Mohamed, A., Elsayed, M., Abdelmaogood, A. (2024). The Effect of Combining Progressive Tension Sutures with Autologous Platelet Gel Sealant Effect on Reducing Seroma Incidence after Lipoabdominoplasty. The Egyptian Journal of Plastic and Reconstructive Surgery, 48(2), 111-120. doi: 10.21608/ejprs.2024.352132
Ahmed Elhussein Mohamed; Mahmoud Mohamed Shaker Elsayed; Asmaa K. K. Abdelmaogood. "The Effect of Combining Progressive Tension Sutures with Autologous Platelet Gel Sealant Effect on Reducing Seroma Incidence after Lipoabdominoplasty". The Egyptian Journal of Plastic and Reconstructive Surgery, 48, 2, 2024, 111-120. doi: 10.21608/ejprs.2024.352132
Mohamed, A., Elsayed, M., Abdelmaogood, A. (2024). 'The Effect of Combining Progressive Tension Sutures with Autologous Platelet Gel Sealant Effect on Reducing Seroma Incidence after Lipoabdominoplasty', The Egyptian Journal of Plastic and Reconstructive Surgery, 48(2), pp. 111-120. doi: 10.21608/ejprs.2024.352132
Mohamed, A., Elsayed, M., Abdelmaogood, A. The Effect of Combining Progressive Tension Sutures with Autologous Platelet Gel Sealant Effect on Reducing Seroma Incidence after Lipoabdominoplasty. The Egyptian Journal of Plastic and Reconstructive Surgery, 2024; 48(2): 111-120. doi: 10.21608/ejprs.2024.352132
The Effect of Combining Progressive Tension Sutures with Autologous Platelet Gel Sealant Effect on Reducing Seroma Incidence after Lipoabdominoplasty
1The Department of Plastic Surgery, Faculty of Medicine, Suez Canal University, Ismailia
2The Department of Clinical & Chemical Pathology, Faculty of Medicine, Suez Canal University, Ismailia
Abstract
Background: Seroma is frequently a self-limiting condition; it might have negative consequences such as infection, flap necrosis, wound dehiscence, and spontaneous drainage through the surgical site. Seroma treatment is time-consuming as it may necessitate several sessions of aspirations, probable drain insertion, and revision procedures. Objective: This study aimed to verify whether combining progressive tension sutures with autologous platelet gel sealant decreased the incidence of seroma formation after lipoabdominoplasty. Methods: This was a prospective, case-controlled, and randomized clinical study of forty female patients, aged 25- 55 years, that was carried out from January 2023 to October 2023. All patients were seen at the plastic surgery outpatient clinic at Suez Canal University Hospital. Patients were allocated randomly into two equal groups: the study group [A] had lipoabdominoplasty combined with progressive tension sutures and autologous platelet gel, while the control group < br />[B] had lipoabdominoplasty alone. A closed suction drain was used in both groups, and total drain output was measured every 24 hours after surgery until the drains were removed. Clinical examinations were used as a subjective assessment at 2, 4, 6, and 8 weeks after surgery, while the incidence of wound disruption or skin sloughing was used as an objective assessment of seroma. The results of the two groups were documented and statistically analysed. Results: Regarding both subjective and objective assessments of seroma formation, there were statistically significant differences between the two groups. The amount of drain output in lipoabdominoplasty with combined PTS and sealant platelet gel (group A) was considerably lower than the control group (p-value <0.00001). The drain removal time (days) was much longer in group B (the control group), with a statistically significant difference between both groups (p-value <0.00001). The incidence of wound dehiscence and flap necrosis was recorded only in the control group (B). Conclusion: Combining progressive tension sutures with autologous platelet gel sealant as an adjuvant in lipoabdominoplasty reduced the incidence of seroma formation after this procedure.
