Skip to main content
Top
Published in: Aesthetic Plastic Surgery 2/2014

01-04-2014 | Original Article

Ligating Perforators in Abdominoplasty Reduces the Risk of Seroma

Authors: J. M. Skillman, M. R. Venus, P. Nightingale, O. G. Titley, A. Park

Published in: Aesthetic Plastic Surgery | Issue 2/2014

Login to get access

Abstract

Background

Seroma formation, a common complication of abdominoplasty, can cause patient discomfort and inconvenience. This study aimed to compare seroma rates after ligation and diathermy of large abdominal perforating vessels during abdominoplasty.

Methods

Consecutive patients undergoing abdominoplasty with epigastric undermining between 2004 and 2011 were studied. Body mass index (BMI), age at operation, smoking history, preoperative weight loss, operative details, perioperative fluid infiltration, concomitant abdominal liposuction, ligation of perforators by clips, suture or diathermy, use of quilting sutures, weight of tissue removed, postoperative drainage, inpatient stay, and seroma rates were recorded. Statistical analysis was undertaken using the unpaired t test, Fisher’s exact test, the Mann–Whitney U test, and Kendall’s tau-b test.

Results

The study included 90 patients. The incidence of seroma was significantly lower among the patients who had perforators ligated (4/60, 6.7 %) than among those who had diathermy (10/30, 33 %) (p = 0.002, Fisher’s exact test). Seroma formation was significantly associated with a higher BMI, (27.45 vs. 25.16 kg/m2; p = 0.025, t test) but not with preoperative weight loss. Postoperative fluid drainage did not differ significantly between ligated and diathermied perforators (p = 0.716 Mann–Whitney U test).

Conclusions

Use of ligation by clip or suture rather than by diathermy to ablate large abdominal perforators significantly reduced the incidence of seroma among abdominoplasty patients.

