Background Quilting sutures attaching the abdominal flap to the aponeurosis contribute to the prevention of seroma formation post-abdominoplasty. The sutures distribute the tension over the subcutaneous tissue along the flap length, theoretically decreasing tension at the distal (cutaneous) end of the flap. This is expected to reduce the risks of necrosis, dehiscence, and enlarged or hypertrophic scars. Objectives The study sought to verify whether quilting sutures decrease the tension required to advance the dermal-fat flap in abdominoplasty. Methods Thirty-four women undergoing abdominoplasty with quilting sutures participated in the study. The tensile force required for flap advancement was measured before and after the placement of quilting sutures, using a digital force gauge, and then compared. Differences in tensile force were tested for correlations with body mass index (BMI), age, weight of flap tissue removed, number of previous pregnancies, and postoperative complications, including seroma formation, hematoma, necrosis, dehiscence, and enlarged or hypertrophic scars. Results A mean reduction in tension of 27.7% was observed at the skin suture after the placement of quilting sutures (p < 0.001). No significant correlation was found of reduced flap tension with BMI, age, weight of tissue removed, and number of births. A case of seroma formation and two cases of enlarged scars were observed, but no case of hematoma, necrosis or wound dehiscence was detected. Conclusions The use of quilting sutures to attach the abdominal flap to the aponeurosis of the anterior abdominal wall reduced tension at the advancing edge of the flap in abdominoplasty.
Background For decades, the postoperative wearing of abdominal binders has been suggested to reduce dead space and prevent mobilization of the musculoaponeurotic layer, as an attempt to decrease the risk of seroma formation and recurrent diastasis. Objectives The study sought to evaluate whether the postoperative wearing of an abdominal binder provides any additional contribution to the reduction of either seroma formation or recurrent diastasis recti when abdominoplasty is performed with the use of quilting sutures. Methods Thirty-four women undergoing abdominoplasty were randomized into 2 groups: the binder group (n = 16) wore abdominal binders, and the control group (n = 18) did not wear abdominal binders during the postoperative period. Ultrasound examination was performed on postoperative days 7 and 14 to assess seroma formation and at 6 months postoperatively to assess recurrence of diastasis recti. Student’s t-test for independent samples was applied to compare means between two numerical variables. Generalized Estimation Equation models were used to evaluate the seroma volume at different timepoints for the different groups. Results No significant differences in seroma volume were found between groups on postoperative days 7 (p = 0.830) and 14 (p = 0.882). Four and 3 cases of subclinical recurrent diastasis were observed by ultrasound examination in the supraumbilical and infraumbilical regions, respectively, but without significant differences (p = 1.000) between groups. Recurrent diastasis was not detected during physical examinations. Conclusions The postoperative wearing of abdominal binders was neither effective in preventing seroma formation nor recurrent diastasis following abdominoplasty with quilting sutures
Background The main disadvantages of wearing a compression garment following abdominoplasty are the increase in intra-abdominal pressure and risk of venous stasis. On the one hand, the wearing of garments may increase the risk of venous thromboembolism. On the other hand, it may be beneficial in decreasing edema formation after surgery. Objectives To evaluate the effectiveness of compression garments in reducing subcutaneous edema after abdominoplasty. Methods Thirty-two women aged from 19 to 50 years were selected and randomly allocated to either the garment (n = 16) or no-garment (n = 16) group. All patients underwent abdominoplasty and received 10 sessions of manual lymphatic drainage during the postoperative period. Postoperative edema formation was assessed by perimetry and bioimpedance, and seroma formation was assessed by ultrasound. The statistical tests included Student's t test, mixed linear models, analysis of variance with repeated measures, and the Kolmogorov-Smirnov test, which were performed at a significance level α of 0.05 (p ≤ 0.05). Results The no-garment group showed a trend toward lower mean waist circumference (WC) at 29 days following abdominoplasty and significantly lower WC after postoperative day 35 compared to values from the garment group (p < 0.001). The mean total body water was slightly lower in the no-garment group than in the garment group 7 days after surgery (p = 0.05). Conclusions Patients who did not wear a compression garment after abdominoplasty showed less subcutaneous edema formation after 24 days of surgery than those who wore the garment.
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