The Aesthetic Society’s Cosmetic Surgery National Data Bank: Statistics 2020. Aesthet Surg. J., 41 (Supplement 2): 1-16, 2021. 2- State Public Health Statistics | America’s Health Rankings. http://www.americashealthrankings.org/explore/2015-annu al-report/measure/Obesity/state/ALL. Accessed May 7, 2016. 3- Cosmetic Surgery National Data Bank Statistics. Aesthetic Surg. J., 36 (Suppl 1): 1-29, 2016. 4- Neaman K.C. and Hansen J.E.: Analysis of complications from abdominoplasty: A review of 206 cases at a university hospital. Ann. Plast. Surg., 58: 292-298, 2007. 5- Teimourian B. and Adham M.N.: A national survey of complications associated with suction lipectomy: What we did then and what we do now. Plastic Reconstructive Surg., 105 (5): 1881-1884, 2000. 6- Hurvitz K.A., Olaya W.A., Nguyen A., et al.: Evidence– based medicine: Abdominoplasty. Plast. Reconstr. Surg., 133: 1214-1221, 2014. 7- Floros C. and Davis P.K.: Complications and long-term results following abdominoplasty: A retrospective study. Br. J. Plastic Surg., 44 (3): 190-194, 1991. 8- Cheng L.F., Lee J.T., Hsu H. and Wu M.S.: Simple skin-stretching device in assisted tension-free wound closure. Ann. Plast. Surg., 78 (3 Suppl 2): S52-S57, 2017. 9- Van Uchelen J.H., Werker P.M. and Kon M.: Complications of abdominoplasty in 86 patients. Plastic Reconstructive Surg., 107 (7): 1869-1873, 2001. 10- Nahas F.X., Ferreira L.M. and Ghelfond C.: Does quilting suture prevent seroma in abdominoplasty? Plastic Reconstructive Surg., 119 (3): 1060-1066, 2007. 11- Zimman O.A., Butto C.D. and Ahualli P.E.: Frequency of seroma in abdominal lipectomies. Plastic Reconstructive Surg., 108 (5): 1449-1451, 2001. Egypt, J. Plast. Reconstr. Surg., April 2024 119 12- Lee K.T. and Mun G.H.: Fibrin Sealants and Quilting Suture for Prevention of Seroma Formation Following Latissimus Dorsi Muscle Harvest: A Systematic Review and Meta-analysis. Aesthetic Plastic Surg., 39 (3): 399-409, 2015. 13- Stewart K.J., Stewart D.A., Coghlan B., Harrison D.H., Jones B.M. and Waterhouse N.: Complications of 278 consecutive abdominoplasties. J. Plastic Reconstructive Aesthetic Surg., 59 (11): 1152-1155, 2006. 14- Coon D., Gusenoff J.A., Kannan N., El Khoudary S.R., Naghshineh N. and Rubin J.P.: Body mass and surgical complications in the post bariatric reconstructive patient: Analysis of 511 cases. Ann. Surg., 249 (3): 397-401, 2009. 15- Kim J. and Stevenson T.R.: Abdominoplasty, liposuction of the flanks, and obesity: analyzing risk factors for seroma formation. Plastic Reconstructive Surg. ;117(3): 773- 781, 2006. 16- Araco A., Gravante G., Araco F., Sorge R. and Cervelli V.: Postoperative seromas after abdominoplasty: A retrospective analysis of 494 patients and possible risk factors. Plastic Reconstructive Surg., 123 (4): 158e-159e, 2009. 17- Pogson C.J., Adwani A. and Ebbs S.R.: Seroma following breast cancer surgery. Eur. J. Surg. Oncol., 29 (9): 711- 717, 2003. 18- Mohammad J.A., Warnke P.H. and Stavraky W.: Ultrasound in the diagnosis and management of fluid collection complications following abdominoplasty. Ann. Plastic Surg., 41 (5): 498-502, 1998. 19- Nasr M.W., Jabbour S.F., Mhawej R.I., Elkhoury J.S. and Sleilati F.H.: Effect of Tissue Adhesives on Seroma Incidence After Abdominoplasty: A Systematic Review and Meta-Analysis. Aesthetic Surg. J., 36 (4): 450-458, 2016. 20- Matarasso A.: Liposuction as an adjunct to a full abdominoplasty. Plastic Reconstructive Surg., 95 (5): 829-836, 1995. 21- Teimourian B.: Management of seroma in abdominoplasty. Aesthetic Surg. J., 25 (5): 510-511, 2005. 22- Sforza M., Husein R., Andjelkov K., Rozental-Fernandes P.C., Zaccheddu R. and Jovanovic M.: Use of Quilting Sutures During Abdominoplasty to Prevent Seroma Formation: Are They Really Effective? Aesthetic Surg. J., 35 (5): 574-580, 2015. 23- Krueger J.K. and Rohrich R.J.: Clearing the smoke: the scientific rationale for tobacco abstention with plastic surgery. Plastic Reconstructive Surg., 108 (4): 1063-1077, 2001. 24- Di Martino M., Nahas F.X., Barbosa M.V.J., et al.: Seroma in lipoabdominoplasty and abdominoplasty: A comparative study using ultrasound. Plastic Reconstructive Surg., 126 (5): 1742-1751, 2010. 25- Ersek R.A. and Schade K.: Subcutaneous pseudo bursa secondary to suction and surgery. Plastic Reconstructive Surg., 85 (3): 442-445, 1990. 