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Abdominoplasty without Drains or Progressive Tension Suturing

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Abstract

Background

Over the years, the techniques of performing abdominoplasty have been modified and altered. Some of these modifications include progressive tension suturing and preservation of sub-Scarpa fat. These alterations have been done to decrease the risk of postoperative seroma and hematoma formation. Abdominoplasty, without the use of drains, is well documented in the literature. Here, the authors describe that raising superficial flaps (in the sub-Scarpa fat plane) will reduce seroma formation risk. As a result, the use of drains and tension suturing can be avoided altogether.

Methods

A retrospective study was conducted from January 2015 to January 2018. The data of patients were extracted from admission files and operative notes. All the procedures were done under general anesthesia using the same operative technique by a single surgeon at the same institute. This article describes the operative technique used, observations, and result in comparison to the literature.

Results

A total of 100 patients were included in the study for over three years; 89% were females, and the average age was 40 years, with a mean BMI of 25.1 kg/m2. Liposuction was performed concomitantly in 56 patients, and rectus plication was done in 47. The overall complication rate was 14%, with the incidence of seroma and hematoma formation being 6% and 2%, respectively. This is comparable to the incidence found in the literature. The average hospital stay was 1.7 days, and the patients were followed for up to 6 months.

Conclusion

Abdominoplasty, when performed in superficial planes with preservation of sub-Scarpa fat, is safe in terms of improved flap vascularity and beneficial in reducing the risk of seroma and hematoma formation. It can be safely performed without drains or progressive tension suturing and reduces the operative time required, patient discomfort, and hospital-stay period.

Level of Evidence IV

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. Awf A. Quaba, F.R.C.S. (2015) (Plast.) Samantha Conlin, M.B.Ch.B. Omar Quaba, F.R.C.S.(Plast.). The No-Drain, No-Quilt Abdominoplasty: A Single-Surgeon Series of 271 Patients. Plast. Reconstr. Surg. 135: 751,

  2. Antonetti JW, Antonetti AR (2010) Reducing seroma in outpatient abdominoplasty: analysis of 516 consecutive cases. AesthetSurg J. 30:418–425

    Article  Google Scholar 

  3. Vasconez LO, De La Torre JI (2005) Abdominoplasty. In: Mathes SJ, Hentz VR (eds) Plastic Surgery, 2nd edn. Saunders, Philadelphia, pp 87–117

    Google Scholar 

  4. Fang RC, Lin SJ, Mustoe TA (2010) Abdominoplasty flap elevation in a more superficial plane: decreasing the need for drains. PlastReconstr Surg. 125:677–682

    Article  CAS  Google Scholar 

  5. Le Louarn C (1996) Partial subfascialabdominoplasty. Aesthetic Plast Surg. 20:123–127

    Article  Google Scholar 

  6. Pollock H, Pollock T (2000) Progressive tension sutures: a technique to reduce local complications in abdominoplasty. PlastReconstr Surg. 105:2583–2586

    Article  CAS  Google Scholar 

  7. Warner JP, Gutowski KA (2009) Abdominoplasty with progressive tension closure using a barbed suture technique. AesthetSurg J. 29:221–225

    Article  Google Scholar 

  8. Saldanha OR (2011) Discussion: abdominoplasty with suction undermining and plication of the superficial fascia without drains: a report of 113 consecutive patients. PlastReconstr Surg. 128:982–983

    Article  CAS  Google Scholar 

  9. Khan UD (2008) Risk of seroma with simultaneous liposuction and abdominoplasty and the role of progressive tension sutures. Aesthetic Plast Surg. 32:93–99; discussion 100

  10. Pollock TA, Pollock H (2012) Progressive tension sutures in abdominoplasty: a review of 597 consecutive cases. AesthetSurg J. 32:729–742

    Article  Google Scholar 

  11. Stoff A, Reichenberger MA, Richter DF (2007) Comparing the ultrasonically activated scalpel (Harmonic) with high-frequency electrocautery for postoperative serous drainage in massive weight loss surgery. PlastReconstr Surg. 120:1092–1093

    Article  CAS  Google Scholar 

  12. Huger WE Jr (1979) The anatomic rationale for abdominal lipectomy. Am Surg. 45:612–617

    PubMed  Google Scholar 

  13. Matarasso A (1991) Abdominolipoplasty: a system of classification and treatment for combined abdominoplasty and suctionassistedlipectomy. Aesthetic Plast Surg. 15:111–121

    Article  CAS  Google Scholar 

  14. Zimman OA, Butto CD, Ahualli PE (2001) Frequency of seroma in abdominal lipectomies. PlastReconstr Surg. 108:1449–1451

    Article  CAS  Google Scholar 

  15. Kosins AM, Scholz T, Cetinkaya M, Evans GRD (2013) Evidence-based value of subcutaneous surgical wound drainage: the largest systematic review and metaanalysis. PlastReconstr Surg. 132:443–450

    Article  CAS  Google Scholar 

  16. Chaouat M, Levan P, Lalanne B, Buisson T, Nicolau P, Mimoun M (2000) Abdominal dermolipectomies: early postoperative complications and long-term unfavorable results. PlastReconstr Surg. 106:1614–1618

    Article  CAS  Google Scholar 

  17. Rodby KA, Stepniak J, Eisenhut N, Lentz CW III (2011) Abdominoplasty with suction undermining and plication of the superficial fascia without drains: a report of 113 consecutive patients. PlastReconstr Surg. 128:973–981

    Article  CAS  Google Scholar 

  18. Stewart KJ, Stewart DA, Coghlan B, Harrison DH, Jones BM, Waterhouse N (2006) Complications of 278 consecutive abdominoplasties. J PlastReconstrAesthet Surg. 59:1152–1155

    CAS  Google Scholar 

  19. Aly A (2010) Editorial comment on “No-drain abdominoplasty with progressive tension sutures.” ClinPlast Surg. 37:525

    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. PlastReconstr Surg. 131:644–651

    Article  CAS  Google Scholar 

  21. Rousseau P, Vincent H, Potier B, Arnaud D, Darsonval V (2011) Diathermocoagulation in cutting mode and large flap dissection. PlastReconstr Surg. 127:2093–2098

    Article  CAS  Google Scholar 

  22. Felmerer G, Muehlberger T, Berens von Rautenfeld D, Vogt PM. The lymphatic system of the deep inferior epigastric artery perforator flap: An anatomical study. Br J Plast Surg. 2002;55:335–339

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

    Article  Google Scholar 

  24. Özdoğan M, Yilmaz KB, Özaslan C, Gürer A, Gülbahar Ö, Ersoy E (2008) Scalpel versus electrocautery dissections: the effect on wound complications and pro-inflammatory cytokine levels in wound fluid. Turkish J Med Sci. 38:000–000

    Google Scholar 

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Dow University of Health Sciences and Dr. Ruth KM Pfau Civil Hospital Karachi, Karachi, Pakistan

    Faisal Akhlaq Ali Khan & Moeez Fatima

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  1. Faisal Akhlaq Ali Khan
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  2. Moeez Fatima
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Correspondence to Moeez Fatima.

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Khan, F.A.A., Fatima, M. Abdominoplasty without Drains or Progressive Tension Suturing. Aesth Plast Surg 45, 1660–1666 (2021). https://doi.org/10.1007/s00266-021-02177-8

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