Xiao Xiangyang, Ye Limin
Department of Burn and Plastic Surgery, Guizhou Provincial People's Hospital, Guiyang, China.
Gastrointestinal Department of Internal Medicine, Guizhou Provincial People's Hospital, Guiyang, China.
Aesthetic Plast Surg. 2017 Jun;41(3):585-590. doi: 10.1007/s00266-017-0784-4. Epub 2017 Jan 27.
Scarpa fascia preservation might be a promising approach to reduce seroma and other complications after abdominoplasty. However, the results remained controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of scarpa fascia preservation in patients with abdominoplasty.
PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials and clinical controlled trials assessing the effect of scarpa fascia preservation versus control (without scarpa fascia) during abdominoplasty were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcomes were seroma and hematoma/bleeding. Meta-analysis was performed using random-effect model.
Four studies involving 630 patients were included in the meta-analysis. Overall, compared with the control group, scarpa fascia preservation was associated with a significant reduced seroma (OR 0.16; 95% CI 0.06-0.43; P = 0.0004), time until drain removal (std. mean difference = -0.92; 95% CI -1.31 to -0.54; P<0.00001;), drain output (std. mean difference = -0.92; 95% CI -1.38 to -0.45; P = 0.0001), and hospital stay (std. mean difference = -0.93; 95% CI -1.48 to -0.39; P = 0.0008), but it failed to alter hematoma/bleeding (OR 0.46; 95% CI 0.09-2.38; P = 0.36), infection (OR 0.38; 95% CI 0.11-1.25; P = 0.11), and suture rupture (OR 0.67; 95% CI 0.12-3.73; P = 0.65) in patients with abdominoplasty.
Scarpa fascia preservation was associated with a significant decreased seroma, time until drain removal, drain output, and hospital stay, but could not change hematoma/bleeding, infection and suture rupture following abdominoplasty. Scarpa fascia preservation should be recommended during abdominoplasty.
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保留斯卡帕筋膜可能是一种减少腹部整形术后血清肿及其他并发症的有效方法。然而，其结果仍存在争议。我们进行了一项系统评价和荟萃分析，以评估保留斯卡帕筋膜在腹部整形患者中的有效性和安全性。
系统检索了PubMed、EMbase、Web of science、EBSCO和Cochrane图书馆数据库。纳入评估腹部整形术中保留斯卡帕筋膜与对照组（不保留斯卡帕筋膜）效果的随机对照试验和临床对照试验。两名研究者独立检索文献、提取数据并评估纳入研究的质量。主要结局指标为血清肿和血肿/出血。采用随机效应模型进行荟萃分析。
荟萃分析纳入了4项涉及630例患者的研究。总体而言，与对照组相比，保留斯卡帕筋膜与血清肿显著减少相关（比值比0.16；95%置信区间0.06 - 0.43；P = 0.0004），引流管拔除时间缩短（标准化均数差值 = -0.92；95%置信区间 -1.31至 -0.54；P < 0.00001），引流量减少（标准化均数差值 = -0.92；95%置信区间 -1.38至 -0.45；P = 0.0001），住院时间缩短（标准化均数差值 = -0.93；95%置信区间 -1.48至 -0.39；P = 0.0008），但在腹部整形患者中未能改变血肿/出血（比值比0.46；95%置信区间0.09 - 上2.38；P = 0.36）、感染（比值比0.38；95%置信区间0.11 - 1.25；P = 0.11）和缝线断裂（比值比0.67；95%置信区间0.12 - 3.73；P = 0.65）的发生率。
保留斯卡帕筋膜与血清肿显著减少、引流管拔除时间缩短、引流量减少及住院时间缩短相关，但不能改变腹部整形术后的血肿/出血、感染和缝线断裂情况。腹部整形术中应推荐保留斯卡帕筋膜。
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