Grand Rapids, Mich. From the Grand Rapids Medical Education and Research Center and the College of Human Medicine, Michigan State University, and Plastic Surgery Associates, P.C.
Plast Reconstr Surg. 2013 Mar;131(3):403e-410e. doi: 10.1097/PRS.0b013e31827c6fc3.
Abdominoplasty is one of the most commonly performed cosmetic operative procedures. Few large studies have examined outcomes of cosmetic abdominoplasty in a community setting. The authors explored postoperative outcome and the preoperative and intraoperative factors that may contribute to these complications.
A retrospective review of consecutive patients undergoing abdominoplasty over an 11-year period was performed. Baseline patient demographics, intraoperative technique, and postoperative outcomes were recorded. Preoperative and intraoperative characteristics were analyzed to determine characteristics that predispose patients to complications and undesirable outcomes.
The 1008 study patients underwent either a full or modified abdominoplasty with a total complication rate of 32.6 percent. The most common complication was seroma (15.4 percent). Liposuction of the abdominal flap was performed in 469 patients (46.5 percent) and liposuction of the flanks was performed in 555 patients (55.1 percent). Chi-square analysis followed by logistic regression revealed that liposuction of the flanks and abdomen was independently associated with seroma formation in addition to major and minor complications (p < 0.05).
Seroma formation following abdominoplasty is the most common complication. Concomitant liposuction of the flanks and abdomen with the addition of aggressive undermining leads to higher seroma rates. This association is likely multifactorial and may be secondary to increased resorptive demands placed on the abdominal lymphatics in the setting of greater dead space and larger fluid shifts as a result of liposuction. To reduce seroma rates, surgeons should avoid aggressive liposuction and undermining, particularly in high-risk patients.
腹部整形术是最常施行的美容手术之一。少数大型研究已经在社区环境中检查了美容腹部整形术的结果。作者探讨了术后结果以及可能导致这些并发症的术前和术中因素。
对 11 年间连续行腹部整形术的患者进行回顾性研究。记录了基线患者人口统计学特征、术中技术和术后结果。分析了术前和术中特征，以确定使患者易发生并发症和不良结果的特征。
1008 例研究患者行全腹部或改良腹部整形术，总并发症发生率为 32.6%。最常见的并发症是血清肿（15.4%）。469 例患者（46.5%）行腹部皮瓣吸脂术，555 例患者（55.1%）行侧腹部吸脂术。卡方分析后行逻辑回归显示，侧腹部和腹部吸脂术与主要和次要并发症的血清肿形成独立相关（p<0.05）。
腹部整形术后血清肿形成是最常见的并发症。侧腹部和腹部吸脂术的同时进行，加上积极的皮下剥离，会导致更高的血清肿发生率。这种关联可能是多因素的，可能是由于吸脂术导致更大的死腔和更大的液体转移，从而对腹部淋巴管的吸收需求增加。为了降低血清肿发生率，外科医生应避免积极的吸脂术和皮下剥离，尤其是在高风险患者中。
