheets/fs311/en/. Accessed 11 Nov 2017.

  2. Segula D (2014) Complications of obesity in adults: a short review of the literature. Malawi Med J 26:20–24

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Bult MJ, van Dalen T, Muller AF (2008) Surgical treatment of obesity. Eur J Endocrinol 158:135–145

    Article  CAS  PubMed  Google Scholar 

  4. Maggard MA, Shugarman LR, Suttorp M, Maglione M, Sugerman HJ, Livingston EH et al (2005) Meta-analysis: surgical treatment of obesity. Ann Intern Med 142:547–559

    Article  PubMed  Google Scholar 

  5. Gloy VL, Briel M, Bhatt DL, Kashyap SR, Schauer PR, Mingrone G et al (2013) Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ 347:15934–15950

    Article  Google Scholar 

  6. Giordano S, Victorzon M, Stormi T, Suominen E (2014) Desire for body contouring surgery after bariatric surgery: do body mass index and weight loss matter? Aesthet Surg J 34:96–105

    Article  PubMed  Google Scholar 

  7. García-García ML, Martín-Lorenzo JG, Campillo-Soto A, Torralba-Martínez JA, Lirón-Ruiz R, Miguel-Perelló J et al (2014) Complications and level of satisfaction after dermolipectomy and abdominoplasty post-bariatric surgery. Cir Esp 92:254–260

    Article  PubMed  Google Scholar 

  8. Fraccalvieri M, Datta G, Bogetti P, Verna G, Pedrale R, Bocchiotti MA et al (2007) Abdominoplasty after weight loss in morbidly obese patients: a 4-year clinical experience. Obes Surg 17:1319–1324

    Article  PubMed  Google Scholar 

  9. Grieco M, Grignaffini E, Simonacci F, Raposio E (2015) Analysis of complications in postbariatric abdominoplasty: our experience. Plast Surg Int 2015, 209173

    PubMed  PubMed Central  Google Scholar 

  10. Andrades P, Prado A (2007) Composition of postabdominoplasty seroma. Aesthet Plast Surg 31:514–518

    Article  Google Scholar 

  11. Janis JE, Khansa L, Khansa I (2016) Strategies for postoperative seroma prevention: a systematic review. Plast Reconstr Surg 138:240–252

    Article  CAS  PubMed  Google Scholar 

  12. Di Martino M, Nahas FX, Kimura AK, Sallum N, Ferreira LM (2015) Natural evolution of seroma in abdominoplasty. Plast Reconstr Surg 135:691e–698e

    Article  PubMed  Google Scholar 

  13. Correia-Gonçalves I, Valença-Filipe R, Carvalho J, Rebelo M, Peres H, Amarante J et al (2017) Abdominoplasty with Scarpa’s fascia preservation—comparative study in a bariatric population. Surg Obes Relat Dis 13:423–428

    Article  PubMed  Google Scholar 

  14. Stocchero IN (1993) Ultrasound and seromas. Plast Reconstr Surg 91:198

    Article  CAS  PubMed  Google Scholar 

  15. Benito-Ruiz J, de Cabo F (2014) Ultrasonography: a useful tool for plastic surgeons. Aesthet Plast Surg 38:561–571

    Google Scholar 

  16. Le Louarn C (1996) Partial subfascial abdominoplasty. Aesth Plast Surg 20:123–127

    Article  Google Scholar 

  17. Saldanha OR, Federico R, Daher PF, Malheiros AA, Carneiro PR, Azevedo SF et al (2009) Lipoabdominoplasty. Plast Reconstr Surg 124:934–942

    Article  CAS  PubMed  Google Scholar 

  18. Costa-Ferreira A, Rebelo M, Vásconez LO, Amarante J (2010) Scarpa fascia preservation during abdominoplasty: aprospective study. Plast Reconstr Surg 125:1232–1239

    CAS  PubMed  Google Scholar 

  19. Koller M, Hintringer T (2012) Scarpa fascia or rectus fascia in abdominoplasty a flap elevation: a prospective clinical trial. Aesthet Plast Surg 36:241–243

    Article  Google Scholar 

  20. Costa-Ferreira A, Rebelo M, Silva A, Vásconez LO, Amarante J (2013) Scarpa fascia preservation during abdominoplasty: randomized clinical study of efficacy and safety. Plast Reconstr Surg 131:644–651

    Article  CAS  PubMed  Google Scholar 

  21. Pollock H, Pollock T (2000) Progressive tension sutures: a technique to reduce local complications in abdominoplasty. Plast Reconstr Surg. 105(7):2583–2586 (discussion 2587–2588)

    Article  CAS  PubMed  Google Scholar 

  22. Nahas FX, Ferreira LM, Ghelfond C (2007) Does quilting suture prevent seroma in abdominoplasty? Plast Reconstruct Surg 119:1060–1064

    Article  CAS  Google Scholar 

  23. Rossetto LA, Garcia EB, Abla LF, Neto MS, Ferreira LM (2009) Quilting suture in the donor site of the transverse rectus abdominis musculocutaneous flap in breast reconstruction. Ann Plast Surg 62:240–243

    Article  CAS  PubMed  Google Scholar 

  24. Di Martino M, Nahas FX, Barbosa MV, Ayaviri NA, Kimura AK, Barella SM et al (2010) Seroma in lipoabdominoplasty and abdominoplasty: a comparative study using ultrasound. Plast Reconstr Surg 126:1742–1745

    Article  PubMed  Google Scholar 

  25. Xiao X, Ye L (2017) Efficacy and safety of Scarpa fascia preservation during abdominoplasty: a systematic review and meta-analysis. Aesthet Plast Surg 4(3):585–590

