Progressive Tension Sutures in the Prevention of Postabdominoplasty Seroma: A Prospective, Randomized, Double-Blind Clinical Trial

Andrades, Patricio; Prado, Arturo; Danilla, Stefan; Guerra, Carolina; Benítez, Susana; Sepúlveda, Sergio A.; Sciarraffia, Carlos; Carolis, V De

doi:10.1097/01.prs.0000253445.76991.de

Cited by 126 publications

(77 citation statements)

References 48 publications

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“…In his series, no patient had a clinically significant fluid collection. Andrades et al, 19 whose study is the only recent randomized, doubleblind, controlled study involving PTS, observed a significant reduction in seroma with PTS relative to controls. Although ultrasonography may demonstrate small collections of fluid, in our experience these collections have not been clinically relevant and they resolve spontaneously without consequence.…”

Section: Discussionmentioning

confidence: 99%

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Progressive Tension Sutures in Abdominoplasty: A Review of 597 Consecutive Cases

Pollock

2012

Aesthetic Surgery Journal

115

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Background: Although abdominoplasty and other body-contouring procedures are being performed more frequently, the incidence of seroma and other complications has remained relatively unchanged. In 2000, a small retrospective series introduced progressive tension sutures (PTS) in abdominoplasty to reduce seroma without the use of drains. Objectives: The authors review the PTS technique and their experience with the procedure. Methods: A retrospective chart review of 597 consecutive abdominoplasty patients treated over 12 years was performed. Collected data included surgical setting, concomitant procedures, and complications. Results: Of the 597 abdominoplasties, 52.4% were performed in the hospital and 47.6% in an American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)-accredited facility. In 63.7% of cases, abdominoplasty was combined with another procedure(s). Liposuction was performed on the abdominoplasty flap or an adjacent area to the abdominoplasty dissection in 67% of patients. The average amount fat aspirate from these areas was 953 mL. No drains were placed. The rate of local complications was 4.2%; all but one of these complications (seroma; 0.1%) were minor. There were no systemic complications related to PTS and no venous thromboembolisms. Conclusions: PTS are an adjunct to abdominoplasty that can minimize seroma and potentially decrease other local complications. They provide secure fixation of the flap to eliminate motion and broadly transfer tension to the superficial fascial system. Drains can safely be eliminated from abdominoplasty, even when liposuction is performed. Systemic complications may be avoided and patient recovery expedited.

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Section: Discussionmentioning

confidence: 99%

“…However, studies have shown that there is no advantage to using drains with PTS. 19,20 Moreover, the placement of PTS is more difficult when drains are in the surgical field, which may increase operating time and the surgeon's learning curve.…”

Section: Surgical Techniquementioning

confidence: 99%

Progressive Tension Sutures in Abdominoplasty: A Review of 597 Consecutive Cases

Pollock

2012

Aesthetic Surgery Journal

115

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“…Further detail was added by Pollock 7 , and the technique was then reproduced by others [21][22][23] .…”

Section: Discussionmentioning

confidence: 99%

Repair of large incisional hernias. To drain or not to drain. Randomized clinical trial

et al. 2015

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. Scientific, intellectual, conception and design of the study, critical revision. ABSTRACT PURPOSE:To evaluate the occurrence of seroma and surgical wound infection after surgery. METHODS:A total of 42 individuals with large incisional hernias were subjected to onlay mesh repair. Following the mesh placement, the participants were randomly allocated to two groups. In group 1, closed-suction drains were placed in the subcutaneous tissue, while progressive tension sutures were performed in group 2. The participants were subjected to clinical and ultrasound assessment to detect seroma and surgical wound infection at three time-points after surgery. RESULTS:The occurrence of seroma at the early, intermediate or late assessments was respectively 19.0%, 47.6%, 52.4% in group 1 and 28.6%, 57.1%, 42.9% in group 2 and was not significantly different between groups (p 0.469; 0.631; 0.619). Surgical wound infection occurred 19% in group 1 and 23.8% in group 2, without a significant difference between the groups (p>0.999). CONCLUSION:The frequency of seroma and infection did not exhibit significant differences between individuals subjected to onlay mesh repair of large incisional hernias with drains or progressive tension sutures without drainage.

