Abdominoplasty without Drains or Progressive Tension Suturing.

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 .