Department of Surgery and Physiology, Faculty of Medicine, Porto University, Porto, Portugal.
Plastic Surgery Department, Portuguese Institute of Oncology of Porto (IPO), Porto, Portugal.
Aesthet Surg J. 2021 Jun 14;41(7):NP804-NP819. doi: 10.1093/asj/sjaa428.
Many strategies have been developed to lower the high complication rate associated with a full abdominoplasty. The dissection technique may have a role to achieve this goal.
The present study compared 2 different dissection techniques to perform a full abdominoplasty with Scarpa fascia preservation: avulsion technique and electrodissection.
A retrospective observational cohort study was performed in 2 health institutions from January 2005 to January 2019. A total of 251 patients were involved: 122 patients submitted to abdominoplasty employing the avulsion technique (Group A) and 129 with diathermocoagulation (coagulation mode) (Group B). The latter was further divided into group B1 (57 patients with device settings according to surgeon's preferences) and B2 (72 patients with a specific regulation aiming at minimal tissue damage). Several variables were analyzed: population characteristics, time of hospital stay, time to drain removal, total and daily drain output, emergency department visits, readmission, reoperation, and local and systemic complications.
The general characteristics of both groups did not statistically significantly differ except for previous abdominal surgery. The diathermocoagulation group had a significantly lower length of hospital stay and time to drain removal. Moreover, these advantages were maximized when electrocautery was conducted with a specific low-voltage setting as significant differences were found. The other outcomes were identical.
Limiting the extension of electrodissection with the avulsion technique did not present any advantage. Utilizing diathermocoagulation (coagulation mode) during a full abdominoplasty with Scarpa fascia preservation, especially when it is aimed at minimal tissue damage, reduces patients' time with drains.
许多策略已经被开发出来，以降低与全腹部整形术相关的高并发症率。解剖技术可能在实现这一目标中发挥作用。
本研究比较了两种不同的解剖技术，即撕脱技术和电切术，以保留 Scarpa 筋膜行全腹部整形术。
这是一项在 2005 年 1 月至 2019 年 1 月期间在 2 家医疗机构进行的回顾性观察队列研究。共涉及 251 例患者：122 例患者采用撕脱技术（A 组）行全腹部整形术，129 例患者采用电切术（凝固模式）（B 组）。后者进一步分为 B1 组（57 例患者根据术者偏好设置设备参数）和 B2 组（72 例患者采用旨在最小化组织损伤的特定调节）。分析了以下几个变量：人口统计学特征、住院时间、引流管拔除时间、总引流量和日引流量、急诊就诊、再入院、再次手术以及局部和全身并发症。
除了既往腹部手术外，两组的一般特征均无统计学差异。电切组的住院时间和引流管拔除时间明显缩短。此外，当使用特定的低电压设置进行电切时，这些优势最大化，因为发现了显著差异。其他结果相同。
限制撕脱技术中电切的范围并没有带来任何优势。在保留 Scarpa 筋膜的全腹部整形术中使用电切（凝固模式），尤其是当旨在最小化组织损伤时，可以减少患者带管时间。
