Background Many strategies have been developed to lower the high complications rate associated with a full abdominoplasty. The dissection technique may have a role to achieve this goal. Objectives The present study compares two different dissection techniques to perform a full abdominoplasty with Scarpa fascia preservation: avulsion technique and electrodissection. Methods A retrospective observational cohort study was performed in two health institutions from January 2005 to January 2019. A total of 251 patients were involved: 122 patients submitted to abdominoplasty using the avulsion technique (Group A) and 129 with diathermocoagulation (coagulation mode) (Group B). The latter was further divided into group B1(57 patients with device settings according to surgeon’s preferences) and B2(72 patients with a specific regulation aiming at minimal tissue damage). Several variables were analyzed: population characteristics, time of hospital stay, time to drain removal, total and daily drain output, emergency department visits, readmission, reoperation, local and systemic complications. Results There were no statistically significant differences between the general characteristics of both groups, except for previous abdominal surgery. The diathermocoagulation group had a significantly lower length of hospital stay and time to drain removal. Moreover, these advantages were maximized when electrocautery was done with a specific low voltage setting as significant differences were found. The other outcomes were identical. Conclusions Limiting the extension of electrodissection with the avulsion technique didn´t present any advantage. Using diathermocoagulation (coagulation mode) during a full abdominoplasty with Scarpa fascia preservation, especially when it’s aimed at minimal tissue damage, reduces patients’ time with drains.
Background Abdominoplasty is becoming increasingly more common, with seroma being the most frequent complication. Suction drains are used very often as a method to prevent seroma formation, and it has been suggested that techniques using Scarpa fascia preservation and closed-suction drains have lower seroma rates than other approaches. However few studies have addressed parameters that may affect drain efficiency. A prospective comparative study was conducted to determine if applying 2 or 3 closed-suction drains, after an abdominoplasty with Scarpa fascia preservation, has any effect on several outcomes. Methods This was a single-center study conducted from September 2016 to March 2019. Patients were allocated according to choice to 1 of the 2 surgeons involved in the study, each responsible for 1 group: abdominoplasty with Scarpa fascia preservation with 2 closed-suction drains placed postoperatively (group A) or with 3 closed-suction drains (group B). A comparative analysis of selected variables was done between both groups, including time to drain removal, total and daily drain output, duration of hospital stay, emergency department visit, readmission to the hospital, secondary surgical procedure, and incidence of postoperative local and systemic complications. Results A total of 73 abdominoplasties with Scarpa fascia preservation were performed in women (group A, 33 patients; group B, 40 patients). General characteristics of group A and B were similar. There were no statistically significant differences between groups in any of the determined variables, namely, main outcomes (total and daily drain output, time to drain removal) or complications (local or systemic). Conclusions Our results suggest that using 3 closed-suction drains postabdominoplasty with Scarpa fascia preservation has no advantages in total and daily drain output, time to drain removal, or complications when compared with the usual 2 drains approach.
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