Does Scarpa's Fascia Preservation in Abdominoplasty Reduce Seroma? A Systematic Review.

Abstract

Abdominoplasty is a widely utilized cosmetic surgery procedure. Despite its popularity, seroma formation remains a prevalent complication. This can lead to extended recovery time, increased medical appointments and the potention for infection or the need for additional surgical revision. Preserving Scarpa's fascia may mitigate the risk of seroma in patients following abdominoplasty. The goal of this systematic review is to determine the impact of preserving Scarpa's fascia on the occurrence of seroma and total drain output following an abdominoplasty procedure. This systematic review searched academic literature in MEDLINE (via PubMed, National Institutes of Health, Bethesda, MD), EMBASE (OvidSP) (Elsevier, Amsterdam, the Netherlands), and The Cochrane Central Register of Controlled Trials (Wiley, Hoboken, NJ). for clinical and observational studies published in peer-reviewed journals from inception to November 2022, which evaluated the impact of preserving Scarpa's fascia on postoperative seroma and total drain output during abdominoplasty. The primary outcomes of interests were seroma and total drain output, with secondary outcomes of interests including hematoma, time to drain removal, length of hospital stay, wound dehiscence and infection rate. This systematic review of 8 studies, involving 846 patients, found that the preservation of Scarpa's fascia during an abdominoplasty procedure was associated with decreased seroma occurrence, reduced drain output, faster drain removal, and less infections. However, it did not affect the incidence of hematoma, hospital stay duration, or wound dehiscence. The preservation of Scarpa's fascia during an abdominoplasty procedure should be considered as a routine practice, as it has been shown to result in reduced seroma incidence rates and faster drain removal.