Fibrin Sealant and Lipoabdominoplasty in Obese Grade 1 and 2 Patients

Abstract

BackgroundEver since lipoabdominoplasty was first developed to achieve better aesthetic outcomes and less morbidity, the rate of seroma formation, especially in obese patients, has disturbed plastic surgeons. The aim of this study was to evaluate the effect of fibrin sealant in the prevention of seroma formation after lipoabdominoplasty in obese patients.MethodsSixty patients with a body mass index (BMI) between 30 and 39.9 were assigned randomly to 1 of 2 groups (30 patients each). Group A underwent lipoabdominoplasty with fibrin glue, while group B underwent traditional lipoabdominoplasty; both had closed suction drainage applied to the abdomen. The patients' demographics and postoperative complications were recorded. Seroma was detected using abdominal ultrasound examinations at two postoperative periods: between postoperative days 10 and 12 and, between postoperative days 18 and 21.ResultsThe age range was 31 to 55 years (38.5±9.5 years) in group A and 25 to 58 years (37.8±9.1 years) in group B, while the mean BMI was 31.4 to 39.9 kg/m2 (32.6 kg/m2) in group A and 32.7 to 37.4 kg/m2 (31.5 kg/m2) in group B. In group A, the patients had a complication rate of 10% in group A versus 43% in group B (P<0.05). The incidence of seroma formation was 3% in the fibrin glue group but 37% in the lipoabdominoplasty-alone group (P<0.05).ConclusionsLipoabdominoplasty with the use of autologous fibrin sealant is a very effective method that significantly reduces the rate of postoperative seroma.

Fixation of split-thickness skin graft using fast-clotting fibrin glue containing undiluted high-concentration thrombin or sutures: a comparison study

“…In addition, patients often report severe pain when staples are removed, and occasionally, an anesthetic procedure is required (O’Grady et al 2000; Batra et al 2016; Himel et al 1994; Best et al 1995; Ghosh et al 2015). Because fibrin sealant adheres to the entire surface, hematoma/seroma formation is significantly reduced compared with point-fixation sutures or staples (Cha et al 2012; Gibran et al 2007; Llanos et al 2006; Myer et al 2015; Mabrouk et al 2013). According to previous studies, fibrin sealant is effective for graft take, particularly in joint and extremity areas that experience difficulty in postoperative immobilization.…”

Effect of Tissue Adhesives on Seroma Incidence After Abdominoplasty: A Systematic Review and Meta-Analysis

“…Although randomization was noted in the reports of the other 2 RCTs, the type of randomization was not described. 27,31 None of the surgeons in the 5 RCTs was blinded to the allocation of patients, owing to the nature…”

“…Therefore, all 5 RCTs were classified as inadequate because of the high risk of bias. [27][28][29][30][31] To assess the risk of bias for incomplete outcome data, we evaluated the incidence of seroma formation after abdominoplasty (ie, the primary outcome measure) for each of the 5 RCTs. We also determined whether an intention-to-treat (ITT) analysis was performed in each study and whether missing data were described and addressed.…”

“…Although it was not possible to evaluate the protocol from which each RCT was derived, we concluded that all 5 RCTs carried a low risk of selective-reporting bias because each trial adequately addressed primary and secondary outcome measures. [27][28][29][30][31] Three of the 5 RCT reports did not include statements of approval by an ethics board. 28,29,31 However, all 5 included descriptions of any conflicts of interest and clear explanations of inclusion and exclusion criteria.…”

“…However, authors who subsequently applied fibrin glue and other TAs in abdominoplasty did not report consistently favorable results. 27,[29][30][31][32] The existing literature regarding TAs in abdominoplasty is limited to small studies and the findings of single institutions. To our knowledge, a systematic review of these studies has not been published.…”