Private practice, Dallas, Texas, USA.
Aesthet Surg J. 2010 May-Jun;30(3):418-25. doi: 10.1177/1090820X10372048.
Over the past 30 years, the preferred techniques and settings for abdominoplasty have evolved considerably, but controversy remains regarding the surgical and postoperative approaches that best limit serious complications such as seroma.
The authors evaluate their 28-year experience with abdominoplasty and suggest a technique (progressive tension sutures without placement of drains) for reducing the overall complication rate, most significantly with regard to seroma.
A retrospective review was conducted of 517 consecutive abdominoplasty cases in the senior author's clinic. The cases were divided into five groups based on operative setting, postoperative care, and surgical technique. Concurrent procedures and complications were also reviewed.
The authors found that the last group of patients, in whom abdominoplasty with progressive tension sutures (but without drains) was performed as an outpatient procedure, had the lowest incidence of seroma. Specifically, the incidence of clinically significant seroma formation requiring aspiration was 9.6% in early groups, when abdominoplasty was performed as an inpatient procedure; the rate was 24% when it was performed as an outpatient procedure without the placement of progressive tension sutures, but was then reduced to 1.7% with the placement of progressive tension sutures and no drains.
Abdominoplasty can be safely performed with other concomitant procedures (such as liposuction) in a strictly outpatient setting when surgical time is limited. Despite controversy in the previous literature, the authors' data support the conclusion that the placement of progressive tension sutures without drains dramatically decreases overall complication and seroma rate during abdominoplasty.
在过去的 30 年中，腹部整形术的首选技术和设置发生了很大的变化，但关于最佳手术和术后方法以限制严重并发症（如血清肿）的争议仍然存在。
作者评估了他们 28 年的腹部整形术经验，并提出了一种技术（不放置引流管的渐进张力缝线），以降低总体并发症发生率，尤其是血清肿。
对高级作者诊所的 517 例连续腹部整形术病例进行回顾性分析。根据手术设置、术后护理和手术技术将病例分为五组。还回顾了同期手术和并发症。
作者发现，最后一组患者（接受渐进张力缝线（但不放置引流管）的腹部整形术作为门诊手术）的血清肿发生率最低。具体来说，当腹部整形术作为住院患者进行时，早期组中临床显著的血清肿形成需要抽吸的发生率为 9.6%；当它作为门诊手术进行而不放置渐进张力缝线时，发生率为 24%，但随后降至 1.7%，放置渐进张力缝线而不放置引流管。
当手术时间有限时，腹部整形术可以与其他同时进行的手术（如吸脂术）一起安全地在严格的门诊环境中进行。尽管之前的文献存在争议，但作者的数据支持这样的结论，即不放置引流管的渐进张力缝线可显著降低腹部整形术的总体并发症和血清肿发生率。
