One key to fit all locks? Routine internal drainage to minimize seromas during thigh lift surgeries

Abstract

Obesity is a worldwide epidemic. Complication rates after body contouring surgeries in massive weight loss patients were quite high, with seroma development being the second most common complication, reported rates averaging 15%-40%, Methods described to reduce the annoying high rate of seroma did not have a statistically significant difference in reducing seromas. Our aim was to find a universal solution that could be used with any body-contouring surgery to manage seromas. We tried this novel technique initially on thigh lifts. Instead of wading in the jungle of methods aiming at preventing seromas, we contemplated a drainage channel that would continuously drain any fluid accumulation. The idea was borrowed from the hypothesis of Thompson on lymphoedema management. By excising an area of deep fascia overlying the Vastus Medialis muscle, the muscle would be directly exposed to any seroma fluid and would imbibe it as blotting paper. Furthermore, this technique would open new drainage channels between the superficial and deep lymphatics. This technique was tried in 20 patients, with the excision of deep fascia carried only in one limb. The other limb was left as a control. Rates of seroma formation were noted and duration before it dried up. This technique significantly reduced the incidence of detected seromas and the amount of seroma fluid. This technique reduced the incidence of seroma formation, and is recommended for routine use during all thigh lift surgeries.