Ardehali Ben, Fiorentino Francesca
St George's Hospital NHS Foundation Trust, London, United Kingdom. Imperial College Trial Unit and Department of Surgery, Imperial College, London, United Kingdom.
Aesthet Surg J. 2017 Oct 16;37(10):1136-1143. doi: 10.1093/asj/sjx051.
Seroma is the most common complication of abdominoplasty. Certain modifications to abdominoplasty may reduce the risk of seroma.
The authors evaluated the incidence of seroma for 3 abdominoplasty techniques: preservation of Scarpa's fascia, placement of progressive tension (or quilting) sutures, and application of fibrin glue.
In this systematic review and meta-analysis, the Cochrane Library, MEDLINE, Embase, and the International Clinical Trials Registry Platform (World Health Organization) were searched to identify studies of patients who underwent abdominoplasty with seroma as a potential "outcome." RevMan 5.3 was utilized for data management, statistical analyses, and graph preparation.
Fifteen studies (1824 total patients) met the criteria for inclusion in this review. The overall risk of bias was high, mainly owing to the nonrandomized nature of most studies. Abdominoplasty with preservation of Scarpa's fascia or placement of progressive tension sutures was associated with a significantly reduced incidence of seroma compared with that of standard abdominoplasty (P < 0.0001 and P < 0.0002, respectively). Abdominoplasty with application of fibrin glue was similar to standard abdominoplasty in terms of seroma development.
Placement of progressive tension sutures or preservation of Scarpa's fascia during abdominoplasty may reduce the likelihood of postoperative seroma. Application of fibrin glue has no impact on seroma formation.
血清肿是腹部整形术最常见的并发症。腹部整形术的某些改良方法可能会降低血清肿的风险。
作者评估了三种腹部整形术技术导致血清肿的发生率：保留斯卡帕筋膜、放置渐进性张力（或褥式）缝线以及应用纤维蛋白胶。
在这项系统评价和荟萃分析中，检索了考克兰图书馆、医学文献数据库、荷兰医学文摘数据库以及国际临床试验注册平台（世界卫生组织），以确定接受腹部整形术且血清肿作为潜在“结局”的患者研究。使用RevMan 5.3进行数据管理、统计分析和图表制作。
15项研究（共1824例患者）符合纳入本评价的标准。总体偏倚风险较高，主要是由于大多数研究的非随机性质。与标准腹部整形术相比，保留斯卡帕筋膜或放置渐进性张力缝线的腹部整形术血清肿发生率显著降低（分别为P < 0.0001和P < 0.0002）。应用纤维蛋白胶的腹部整形术在血清肿形成方面与标准腹部整形术相似。
腹部整形术中放置渐进性张力缝线或保留斯卡帕筋膜可能会降低术后血清肿的可能性。应用纤维蛋白胶对血清肿形成没有影响。
2级。
