Scarpa Fascia versus Rectus Sheath Plane in Lipoabdominoplasty Flap Dissection: Comparative Study

Document Type : Original Article

Authors

The Department of Plastic Surgery, Faculty of Medicine, Alexandria University, Egypt

Abstract

Background: Abdominoplasty and lipoabdominoplasty
are frequently performed aesthetic procedures to improve the
contour of the abdomen and flanks. The improvement obtained
would positively impact the patient's self-image and life
quality. A lot of potential complications would compromise
surgeon/patient satisfaction, the most frequent being seroma
formation. A lot of measures/techniques were advocated to
reduce seroma incidence including the use of suction drain,
dead space obliteration by quilting sutures, and preservation
of infraumbilical Scarpa fascia/deep fat layer. The latter is
the focus of the current comparative study.
Patients and Methods: 40 full lipoabdominoplasty cases
were randomized into 2 equal groups based on the infraumbilical
dissection plane. Group A with traditional rectus sheath
dissection plane and group B with supra Scarpa dissection
plane. Post-operative drainage volume, time of drain removal,
and incidence of symptomatic seromas were documented.
Results: Drainage volume and duration of drainage were
significantly lower in the supra Scarpa dissection group (B)
than those of the rectus plane group (A) (p < 0.001). Clinically
evident seroma was detected in 3 cases of group (A) and one
case of group (B). All resolved after 2-3 aspirations in outpatient
settings. Both groups were homogenous regarding BMI,
age, volume of lipoaspirate, weight of excised dermofat and
mean operative time.
Conclusion: Scarpa fascia/deep fat preservation significantly
reduced the drainage volume and duration. A lower
seroma incidence was also observed.

Keywords

Main Subjects


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