Louisville Aesthetic Plastic Surgery

Research Roundup

Decreasing Complications Associated with Abdominoplasty

Luis H. Macias, MD, FACS, Edwin Kwon, MD, Daniel J. Gould, MD, PhD, Michelle A. Spring, MD, FACS, W. Grant Stevens, MD, FACS; Decrease in Seroma Rate After Adopting Progressive Tension Sutures Without Drains: A Single Surgery Center Experience of 451 Abdominoplasties Over 7 Years. Aesthet Surg J 2016; 36 (9): 1029-1035.

Background

                Abdominoplasty is the fourth most common aesthetic procedure in plastic surgery.  A common complication is the development of seroma.  Traditional techniques have included the placement of drains during the procedure to decrease the incidence of seroma.  More recent experience has shown that placement of progressive tension sutures may decrease the risk of seroma compared to placement of drains.

Methods

                The authors reviewed the data on 453 abdominoplasty procedures over a 7 year period.  Drains were used during the initial 4 years.  There was a transition to the use of progressive tension sutures over the next 3 years. A retrospective review was performed to evaluate the incidence of post-operative complications, including: seroma, hematoma, delayed wound healing, need for revision surgery, and pulmonary embolism/deep venous thrombosis.

Results

                Development of seroma and need for scar-revision were decreased in the patients who received progression tension sutures compared to placement of drains.  There were no significant differences in the incidence of the remaining complications.

Conclusion

                Placement of progressive tension sutures decreased the rate of seroma formation.  Further study is recommended to validate these results

Take-home message

                Abdominoplasty (tummy-tuck) is a common aesthetic procedure to remove excess skin and fat from the lower abdomen and to tighten the abdominal muscles.  The development of seroma (fluid collection beneath the skin) is a known complication.  This may require additional procedures to address.  Traditionally, drains have been used to decrease the rate of seroma.  Newer techniques during the procedure have been shown to decrease the rate of seroma and eliminate the use of drains. 

            This study demonstrates that abdominoplasty procedures may be safely performed without the use of drains in certain patients. Newer techniques may even decrease the risk of certain complications compared with traditional techniques.  Avoidance of drain placement may significantly decrease the discomfort associated with abdominoplasty procedures.