Journal Logo

VIEWPOINTS

The Use of Suction Drains in Abdominal Dermolipectomy: A Randomized Clinical Trial

Borile, Giuliano M.D.; Pavelecini, Michel M.D.; Dreher, Rodrigo M.D.; Chem, Eduardo M.D.; Chem, Roberto Corrêa M.D., Ph.D.

Author Information
Plastic and Reconstructive Surgery: April 2008 - Volume 121 - Issue 4 - p 228e-229e
doi: 10.1097/01.prs.0000305389.29451.b0
  • Free

Sir:

We conducted a randomized trial with 63 abdominal dermolipectomy procedures performed at the Department of Plastic Surgery at Santa Casa Hospital Center–Fundação Faculdade Federal de Ciências Médicas de Porto Alegre between January 1, 2003, and April 20, 2004. After assessment and indication for abdominal dermolipectomy, patients were randomly allocated to two groups. Both groups underwent conventional surgery. Patients in group 1 (n = 30) received closed tubular drainage with negative pressure for the time needed to stabilize drainage volumes at 30 to 50 ml/day. Patients in group 2 (n = 33) did not receive any kind of drainage and were only made to wear a compressive garment during the postoperative period. Both groups received follow-up after hospital discharge and were examined on a weekly basis in the first 6 weeks after surgery and then fortnightly up to the third postoperative month. From the third to the sixth postoperative months, the patients were examined monthly. Those patients who presented clinical signs suggestive of fluid collections, such as swelling, contour deformities, extensive hematomas, or fluid waves, were treated with needle puncture and the volume of fluid collected was recorded.1,2 All patients were assessed according to the research protocol. Statistical analysis used the chi-square and Fisher’s exact tests, and p < 0.05 was considered significant.

Group 1 presented one case of fluid collection (seroma), which was diagnosed and drained around the tenth postoperative day. Group 2 presented three cases of fluid collection (one hematoma and two seromas), which were diagnosed on the seventh (hematoma) and ninth (seromas) postoperative days. There was no statistically significant difference between groups 1 and 2 with regard to fluid collection in the postoperative period.

We believe that because of their late presentation (between the sixth and tenth postoperative days), use of aspiration drains seems to have no effect on seroma prevention. In the case of the hematomas, it is believed that use of drains has an important role in monitoring bleeding in the first 24 hours after surgery. Later hematomas, such as the ones identified in this study, are not prevented by the use of drains, which are removed around the first or second postoperative day (when drainage volumes are less than 50 ml/24 hours). In addition, use of drains for extended periods is not advisable, as they increase discomfort and reduce patient mobility, which contributes to a higher incidence of morbidities such as local infections and thromboembolic accidents.3,4

The patient population in this study consisted of young women with early first pregnancy and multiple pregnancies and a history of recent weight loss. It was seen that the formation of fluid collections was not significantly affected by the use of drains.

Giuliano Borile, M.D.

Department of Plastic Surgery and Reconstructive Microsurgery

Santa Casa Hospital Center

Michel Pavelecini, M.D.

Rodrigo Dreher, M.D.

Department of Plastic Surgery and Reconstructive Microsurgery

Santa Casa Hospital Center

School of Plastic Surgery

Fundação Faculdade Federal de Ciências Médicas de Porto Alegre

Eduardo Chem, M.D.

Department of Plastic Surgery and Reconstructive Microsurgery

Santa Casa Hospital Center

Roberto Corrêa Chem, M.D., Ph.D.

Department of Plastic Surgery and Reconstructive Microsurgery

Santa Casa Hospital Center

School of Plastic Surgery

Fundação Faculdade Federal de Ciências Médicas de Porto Alegre

Porto Alegre, Brazil

REFERENCES

1. Kargi, E., Akduman, D., Dokuzoguz, B., et al. Late complication of abdominoplasty in an obese patient: Systemic inflammatory response syndrome and seroma. Plast. Reconstr. Surg. 111: 1568, 2003.
2. Baroudi, R., and Ferreira, C. A. Contouring the hip and the abdomen. Clin. Plast. Surg. 23: 551, 1996.
3. Chaouat, M., Levan, P., Lalanne, B., Buisson, T., Nicolau, P., and Mimoun, M. Abdominal dermolipectomies: Early postoperative complications and long-term unfavorable results. Plast. Reconstr. Surg. 106: 1614, 2000.
4. Manassa, E. H., Hertl, C. H., and Olbrisch, R. R. Wound healing problems in smokers and nonsmokers after 132 abdominoplasties. Plast. Reconstr. Surg. 111: 2082, 2003.

Section Description

GUIDELINES

Viewpoints, pertaining to issues of general interest, are welcome, even if they are not related to items previously published. Viewpoints may present unique techniques, brief technology updates, technical notes, and so on. Viewpoints will be published on a space-available basis because they are typically less timesensitive than Letters and other types of articles. Please note the following criteria:

Authors will be listed in the order in which they appear in the submission. Viewpoints should be submitted electronically via PRS' enkwell, at www.editorialmanager.com/prs/. We strongly encourage authors to submit figures in color.

We reserve the right to edit Viewpoints to meet requirements of space and format. Any financial interests relevant to the content must be disclosed. Submission of a Viewpoint constitutes permission for the American Society of Plastic Surgeons and its licensees and assignees to publish it in the Journal and in any other form or medium.

The views, opinions, and conclusions expressed in the Viewpoints represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the Journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such correspondence.

©2008American Society of Plastic Surgeons