Abstract
Objective: To describe abdominoplasty by electrodissection technique for improving short-term complications.Design: A prospective controlled study consisting of 100 consecutive female candidates for abdominoplasty by electrodissection employing spray-coagulation was conducted . The technique and electrical current used are described in detail.Results: Intraoperative bleeding ranged from 25 to 160 ml, (median 85 ml). The short-term specific and general complication rates were very low, not exceeding the rates observed using cold scalpel. The frequency of seroma was 24% and the occurrence of seroma, total seroma volume, and total suction tube discharge were correlated to the area of dissection or depth of electrical tissue injury. Conclusion: Despite the relatively high frequency of seroma, we recommend the use of spray-coagulation for abdominoplasty because bleeding is minimized, visibility during dissection is highly increased and the rate of short-term complications is very low.
Highlights
Seroma is defined as the serous fluid collection under the skin flaps and dead space, which can eventually result in flap necrosis, wound dehiscence, delay in recovery, and adjuvant treatment, and usually requires repeated needle aspirations
A total of 83 patients had a completely uneventful postoperative course. In another 10 patients, remarkable hyperemia of the skin flaps lasting for 3–4 days was observed
In only one of these patients, a positive culture of Staphylococcus aureus from the drain fluid was obtained, and the patient was successfully treated with antibiotics
Summary
Since the 1970s, electrocautery has become a widespread surgical tool to raise the flaps and excise breast specimen to perform bloodless mastectomy [1]. Both experimental and clinical deleterious effects of electrocautery on wound healing and infection have been frequently reported [2,3]. Numerous evidences on the role of electrocautery in wound complications, especially seroma formation, have been reported [3,4,5]. Seroma is defined as the serous fluid collection under the skin flaps and dead space, which can eventually result in flap necrosis, wound dehiscence, delay in recovery, and adjuvant treatment, and usually requires repeated needle aspirations. Pro-inflammatory cytokines are known to increase in wounds after trauma [7,8], there have been only a few studies on the accumulation of cytokines in human wounds [9] and wound fluids [10,11]
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