Therapeutical Strategies to Prevent Abdominoplasty Complications: A Systematic Review

Background: Abdominoplasty is one of the most commonly performed procedures. Despite improvements in the abdominoplasty technique, seroma is the most common complication, ranging from 5 to 43%. This study aimed to review the literature to compare therapeutic strategies to prevent common adverse events in abdominoplasty.

Methods: This review analyzed patients of both sexes older than 18 years who underwent abdominoplasty with or without liposuction. This study analyzed the following endpoints: frequency of seromas, surgical site infection, hematoma, dehiscence, necrosis, death, treatment duration for adverse events, length of hospital stay, seroma/hematoma volume.

Results: We analyzed 24 articles, totaling 2997 participants with ages ranging from 18 to 85 years. The meta-analysis of 4 studies, with 180 participants, showed a 69% reduction in the occurrence of seroma when Scarpa's fascia preservation was adopted (OR, 0.38; 95%CI 0.16-0.91). Regarding other complications, Scarpa's fascia preservation showed a lower risk of infection (OR 0.31; 95%CI 0.12-0.79) and also lower risk of hematoma (OR 0.29; 95% CI 0.09-0.95) in seroma for Scarpa's fascia preservation when compared to not fascia's preservation.

Conclusion: This review suggests that Scarpa fascia preservation decreases seromas, infections, and hematomas. However, more randomized controlled trials are necessary to improve the level of certainty.

Level of evidence ii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .