Prevention of Seroma Formation Following Abdominoplasty: A Systematic Review and Meta-Analysis

Seretis, Konstantinos; Goulis, Dimitrios G.; Demiri, Efterpi; Lykoudis, Efstathios G.

doi:10.1093/asj/sjw192

Cited by 88 publications

(72 citation statements)

References 31 publications

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“…[15][16][17] Although the relationship between compression and seroma formation is controversial, we expect that the compression does have a role in reducing seroma-related complications by obliterating the dead space of the flap with appropriate pressure. 18,19 In our experience, we note increased discharge from the flap margins when compression is applied early, supporting our notion.…”

Section: Discussionsupporting

confidence: 80%

Is Early Compression Therapy after Perforator Flap Safe and Reliable?

Suh

Jeong

Hong

2018

J reconstr Microsurg

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Background Due to the concern of circulation compromise, many surgeons hesitate to dangle or challenge the flap in the early postoperative phase. In our experience, early compression may have advantages such as collapse of dead space, evacuation of hematoma, reduction of edema, and stabilization of flap when ambulating. In this study, the effect of early compression of flaps with regard to flap physiology and outcome is evaluated. Methods From postoperative day 3 to 5, a custom-made compression garment was fitted aiming to compress with a pressure of 30 to 35 mmHg. A total of 52 patients (52 flaps) were enrolled for the study and 48 flaps underwent early compression. The compression was applied not only over the flap but also over the extremity or trunk. The flap outcome as well as flow velocity and flow volume of the pedicle before and after compression was measured and evaluated. Results There was no flap complication during the early compression and early ambulation. And, there was no statistical difference either in the flow velocity or in the volume before and after the compression therapy (29.21 vs. 29.42 cm/s and 7.13 vs. 6.56 cm3/s, respectively). Conclusion Early compression with a 30-mmHg pressure customized pressure garment after the flap surgery does not affect the hemodynamics of the perforator and can be safely used after extremity reconstruction before ambulation.

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Section: Discussionsupporting

confidence: 80%

Is Early Compression Therapy after Perforator Flap Safe and Reliable?

Suh

Jeong

Hong

2018

J reconstr Microsurg

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“…Vervielfältigung nur mit Zustimmung des Verlages. [3,4]. Es existieren keine gesicherten Daten, die für eine Reduktion des Seromvolumens durch den Einsatz von Wunddrainagen nach Straffungseingriffen sprechen [3,5].…”

Section: Introductionunclassified

“…In der aktuellen Fachliteratur finden sich Hinweise auf nur geringe Komplikationsraten bei Straffungseingriffen ohne Drainagen [2,3,7]. Dennoch ist der Einsatz von Wunddrainagen bei plastischchirurgischen Eingriffen national und international weit verbreitet [4,[8][9][10] Die Studienteilnehmer wurden prospektiv in zwei Gruppen mit Drainagen (MD) und ohne Drainagen (OD) randomisiert. Bei der MD Kohorte wurden jeweils drei Redon-Drainagen mit 400 ml Fassungsvolumen (Redovac, B. Braun Melsungen AG, Hessen, Deutschland), konnektiert mit einem 12-Charrière-Silikonschlauch, subkutan eingebracht und standardisiert links/rechts lateral sowie in der Mittellinie platziert.…”

Section: Introductionunclassified

Verzicht auf Drainagen bei der Abdominoplastik – eine randomisiert-kontrollierte Studie

Anker

Prantl

Baringer

et al. 2020

Handchir Mikrochir Plast Chir.

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ZUSAMMENFASSUNG Einleitung Es gibt keine wissenschaftliche Evidenz aus randomisiert-kontrollierten Studien, die für eine routinemäßige Anlage von subkutanen Drainagen bei körperformenden Eingriffen in der Plastischen Chirurgie spricht. Die vorliegende Studie untersucht, inwiefern sich ein Verzicht auf Wunddrainagen bei Abdominoplastik auf das Seromvolumen, die stationäre Verweildauer und postoperative Komplikationen auswirkt. Material und Methoden Die Studienteilnehmer wurden prospektiv in zwei Gruppen mit Anlage von Drainagen (MD) und ohne Anlage von Drainagen (OD) bei Abdominoplastik randomisiert. Einschlusskriterien waren eine Abdominoplastik mit horizontaler oder kombiniert horizontal/vertikaler Schnittführung unter Schonung der Scarpa-Faszie und ein BMI ≤ 30 kg/m2. Ausschlusskriterien beinhalteten eine simultane Liposuction des Operationsgebietes, bekannte Gerinnungsstörungen sowie ein ASA-Score ≥ 3. Das kumulative Seromvolumen über einen Beobachtungszeitraum von 4 Wochen wurde als primärer Endpunkt definiert. Die stationäre Verweildauer und revisionspflichtige Komplikationen stellten sekundäre Endpunkte dar. Resultate Bei 53 Studienteilnehmern wies das kumulative Seromvolumen keinen statistisch signifikanten Unterschied zwischen den beiden Studienpopulationen MD (30/53) und OD (23/53) auf (MMD 493 ± SD 407 ml; MOD 459 ± SD 624 ml; p = 0,812). Verglichen mit dem MD-Patientenkollektiv, konnte durch den Verzicht auf Wunddrainagen in der OD-Kohorte eine signifikant kürzere mittlere stationäre Verweildauer erzielt werden (MMD 5,1 ± SD 1,4 d; MOD 4,2 ± SD 1,5 d; p = 0,023). Beide Studiengruppen hatten identische Komplikationsraten (nMD = 1; nOD = 1). Schlussfolgerung Bezugnehmend auf die Ergebnisse der vorliegenden Erhebung, kann bei präadipösen Patienten (BMI ≤ 30 kg/m2) ein routinemäßiger Verzicht auf Drainagen bei Abdominoplastik (horizontale, kombiniert horizontale/vertikale Schnittführung) in Erwägung gezogen werden. Die Anlage von Drainagen sollte lediglich auf patientenindividueller Basis erfolgen.

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“…The most common complication of abdominoplasty is a seroma between the abdominal wall fascia and the skin-subcutaneous fat flap, seen in 10%-20% of cases and typically occurring during the 2nd or 3rd postoperative week (2,6,7). Causes of seroma formation include dissection of numerous lymphatic vessels, dead space secondary to detachment of the dermal-fat flap, shearing between the flap and aponeurosis, and inflammatory mediator release (7).…”

Section: Introductionmentioning

confidence: 99%

“…Treatment is typically needle aspiration performed in the office. Lower rates of seroma formation have been reported with preservation of the Scarpa fascia, use of tissue adhesives, use of compression garments in the postoperative period, and quilted or progressive tension sutures (6).…”

Section: Introductionmentioning

confidence: 99%

Adventures and Misadventures in Plastic Surgery and Soft-Tissue Implants

et al. 2017

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Soft-tissue augmentation and implants are increasingly seen by the radiologist as more techniques emerge for a variety of indications and locations. Some surgical and implant procedures are performed for purely cosmetic reasons in otherwise healthy patients seeking to improve their body image, and some are performed for reconstruction after cancer or other chronic illnesses. Abdominoplasty, liposuction, and autologous fat grafting can be performed for abdominal and gluteal contouring. Injection of liquid injectable silicone has historically been fraught with legal issues, although it continues to be used for augmentation in a variety of anatomic locations. Newer solid silicone implants have revolutionized cosmetic and reconstructive muscular contouring. Subdermal implants placed by nonmedical professionals are relatively new and unrecognized within the medical establishment, although such implants have been described in the popular culture. Perhaps the most rapidly increasing segment of cosmetic procedures, however, is minimally invasive cosmesis in the form of soft-tissue fillers in the hands and face. Finally, the major principles of breast augmentation and penile implants are also reviewed. Regardless of the location and the type of implant, complications of plastic surgery and soft-tissue implants can generally be classified into the following categories: seroma, hematoma, infection, migration, vascular or nerve compression, fibrosis, foreign-body reaction, and rupture or breakdown. Key concepts include knowing the appropriate anatomic location and the normal postoperative appearance so that complications can be properly detected. A broad range of approved, off-label, and illicit plastic surgical and implant procedures are described and their complications illustrated with cases with classic imaging findings. RSNA, 2017.

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Prevention of Seroma Formation Following Abdominoplasty: A Systematic Review and Meta-Analysis

Cited by 88 publications

References 31 publications

Is Early Compression Therapy after Perforator Flap Safe and Reliable?

Is Early Compression Therapy after Perforator Flap Safe and Reliable?

Verzicht auf Drainagen bei der Abdominoplastik – eine randomisiert-kontrollierte Studie

Adventures and Misadventures in Plastic Surgery and Soft-Tissue Implants

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