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Background: Seroma formation is the most common complication in abdominoplasty procedure. The primary objective of this review was to assess the effect of three different abdominoplasty techniques, namely progressive tension sutures, application of glue and elevation of flap in a superficial Scarpa’s plane, on the outcome of seroma formation in abdominoplasty and other secondary outcomes.
Methods: The following electronic databases were searched: Cochrane Library, MEDLINE (via Ovid), EMBASE (via Ovid), World Health Organisation (WHO) International Clinical Trials Registry Platform , with no language restriction. Studies were included according to pre-specified inclusion and exclusion criteria. Data for the outcome of interest were extracted. Treatment effect was investigated with Review Manager software tool.
Results: Out of 121 citations 15 studies fulfilled the inclusion / exclusion criteria for the final analysis involving 1824 patients. Four randomised controlled trials (RCTs) and eleven non-randomised studies (NRS) were identified with five studies for each group. The risk of bias across the study designs was high mainly due to the non-randomised nature of the majority of the studies. The patients in the quilting group and those undergoing superficial fascia (Scarpa’s group) abdominoplasty have a reduced incidence of seroma formation and time till drain removal compared to patients undergoing standard abdominoplasty. Patients in the glue group do not appear to have significant change in outcome compared to the control arm.
Conclusion: The data suggests that progressive tension sutures and raising the flap in a more superficial plane (Scarpa’s fascia) can reduce the incidence of seroma but using fibrin glue has no impact on the occurrence of seroma.