Scarpa Fascia Preservation During Abdominoplasty: What's the Point?

Abdominoplasty is one of the most popular body-contouring procedures. Previous studies described two different compartments in the lower abdominal wall: superficial and deep, separated by Scarpa fascia. Preservation of this fascial plane has been suggested as a way to lower the complication rate associated with conventional abdominoplasty, but solid evidence supporting this idea is lacking. The purpose of this study was to evaluate the effect of preservating Scarpa fascia during a full abdominoplasty.

A prospective study was made, involving patients submitted to abdominoplasty between November 2005 and November 2007 at the Department of Plastic Surgery of São João Hospital, Porto Medical School. Two groups of patients were created: patients who underwent classical full abdominoplasty (group A) and patient who underwent a full abdominoplasty with preservation of Scarpa fascia in the infra-umbilical region (group B). The variables analyzed, for each group, were: age, body mass index (BMI), previous abdominal surgery, comorbid medical conditions, specimen weight, time to suction drain removal, total volume of drain output and length of hospital stay. T-student and Mann-Whitney test were used to analyze continuous variables; χ2 test was used to analyze categorical variables.

A total of 208 full abdominoplasties were performed (group A, 143 patients; group B, 65 patients). There was no statistical difference between groups with respect to BMI, previous abdominal surgeries, comorbid medical conditions or surgical specimen weight (p>0.05). There was a statistically significant difference between both group on the total volume of drain output (p<0.001), time to drain removal (p<0.001) and hospital stay duration (p<0.001). The group with preservation of Scarpa’s fascia had an average reduction of the amount of drain output of more than 50% and an average reduction of 2.0 days on time to drain reduction and 1.9 days on hospital stay, when compared to the other group.

Preservation of Scarpa’s fascia during abdominoplasty has beneficial effect on patient recovery as it reduces total drain output, reduces time to drain removal and reduces hospital stay.