Abdominoplasty and seroma: A prospective randomised study comparing scalpel and handheld electrocautery dissection

Marsh, Daniel; Fox, Andreas; Grobbelaar, Adriaan O.; Chana, Jagdeep S.

doi:10.1016/j.bjps.2014.10.004

Cited by 44 publications

(28 citation statements)

References 19 publications

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“…Swanson [ 16 ] argued that a seroma rate of 5.4% can be achieved with scalpel dissection below the Scarpa fascia (Level of Evidence: Therapeutic, V). In 2015, Marsh et al [ 17 ] published a prospective randomized study comparing scalpel and handheld electrocautery dissection, finding no difference in the seroma rate between the 2 groups (Level of Evidence: Therapeutic, II).…”

Section: Resultsmentioning

confidence: 99%

Managing Complications in Abdominoplasty: A Literature Review

2017

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BackgroundAbdominoplasty, with or without liposuction, is among the most frequently performed aesthetic procedures. Its main objective is to improve the body contour by means of excising redundant skin and fat tissue. Although abdominoplasty is considered a safe procedure with high satisfaction rates, intraoperative and postoperative complications can become a challenge for the surgical team. The aim of this article is to offer a synopsis of the most common complications arising after abdominoplasty, along with evidence-based guidelines about how to prevent and treat them.MethodsA systematic MEDLINE search strategy was designed using appropriate Medical Subject Headings (MeSH) terms, and references were scanned for further relevant articles.ResultsAccording to the published case series, local complications are considerably more common than complications with systemic repercussions. Approximately 10% to 20% of patients suffer a local complication following abdominoplasty, while fewer than 1% suffer a systemic complication. Prevention and management strategies are critically discussed for complications including seroma, haematoma, infection, skin necrosis, suture extrusions, hypertrophic scars, neurological symptoms, umbilical anomalies, deep venous thrombosis and pulmonary thromboembolism, respiratory distress, and death.ConclusionsThe complications of abdominoplasty vary in severity and in the impact they have on the aesthetic outcomes. Recommendations for prevention and management are based on various levels of evidence, with a risk of observer bias. However, most complications can be treated appropriately following the current standards, with satisfactory results.

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Section: Resultsmentioning

confidence: 99%

Managing Complications in Abdominoplasty: A Literature Review

2017

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“…To the best of our knowledge, strong scientific evidence in favor of either option during abdominoplasty is still needed as the available publications present contradictory data. 57,[73][74][75][76] …”

Section: Discussionmentioning

confidence: 99%

Abdominoplasty With Scarpa Fascia Preservation

Costa‐Ferreira

Rebelo

Vásconez

et al. 2016

Annals of Plastic Surgery

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The plane of dissection used during a full abdominoplasty has been implicated on the seroma rate. Avoiding the classic plane of dissection on top of the rectus fascia and using a more superficial plane of dissection has been suggested as a strategy to improve recovery and lower the complication rate. The authors have been applying this principle in their practice for more than a decade, and they performed 2 prospective comparative studies to evaluate the clinical effects of using a more superficial plane of dissection (with Scarpa fascia preservation) during a full abdominoplasty.The technique is presented and explained along with the results of both comparative studies.The results of both studies are discussed particularly the effects on drain volume (total and daily), the duration of drain usage and the avoidance of "long drainers." These are very relevant advantages of the technique that have not been discussed in the literature. The results and surgical strategies used by other authors which apply a more superficial plane of dissection are presented.Controversy still exits on the manipulation of the deep fat compartment by liposuction or direct fat excision. No manipulation is another option which should be considered but it has been questioned due to the risk of aesthetic compromise. A morphometric study performed on the surgical specimens of 41 female patients submitted to a full abdominoplasty validates that option.Based on this evidence, the authors recommend that surgeons consider performing abdominoplasties using a more superficial plane of dissection in the infraumbilical area with total preservation of Scarpa fascia and the deep fat compartment. The classic plane of dissection, on top of the deep fascia, should be avoided in the lower abdomen.

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“…Marsh et al 1 conclude that electrodissection does not increase the risk of seroma after abdominoplasty. In describing their technique, the authors do not mention the use of a wetting solution prior to performing either abdominoplasty or liposuction.…”

Section: Dear Sirmentioning

confidence: 98%

“…However, it is also possible that reduced electrodissection is responsible for their improved seroma rates. 2 Marsh et al 1 do not provide a statistical power analysis. A power analysis is needed to determine whether there are sufficient numbers of subjects to reliably detect a treatment difference.…”

Section: Dear Sirmentioning

confidence: 98%

“…Defects of the nasal columella can be a consequence of surgical resection of nasal lesions, infection, congenital cleft nose and also as a result of nasal trauma. 1 When reconstructing the nose, it is widely believed that a subunit approach is vital to a satisfactory cosmetic end result. The columella has repeatedly proven to be one of the most complex nasal subunits to reconstruct, and therefore has prompted multiple techniques published in literature.…”

Section: Fundingmentioning

confidence: 99%

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