Suction Drains, Quilting Sutures, and Fibrin Sealant in the Prevention of Seroma Formation in Abdominoplasty: Which is the Best Strategy?

Abstract

Seroma formation was significantly lower in the DN and QS groups compared with the FS group on postoperative day 15.

The effect of TISSEEL fibrin sealant on seroma formation following complex abdominal wall hernia repair: a single institutional review and derived cost analysis

“…In contrast, slow thrombin sealant concentration does not exacerbate these same clotting/hemostasis mechanisms and likely allows for more uniform tissue adherence [20]. Bercial et al compared the use of suction drains, quilting sutures, and fibrin sealant Quixil Ò (Thrombin Concentration 800-1200 IU/ml) in the prevention of seroma formation following abdominoplasty [9]. Though there was a significant reduction in seromas on post-operative days 15 and 30 in the three groups, there was a significantly higher rate of seroma formation in the fibrin sealant group compared to the drain and quilting suture group [9].…”

“…However, data are limited to small case series with fewer than 50 patients in the treatment and control groups [9,16,17]. Morales-Conde et al performed a prospective non-randomized single-center study on 50 patients undergoing laparoscopic ventral hernia repair divided into two groups with and without sealant (Tissucol Ò Duo: Baxter, Vienna, Austria) [18].…”

“…Bercial et al compared the use of suction drains, quilting sutures, and fibrin sealant Quixil Ò (Thrombin Concentration 800-1200 IU/ml) in the prevention of seroma formation following abdominoplasty [9]. Though there was a significant reduction in seromas on post-operative days 15 and 30 in the three groups, there was a significantly higher rate of seroma formation in the fibrin sealant group compared to the drain and quilting suture group [9]. Interestingly, whereas fibrin sealant has been shown to have adhesive properties when used properly, its anti-adhesive properties have also been described [21].…”

“…The use of subcutaneous drains is commonplace in these VHRs. Although the use of drains has been shown to be associated with a reduced incidence of seroma post-operatively, infection risk may be higher in the presence of the foreign material [2,9]. Other techniques have been explored in an attempt to reduce seroma formation following abdominal wall surgery.…”

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

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