Abstract
INTRODUCTION: The most effective dissection technique for raising the flap in abdominoplasty is still controversial. Bipolar coagulation (Ligasure Impactª, LS, Covidien, Dublin, Ireland) is an energy device commonly used among different surgical specialties to reduce morbidity and implement outcomes. We investigated the effectiveness of LS in abdominoplasty compared with the conventional techniques (CT), scalpel and/or diathermia. MATERIALS AND METHODS: Patients underwent primary abdominoplasty at a single center over 8 years were retrospectively reviewed. Bodylift, secondary operations and procedures with other energy devices were excluded. Ninety-four patients underwent a primary abdominoplasty and were divided into two groups on basis of the dissection technique: LigaSure (LS) group (29 patients) and the conventional technique (CT) group (65 patients). Patient demographics, perioperative parameters, postoperative complications and hospital stay were compared. Early complications were graded according to Clavien-Dindo classification system. RESULTS: Significant differences were found in intraoperative blood loss favouring LS-group (259.6 ± 198.8 ml vs 377.9 ± 190.0 ml, p = 0.004) and blood transfusion rates (13.8 % vs 35.4 %, p = 0.047). Overall complications occurrence, Clavien-Dindo grade II (24.1 % vs 55.4 %) and grade III (13.8 % vs 30.8 %) complications were significantly lower in LS-group (respectively, p = 0.005, p = 0.007, p = 0.016). Late (>30 days) re-operation rate was 6.9 % in LS-group and 27.70 % in CT-group, which was significantly different (p = 0.0028). However, operative time was significantly longer in LS-group (168.6 ± 121.2 vs 179.7 ± 57.6 min, p = 0.005), while a tendency to shorter hospital stay was found in LS.group (3.6 ± 1.1 days vs 4.6 ± 3.2 days, p = 0.081). Specific wound complications showed no significant difference. CONCLUSIONS: LigaSure Impact may be beneficial in improving abdominoplasty outcomes because it might reduce blood loss, need for transfusions, complications and re-operations.
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