Outcome after preservation of Scarpa’s fascia in abdominoplasty

Abstract

Background Postoperative seroma formation remains the most frequent complication following abdominoplasty. The exact pathogenesis of postabdominoplasty seroma remains unclear. Both the process of flap elevation and redundant skin resection disrupt lymphatic drainage in the immediate postoperative period. Preservation of the Scarpa’s fascia in abdominoplasty leads to preservation of deep lymphatic vessels. Patients and methods Thirty-eight patients underwent abdominoplasty (18 of them with Scarpa’s fascia preservation) in the General Surgery Department of Menoufia University Hospital in the period between April 2015 and May 2017. Comparison was done between classic technique and Scarpa’s fascia preservation regarding early outcomes and postoperative complications. Results With Scarpa’s fascia preservation, the mean total drain output (171.5±72.18 ml) was much lesser than classic abdominoplasty (702±136.7 ml); moreover, drains were removed earlier with Scarpa’s fascia preservation (P=0.001 and 0.002, respectively). All patients passed without seroma formation in Scarpa’s fascia preservation group; however, in the group of classic abdominoplasty, seroma was detected in three (15%) patients. In Scarpa’s fascia preservation group, minor wound dehiscence occurred in two (11%) patients and asymmetry in two (11%) other patients, whereas in the other group, two (10%) patients presented with minor wound dehiscence and two (10%) patients developed wound infection. Conclusion Preservation of Scarpa fascia during abdominoplasty has a beneficial effect on patient recovery, reducing total drain output, time to drain removal, and hospital stay.