26- Roje Z., Roje Z, Karanovi´c N. and Utrobici´c I.: Abdominoplasty complications: A comprehensive approach for the treatment of chronic seroma with pseudo bursa. Aesthetic Plastic Surg., 30 (5): 611-615, 2006. 27- Toman N., Buschmann A. and Muehlberger T.: [Fibrin glue and seroma formation following abdominoplasty]. Chir Z Für Alle Geb Oper Medizen, 78 (6): 531-535, 2007. 28- Zecha P.J. and Missotten F.E.: Pseudocyst formation after abdominoplasty-extravasations of Morel-Lavallée. Br. J. Plastic Surg., 52 (6): 500-502, 1999. 29- Pilone V., Vitiello A., Borriello C., Gargiulo S. and Forestieri P.: The use of a fibrin glue with a low concentration of thrombin decreases seroma formation in post bariatric patients undergoing circular abdominoplasty. Obesity Surg., 25 (2): 354-359, 2015. 30- Khan U.D.: Risk of seroma with simultaneous liposuction and abdominoplasty and the role of progressive tension sutures. Aesthetic Plast Surg., 32: 93-99, 2008. 31- Stoff A., Reichenberger M.A. and Richter D.F.: Comparing the ultrasonically activated scalpel (Harmonic) with high frequency electrocautery for postoperative serous drainage in massive weight loss surgery. Plastic Reconstructive Surg., 120 (4): 1092-1093, 2007. 32- Jabbour S., Awaida C. and Mhawej R.: Does the addition of progressive tension sutures to drains reduce seroma incidence after abdominoplasty? A systematic reviewand meta-analysis. Aesthet. Surg. J., 37: 440-447, 2017. 33- Bercial M.E., Sabino Neto M., Calil J.A., et al.: Suction drains, quilting sutures, and fibrin sealant in the prevention of seroma formation in abdominoplasty: Which is the best strategy? Aesthetic Plast Surg., 36: 370-373, 2012. 34- Mladick R.A.: Progressive tension sutures to reduce complications in abdominoplasty. Plastic Reconstructive Surg., 107 (2): 619, 2001. 35- Baroudi R. and Ferreira C.A.: Seroma: How to avoid it and how to treat it. Aesthetic Surg J., 18 (6): 439-441, 1998. 36- Fang C.L., Hsu C.H., Yang H.Y., et al.: Using of progressive tension sutures and close drainage can prevent seroma occurrence in abdominal wall repair with mesh or direct repair after DIEP flap harvesting. J. Taiwan Soc. of Plast Surg., 27: 1-11, 2018. 37- Andrades P., Prado A., Danilla S., et al.: Progressive tension sutures in the prevention of post abdominoplasty seroma: A prospective, randomized, double-blind clinical trial. Plastic Reconstructive Surg., 120 (4): 935-946-951, 2007. 38- Pollock H. and Pollock T.: Progressive tension sutures: Atechnique to reduce local complications in abdominoplasty. Plastic Reconstructive Surg., 105 (7): 2583-2586-2588, 2000. 39- Pollock T. and Pollock H.: Progressive tension sutures in abdominoplasty. Clin. Plastic Surg., 31 (4): 583-589, vi, 2004. Vol. 48, No. 2 / Combining Progressive Tension Sutures Autologous Platelet G 120 el Sealant Reducing Seroma 40- Antonetti J.W. and Antonetti A.R.: Reducing seroma in outpatient abdominoplasty: Analysis of 516 consecutive cases. Aesthetic Surg J., 30 (3): 418-425, 2010. 41- Gutowski K.A. and Warner J.P.: Incorporating barbed sutures in abdominoplasty. Aesthetic Surg. J., 33 (3 Suppl): 76S-81S, 2013. 42- Melmed E.P.: Autologous platelet gel in plastic surgery. Aesthetic Surg. J., Jul. 21 (4): 377-9. doi: 10.1067/ maj.2001.118027. PMID: 19331920, 2001. 43- Czinn E.A. and Chediak J.R.: Coagulation and hemostasis. In: Salem M.R., ed. Blood Conservation in the Surgical Patient. Baltimore; Williams & Wilkins, 45-51, 1996. 44- Nasr M.W., Jabbour S.F., Mhawej R.I., Elkhoury J.S. and Sleilati F.H.: Effect of Tissue Adhesives on Seroma Incidence. Quoted from Pierce G.F., Cande Berg J., Rudolph R., et al. Abdominoplasty: A Systematic Review and Meta- Analysis. Aesthet. Surg. J., 36 (4): 450-458, 2016. 45- Cruz-Korchin N. and Korchin L.: The Use of Fibrin Sealant (Tisseel) in Abdominoplasty: 17. Plastic Reconstructive Surg., 116 (3): 23-5, 2005. 46- Bercial M.E., Neto M.S., Calil J.A., Rossetto L.A. and Ferreira L.M.: Suction Drains, Quilting Sutures, and Fibrin Sealant in the Prevention of Seroma Formation in Abdominoplasty: Which is the Best Strategy? Aesthetic Plastic Surg., 36 (2): 370-3, 2012. 47- Greenberg B.M. and Koumanis D.: Fibrin Sealants: Use in Abdominoplasty, 2006. 48- Toman N., Buschmann A. and Muehlberger T.: Fibrinkleber und Serombildung Nach Abdominoplasty Chirurg., 78 (6): 531-5, 2007.
View on SCiNiTO
Top