    Article  Google Scholar 

  26. Costa-Ferreira A, Rodrigues-Pereira P, Rebelo M, Vásconez LO, Amarante J (2014) Morphometric study (macroscopic and microscopic) of the lower abdominal wall. Plast. Reconstr. Surg 134:1313–1322

    Article  CAS  PubMed  Google Scholar 

  27. Friedman T, Coon D, Kanbour-Shakir A, Michaels J V, Rubin JP (2015) Defining the lymphatic system of the anterior abdominal wall: an anatomical study. Plast Reconstr Surg 135:1027–1032

    Article  CAS  PubMed  Google Scholar 

  28. Tourani SS, Taylor GI, Ashton MW (2015) Scarpa fascia preservation in abdominoplasty: does it preserve the lymphatics? Plast Reconstr Surg 136:258–262

    Article  CAS  PubMed  Google Scholar 

  29. Kirkwood BR, Sterne JAC (eds) (2003) Essential medical statistics, 2nd edn. Blackwell, Malde

    Google Scholar 

  30. Lancaster GA, Dodd S, Williamson PR (2004) Design and analysis of pilot studies: recommendations for a good practice. J Eval Clin Pract. 10(2):307–312

    Article  PubMed  Google Scholar 

  31. Persichetti P, Simone P, Scuderi N (2005) Anchor-line abdominoplasty: a comprehensive approach to abdominal wall reconstruction and body contouring. Plast Reconstr Surg 116:289–294

    Article  CAS  PubMed  Google Scholar 

  32. Costa LF, Landecker A, Manta AM (2004) Optimizing body contour in massive weight loss patients: the modified vertical abdominoplasty. Plast Reconstr Surg. 114(7):1917–1923

    Article  PubMed  Google Scholar 

  33. Bercial ME, Sabino Neto M, Calil JA, Rossetto LA, Ferreira LM (2012) Suction drain, quilting sutures, and fibrin sealant in the prevention of seroma formation in abdominoplasty: which is the best strategy? Aesthet Plast Surg 36:370–373

    Article  Google Scholar 

  34. Nurkim MV, Mendonça LB, Martins PAM, Silva JLB, Martins PDE (2002) Incidence of hematoma and seroma in abdominoplasty with and without the use of drains. Rev Soc Bras Cir Plast 17:69–74

    Google Scholar 

  35. Seretis K, Goulis D, Demiri EC, Lykoudis EG (2017) Prevention of seroma formation following abdominoplasty: a systematic review and meta-analysis. Aesthet Surg J 37:316–323

    Article  PubMed  Google Scholar 

  36. Pilone V, Vitiello A, Borriello C, Gargiulo S, Forestieri P (2015) The use of a fibrin glue with a low concentration of thrombin decreases seroma formation in postbariatric patients undergoing circular abdominoplasty. Obes Surg 25:354–359

    Article  PubMed  Google Scholar 

  37. Khan UD (2012) Seroma formation following abdominoplasty: a retrospective clinical review following three different techniques. Eur J Plast Surg 35:299–308

    Article  Google Scholar 

  38. Nahas FX, Di Martino M, Ferreira LM (2012) Fibrin glue as a substitute for quilting suture in abdominoplasty. Plast Reconstr Surg 129:212e–213e

    Article  CAS  PubMed  Google Scholar 

  39. Andrades P, Prado A, Danilla S, Guerra C, Benitez S, Sepulveda S et al (2007) Progressive tension sutures in the prevention of postabdominoplasty seroma: a prospective, randomized, double-blind clinical trial. Plast Reconstr Surg 120:935–946

    Article  CAS  PubMed  Google Scholar 

  40. Stocchero IN (2004) Ultrasound in the diagnosis and management of fluid collection complications following abdominoplasty. Ann Plast Surg 52:331

    Article  PubMed  Google Scholar 

  41. Mohammad JA, Warnke PH, Stavraky W (1998) Ultrasound in the diagnosis and management of fluid collection complications following abdominoplasty. Ann Plast Surg 41:498–502

    Article  CAS  PubMed  Google Scholar 

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Funding

The authors have no financial interests to declare in relation to the content of this article. No outside funding was received.

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Authors and Affiliations

  1. Plastic Surgeon, Postgraduate Program in Translational Surgery, University Federal of São Paulo (UNIFESP), São Paulo, Brazil

    Heraldo Carlos Borges Inforzato & Luiz Antonio Rossetto

  2. Department of Surgery, University Federal of São Paulo (UNIFESP), São Paulo, SP, Brazil

    Elvio Bueno Garcia & Juan Carlos Montano-Pedroso

  3. Division of Plastic Surgery, Department of Surgery, University Federal of São Paulo (UNIFESP), São Paulo, SP, Brazil

    Lydia Masako Ferreira

  4. University Federal of São Paulo (UNIFESP), Avenida Ana Costa 493, cj 21, Santos, SP, CEP 11060-911, Brazil

    Heraldo Carlos Borges Inforzato

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  1. Heraldo Carlos Borges Inforzato
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  2. Elvio Bueno Garcia
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  3. Juan Carlos Montano-Pedroso
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  4. Luiz Antonio Rossetto
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Correspondence to Heraldo Carlos Borges Inforzato.

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Ethical Approval

This study was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki and its subsequent amendments.

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Informed consent was obtained from all patients.

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Inforzato, H.C.B., Garcia, E.B., Montano-Pedroso, J.C. et al. Anchor-Line Abdominoplasty with Scarpa Fascia Preservation in Postbariatric Patients: A Comparative Randomized Study. Aesth Plast Surg 44, 445–452 (2020). https://doi.org/10.1007/s00266-019-01547-7

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  • DOI: https://doi.org/10.1007/s00266-019-01547-7

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