Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Aesthet Surg J. 2018 Jun 13;38(7):763-769. doi: 10.1093/asj/sjx235.
Several studies have demonstrated that progressive tension sutures (PTS) reduce seroma. Many fear that adding liposuction to abdominoplasty will increase seroma rates and avoid drainless abdominoplasty when performing concomitant liposuction.
We sought to identify whether liposuction increases seroma in PTS and non-PTS abdominoplasty.
In this retrospective study, 619 patients underwent abdominoplasty between 2009 and 2017, of which 299 patients had drainless abdominoplasty with PTS and 320 had drain-based abdominoplasty. We compared complications among PTS patients with and without liposuction and among drain-based abdominoplasty patients with and without liposuction.
Demographics were similar between PTS and drain patients and between liposuction and nonliposuction PTS. Mean liposuction volume with PTS was 1592 ± 1048 mL. Seroma in the PTS group was found to be 2.6%, which is consistent with previous data. PTS without liposuction had a rate of seroma of 6.67% compared to a rate of 2.2% with liposuction; these rates were not significantly different (P = 0.20). A total of 207 patients had drain-based abdominoplasty with liposuction, and 113 had it without liposuction. Seroma with liposuction was 9.17% and without liposuction was 6.19%, although these differences were not significant (P = 0.52). PTS lipoabdominoplasty had less seroma compared with drain-based lipoabdominoplasty (P = 0.01).
Liposuction was performed in 80% of the patients, and patients with lipoabdominoplasty were not at a higher risk of seroma, in the drain group or the PTS group. More patients may allow validation that liposuction may actually be protective with PTS. Regardless, there is no increase in seroma with the addition of liposuction to PTS drainless abdominoplasty.
多项研究表明，渐进性张力缝线（PTS）可减少血清肿。许多人担心，在进行抽脂的同时行腹部整形术会增加血清肿的发生率，并避免在进行无引流的腹部整形术时使用 PTS。
我们旨在确定抽脂是否会增加 PTS 和非 PTS 腹部整形术后的血清肿。
在这项回顾性研究中，2009 年至 2017 年间有 619 例患者接受了腹部整形术，其中 299 例接受了 PTS 无引流的腹部整形术，320 例接受了基于引流的腹部整形术。我们比较了 PTS 患者中有无抽脂术以及基于引流的腹部整形术患者中有无抽脂术的并发症。
PTS 患者和引流患者以及有和无 PTS 抽脂术患者的人口统计学特征相似。PTS 合并抽脂术的平均抽脂量为 1592±1048ml。PTS 组的血清肿发生率为 2.6%，与既往数据一致。PTS 无抽脂术的血清肿发生率为 6.67%，而 PTS 合并抽脂术的血清肿发生率为 2.2%，但差异无统计学意义（P=0.20）。207 例患者接受了基于引流的腹部整形术联合抽脂术，113 例患者接受了无抽脂术。有和无抽脂术的血清肿发生率分别为 9.17%和 6.19%，但差异无统计学意义（P=0.52）。与基于引流的腹部整形术联合抽脂术相比，PTS 联合抽脂术的血清肿发生率更低（P=0.01）。
80%的患者接受了抽脂术，在引流组或 PTS 组中，接受抽脂术的患者并未增加血清肿的风险。更多的患者可能证实，在 PTS 中加入抽脂术实际上可以起到保护作用。尽管如此，在 PTS 无引流的腹部整形术上加用抽脂术并不会增加血清肿的发生率。
