We reviewed the charts of 276 patients who underwent abdominoplasty, panniculectomy or belt lipectomy at Mayo Clinic Rochester,MN between January 2003 and December 2005. The purpose of the review was to evaluate the minor and major complications and determine whether our current treatment algorithm affected outcome, when compared to the current literature. Here we present our current treatment algorithm for drain placement, the criteria for removal and their affect on short term outcome (initial twelve post operative months). Our criterion for drain removal is less than 30cc per drain, per 24 hour period. The overall seroma rate was 7.6%. In patients who had removal of the drain with greater than 30 cc in a 24 hour period, the seroma rate was 26%, versus 6 % of patients who had their drains removed if the output was less than 30cc/24 hour period.

Superficial skin necrosis/dehiscence occurred in 12% of patients. 66% of patients who developed skin necrosis/dehiscence underwent combination procedures including, ventral hernia repair, TAH/BSO, radical prostatectomy and ileostomy takedown. Minor complications (skin necrosis, cellulitis, hypertrophic scar, neuropraxia and dermatitis) occurred in 23.5% of the total patient population; moderate (seroma, umbilical ischemia) 9.4% and major (death, DVT, PE, hematoma and return to OR) 17.3%. When combined with GU and/or general surgery procedures the following complication rates were observed: minor 26%, moderate 8.4% and major 20.6%.

Our findings support our current treatment algorithm for drain removal. The complication rates of the combination cases are comparable to the current literature, and reinforce the necessity to educate this patient population on the short and long term expectations of these procedures.