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.
Literature
1.
go back to reference Andrades P, Prado A, Danilla S et al (2007) Progressive tension sutures in the prevention of postabdominoplasty seroma: a prospective, randomized, double-blind clinical trial. Plast Reconstr Surg 120:935–946PubMedCrossRef Andrades P, Prado A, Danilla S et al (2007) Progressive tension sutures in the prevention of postabdominoplasty seroma: a prospective, randomized, double-blind clinical trial. Plast Reconstr Surg 120:935–946PubMedCrossRef
2.
go back to reference Arantes HL, Rosique RG, Rosique MJ, Mélega JM (2010) The use of quilting suture in abdominoplasty does not require aspiratory drainage for prevention of seroma. Aesthetic Plast Surg 34:102–104PubMedCrossRef Arantes HL, Rosique RG, Rosique MJ, Mélega JM (2010) The use of quilting suture in abdominoplasty does not require aspiratory drainage for prevention of seroma. Aesthetic Plast Surg 34:102–104PubMedCrossRef
3.
4.
go back to reference Bercial ME, Sabino Neto M, Calil JA, Rossetto LA, Ferreira LM (2012) Suction drains, quilting sutures, and fibrin sealant in the prevention of seroma formation in abdominoplasty: Which is the best strategy? Aesthetic Plast Surg 36:370–373PubMedCrossRef Bercial ME, Sabino Neto M, Calil JA, Rossetto LA, Ferreira LM (2012) Suction drains, quilting sutures, and fibrin sealant in the prevention of seroma formation in abdominoplasty: Which is the best strategy? Aesthetic Plast Surg 36:370–373PubMedCrossRef
5.
go back to reference Blomqvist L, Sellman G, Strömbeck JO (1996) Reduction mammaplasty with adrenaline infiltration: effects on perioperative bleeding. Scand J Plast Reconstr Surg Hand Surg 30:29–32PubMedCrossRef Blomqvist L, Sellman G, Strömbeck JO (1996) Reduction mammaplasty with adrenaline infiltration: effects on perioperative bleeding. Scand J Plast Reconstr Surg Hand Surg 30:29–32PubMedCrossRef
6.
go back to reference Felmerer G, Muehlberger T, von Berens Rautenfeld D, Vogt PM (2002) The lymphatic system of the deep inferior epigastric artery perforator flap: An anatomical study. Br J Plast Surg 55:335–339PubMedCrossRef Felmerer G, Muehlberger T, von Berens Rautenfeld D, Vogt PM (2002) The lymphatic system of the deep inferior epigastric artery perforator flap: An anatomical study. Br J Plast Surg 55:335–339PubMedCrossRef
7.
go back to reference Kim J, Stevenson TR (2005) Abdominoplasty, liposuction of the flaps, and obesity: analyzing risk factors for seroma formation. Plast Reconstr Surg 117:773–779CrossRef Kim J, Stevenson TR (2005) Abdominoplasty, liposuction of the flaps, and obesity: analyzing risk factors for seroma formation. Plast Reconstr Surg 117:773–779CrossRef
8.
go back to reference Manassa EH, Hertl CH, Olbrisch RR (2003) Wound healing problems in smokers and nonsmokers after 132 abdominoplasties. Plast Reconstr Surg 111:2082–2087PubMedCrossRef Manassa EH, Hertl CH, Olbrisch RR (2003) Wound healing problems in smokers and nonsmokers after 132 abdominoplasties. Plast Reconstr Surg 111:2082–2087PubMedCrossRef
9.
go back to reference Metaxotos NG, Asplund O, Hayes M (1999) The efficacy of bupivacaine with adrenaline in reducing pain and bleeding associated with breast reduction: a prospective trial. Br J Plast Surg 52:290–293PubMedCrossRef Metaxotos NG, Asplund O, Hayes M (1999) The efficacy of bupivacaine with adrenaline in reducing pain and bleeding associated with breast reduction: a prospective trial. Br J Plast Surg 52:290–293PubMedCrossRef
10.
go back to reference Momeni A, Heier M, Bannasch H, Stark GB (2009) Complications in abdominoplasty: a risk factor analysis. J Plast Reconstr Aesthet Surg 62:1250–1254PubMedCrossRef Momeni A, Heier M, Bannasch H, Stark GB (2009) Complications in abdominoplasty: a risk factor analysis. J Plast Reconstr Aesthet Surg 62:1250–1254PubMedCrossRef
11.
go back to reference Najera RM, Asheld W, Sayeed SM, Glickman LT (2011) Comparison of seroma formation following abdominoplasty with or without liposuction. Plast Reconstr Surg 127:417–422PubMedCrossRef Najera RM, Asheld W, Sayeed SM, Glickman LT (2011) Comparison of seroma formation following abdominoplasty with or without liposuction. Plast Reconstr Surg 127:417–422PubMedCrossRef
12.
go back to reference 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. Plast Reconstr Surg 128:973–981PubMedCrossRef 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. Plast Reconstr Surg 128:973–981PubMedCrossRef
13.
go back to reference Salgarello M, Tambasco D, Farallo E (2012) DIEP Flap donor site versus elective abdominoplasty short-term complication rates: a meta-analysis. Aesthetic Plast Surg 36:363–369PubMedCrossRef Salgarello M, Tambasco D, Farallo E (2012) DIEP Flap donor site versus elective abdominoplasty short-term complication rates: a meta-analysis. Aesthetic Plast Surg 36:363–369PubMedCrossRef
14.
go back to reference La-Touche S, Ayres B, Lam W, Alnajjar HM, Perry M, Watkin N (2012) Trial of ligation versus coagulation of lymphatics in dynamic inguinal sentinel lymph node biopsy for staging of squamous cell carcinoma of the penis. Ann R Coll Surg Engl 94:344–346PubMedCentralPubMedCrossRef La-Touche S, Ayres B, Lam W, Alnajjar HM, Perry M, Watkin N (2012) Trial of ligation versus coagulation of lymphatics in dynamic inguinal sentinel lymph node biopsy for staging of squamous cell carcinoma of the penis. Ann R Coll Surg Engl 94:344–346PubMedCentralPubMedCrossRef
15.
go back to reference Tourani SS, Taylor GI (2013) Ashton MW Anatomy of the superficial lymphatics of the abdominal wall and the upper thigh and its implications in lymphatic microsurgery. J Plast Reconstr Aesthet Surg 66:1390–1395PubMedCrossRef Tourani SS, Taylor GI (2013) Ashton MW Anatomy of the superficial lymphatics of the abdominal wall and the upper thigh and its implications in lymphatic microsurgery. J Plast Reconstr Aesthet Surg 66:1390–1395PubMedCrossRef
16.
go back to reference Wattin GR, Van Loock K (2011) Sprayed fibrin glue in lipoabdominoplasty and abdominoplasty. Plast Reconstr Surg 128:378e–379ePubMedCrossRef Wattin GR, Van Loock K (2011) Sprayed fibrin glue in lipoabdominoplasty and abdominoplasty. Plast Reconstr Surg 128:378e–379ePubMedCrossRef
Metadata
Title
Ligating Perforators in Abdominoplasty Reduces the Risk of Seroma
Authors
J. M. Skillman
M. R. Venus
P. Nightingale
O. G. Titley
A. Park
Publication date
01-04-2014
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 2/2014
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-013-0267-1

Other articles of this Issue 2/2014

Aesthetic Plastic Surgery 2/2014 Go to the issue