Department
of Surgery, Faculty of Medicine , Cairo University
Kasr El-Aini Journal of Surgery,
2005; 6 (2) May
Abdominoplasty is one of the commonest
plastic surgery procedures done worldwide, however, it is plagued by a
number of local complications including; hematoma and seroma formation,
flap necrosis and hypertrophic scars. To avoid these complications, suction
drainage and limitation of postoperative ambulation are widely used by
most surgeons. The use of progressive tension sutures (PTS) has been introduced
in plastic surgery in various operations to ease the advancement of various
skin flaps. The basic concept of their use in abdominoplasty is to control
redrapping of the abdominal flap eliminating dead space and nullifying
the need for drains. It also avoids tension on the terminal suture lines
by dividing flap tension over many successive points thus minimizing the
possibility of flap edge necrosis and allowing early postoperative ambulation.
Progressive tension sutures were used in 15 cases. No drains were used
and early ambulation was allowed in all cases. The incidence of complications
was very low (0.13%), minimal seroma was encountered in one case (6.65%)
and was managed conservatively and superficial flap necrosis in another
case (6.65%) which was managed by repeated dressings. The average duration
of operation was 2.4 hours and the average postoperative hospital stay
was 2.6 days. These results suggest that the use of progressive tension
sutures in abdominoplasty reduces the risk of local complications, ease
the early postoperative period without adding significant operative time
or hospital stay.
