Epstein Sarah, Epstein Michael A, Gutowski Karol A
Ms Epstein is an undergraduate student at the University of Michigan, Ann Arbor, Michigan. Drs Epstein and Gutowski are plastic surgeons in private practice in Northbrook, Illinois.
Aesthet Surg J. 2015 May;35(4):434-40. doi: 10.1093/asj/sju049.
Subcutaneous surgical drains are commonly used in abdominoplasties to prevent seromas but are not tolerated well by patients and add additional discomfort after the procedure. The lipoabdominoplasty modification may create a more favorable surgical field to reduce the need for surgical drains without increasing seroma formation.
The goal of this review was to determine if surgical drains can be completely eliminated in lipoabdominoplasty procedures without an increased risk of seromas.
The authors conducted a retrospective chart review of 100 consecutive standard, extended, and circumferential lipoabdominoplasty patients done by a single surgeon with at least a 3-month follow-up period.
Seroma was identified in 5% of patients, hematoma and abscess each in 2% of patients, and granuloma, cellulitis, and delayed wound healing each in 1% of patients.
The use of discontinuous undermining with liposuction, limited direct undermining in the midline, preservation of a thin layer of fibrofatty tissue on the superficial abdominal wall fascia, and targeted surgical site compression can eliminate the need for surgical drains without increasing seroma rates.
皮下手术引流管常用于腹部整形术中以预防血清肿,但患者对此耐受性不佳,且术后会增加额外不适。脂肪抽吸腹部整形术改良术式可能会创造一个更有利的手术视野,以减少手术引流管的使用,同时不增加血清肿的形成。
本综述的目的是确定在脂肪抽吸腹部整形术中是否可以完全不使用手术引流管而不增加血清肿风险。
作者对由一名外科医生连续进行的100例标准、扩大和环形脂肪抽吸腹部整形术患者进行了回顾性病历审查,随访期至少为3个月。
5%的患者出现血清肿,2%的患者出现血肿和脓肿,1%的患者出现肉芽肿、蜂窝织炎和伤口愈合延迟。
采用间断性吸脂剥离、中线有限直接剥离、保留腹前壁筋膜浅层的一层薄纤维脂肪组织以及针对性的手术部位压迫,可无需使用手术引流管,且不增加血清肿发生率。