Thursday, March 23, 2006
9782

Controlled Study of Fibrin Sealants in Abdominoplasty

Dimitri Koumanis, MD

Abdominoplasty surgery is commonly performed as an outpatient procedure. A common sequalae is seroma fluid accumulation beneath the abdomoinal wall flap. Drain therapy has long been used to remove lymphatic fluid and allow the anterior fasciocutaneous flap to seal quickly. Authors have proposed however, that drains may actually produce additional reactive fluid and prolong initial healing time. Fibrin sealants have been used for several years in cardiac, vascular and intraabdominal surgery to seal anastomoses and minimize diffuse generalized surgical bed bleeding . We used fibrin sealants applied immediately prior to abdominoplasty flap closure in sixty (60) consecutive patients. A compartive and statistical evaluation of an aerosol sealant (Tisseel: Baxter) and a topical viscous sealant were (Orthovita) was compared against 60 controls. Factors analyzed included (1) Jackson Pratt output; (2) time to drain removal; (3) fap integrity; (4) complications. Our results indicated a (1) reduction in seroma formation (2) decreased drain output with a statistical P value (p<0.05). There was no difference in aerosol versus topical applications. Drains were removed an average of 2 days earlier than controls. We recommend fibrin sealant therapy as an adjunct in abdominoplasty and discuss future studies and applications in plastic surgery.