Scarpa Fascia Preservation in Abdominoplasty: Does It Preserve the Lymphatics?

Razzano, Sergio; Gathura, Esther; Sassoon, Elaine M.; Ali, Rozina; Haywood, Richard M.; Figus, Andrea

doi:10.1097/prs.0000000000002089

Cited by 6 publications

(2 citation statements)

References 5 publications

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“… 43 However, because the larger lymphatics are located near the fascial planes rather than in the adipose tissue itself, the impact of thermal damage of the superficial small lymphatics on seroma formation after abdominoplasty procedures remains uncertain. 29 Possibly, when focusing on the thermal damage of the small blood vessels of the abdominal flap, the usage of scalpel dissection during an abdominoplasty lowers the risk of wound dehiscence or necrosis, however concrete evidence to support this claim is lacking in the literature. 44 A downside of scalpel dissection is that it may carry a higher risk of hematoma formation.…”

Section: Discussionmentioning

confidence: 99%

“… 11 Scarpa's fascia preservation is believed to be effective because it spares the lymphatics that are located near the fascial planes rather than in the adipose tissue itself. 29 The importance of avoiding the lymphatics of the femoral triangle during a lower body lift to minimize complications has been previously highlighted by Lockwood, and Le Louarn has also previously demonstrated the effectiveness of sparing the fascia of Scarpa in reducing seroma incidence rates following an abdominoplasty procedure. 17 , 18 , 30 …”

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confidence: 99%

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Does Scarpa's Fascia Preservation in Abdominoplasty Reduce Seroma? A Systematic Review

Sluis

Dongen

Caris

et al. 2023

Aesthetic Surgery Journal

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Background Abdominoplasty is a widely utilized cosmetic surgery procedure. Despite its popularity, seroma formation remains a prevalent complication. This can lead to extended recovery time, increased medical appointments and the potention for infection or the need for additional surgical revision. Preserving Scarpa's fascia may mitigate the risk of seroma in patients following abdominoplasty. Objectives The goal of this systematic review is to determine the impact of preserving Scarpa’s fascia on the occurrence of seroma and total drain output following an abdominoplasty procedure. Methods This systematic review searched academic literature in MEDLINE (via PubMed, National Institutes of Health, Bethesda, MD), EMBASE (OvidSP) (Elsevier, Amsterdam, the Netherlands), and The Cochrane Central Register of Controlled Trials (Wiley, Hoboken, NJ). for clinical and observational studies published in peer-reviewed journals from inception to November 2022, which evaluated the impact of preserving Scarpa’s fascia on postoperative seroma and total drain output during abdominoplasty. The primary outcomes of interests were seroma and total drain output, with secondary outcomes of interests including hematoma, time to drain removal, length of hospital stay, wound dehiscence and infection rate. Results This systematic review of 8 studies, involving 846 patients, found that the preservation of Scarpa’s fascia during an abdominoplasty procedure was associated with decreased seroma occurrence, reduced drain output, faster drain removal, and less infections. However, it did not affect the incidence of hematoma, hospital stay duration, or wound dehiscence. Conclusions The preservation of Scarpa’s fascia during an abdominoplasty procedure should be considered as a routine practice, as it has been shown to result in reduced seroma incidence rates and faster drain removal.

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Section: Discussionmentioning

confidence: 99%