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“…O mecanismo proposto na sua gênese baseia-se nas lesões vasculares e linfáticas, no desenvolvimento de espaço morto secundário ao descolamento do retalho dermoadiposo e na força de cisalhamento existente entre o retalho e o complexo músculo-aponeurótico 17 . Bozola e Psillakis 16 , em 1988, relacionaram a incidência de seromas com a extensão da cirurgia, tendo as cirurgias de maior porte predisposição aumentada ao desenvolvimento desta complicação.…”

Section: Discussionunclassified

Pontos de adesão na cirurgia do contorno corporal

Boggio¹,

Almeida²,

Baroud³

2011

Rev. Bras. Cir. Plást. (Impr.)

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Rev. Bras. Cir. Plást. 2011; 26(1): 121-6 121Pontos de adesão na cirurgia do contorno corporal Pontos de adesão na cirurgia do contorno corporalAdhesion suture in plastic of body countering RESUMO Introdução: Seromas, hematomas e alterações cicatriciais são complicações potenciais no pós-operatório das abdominoplastias. Drenagem aspirativa e pontos de adesão são estratégias utilizadas na prevenção destas complicações. A proposta deste estudo é avaliar a eficácia dos pontos de adesão na prevenção ou redução da formação de seroma, hematoma e de complicações cicatriciais em pacientes submetidos a cirurgia plástica do contorno corporal. Método: Cento e quinze pacientes (grupo 2: janeiro de 2006 -junho de 2010) submetidos a cirurgia plástica do contorno corporal com o uso dos pontos de adesão foram comparados, retrospectivamente, com um grupo de 39 pacientes (grupo 1: janeiro de 2004 -dezembro de 2005) submetidos a mesma cirurgia com o uso de drenagem aspirativa. Avaliação clínica dos pacientes foi realizada com 7 dias, 2 semanas, um, dois, três e seis meses de pós-operatório. Resultados: No grupo 1, houve 9 (23%) casos de seroma, 1 (2,5%) de hematoma e 20 (55%) de complicações cicatriciais, enquanto que, no grupo 2, nenhum caso de seroma ou hematoma foi reportado. A avaliação clínica revelou diferenças estatísticas entre o uso dos pontos de adesão e a drenagem aspirativa, no que se refere à incidência de seroma e de complicações cicatriciais. Conclusão: O uso dos pontos de adesão é um método eficiente na prevenção de seromas, hematomas e complicações cicatriciais nas cirurgias do contorno corporal. Descritores:Abdome. Seroma/prevenção & controle. Cirurgia plástica/métodos. ABSTRACT Introduction: Seroma, hematoma and wound alterations are potential complications following abdominoplasty. Aspiratory drainage and adhesion suture are widely employed strategies for prevention of these complications. The purpose of this study is to evaluate the efficacy of adhesion suture in preventing or reducing seroma, hematoma formation and local wound complications in patients undergoing plastic of body countering. Methods: 115 patients (group 2: January 2006 -June 2010) who underwent plastic of body countering with the use of adhesion suture were retrospectively compared with a group of 39 patients (group 1: January 2004 -December 2005) who underwent with the use aspiratory drainage. Clinical evaluation of the patients was performed seven days, two weeks, one, two, three and six months postoperatively. Results: In group 1, there was 9 (23%) cases of seroma, 1 (2.5%) case of hematoma and 20 (55%) cases of wound complications, whereas in group 2 no seroma or hematoma was reported. In this group, there were 14 (12%) cases of wound complications. Clinical evaluation revealed statistical difference between the use of adhesion suture and the aspiratory drainage in the incidence of seroma and wound complications. Conclusion: The use of adhesion suture is an effective measure to prevent seroma, hematoma and wound complications in patients u...

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Progressive Tension Sutures in the Prevention of Postabdominoplasty Seroma: A Prospective, Randomized, Double-Blind Clinical Trial

Cited by 126 publications

References 48 publications

Progressive Tension Sutures in Abdominoplasty: A Review of 597 Consecutive Cases

Progressive Tension Sutures in Abdominoplasty: A Review of 597 Consecutive Cases

Repair of large incisional hernias. To drain or not to drain. Randomized clinical trial

Pontos de adesão na cirurgia do contorno corporal

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