Progressive tension sutures in the prevention of postabdominoplasty seroma: a prospective, randomized, double-blind clinical trial.
BACKGROUND
The purpose of this study was to evaluate the seroma reduction capabilities of progressive tension sutures and compare them with the conventional use of drains.


METHODS
Sixty female patients were randomized into four groups: group 1 (control, no drains, and no progressive tension sutures), group 2 (progressive tension sutures alone), group 3 (drains alone), and group 4 (progressive tension sutures and drains). All patients underwent a classic abdominoplasty and drains were left for 7 days in the corresponding groups. Clinical and ultrasound assessments were performed 2 weeks after the operation by blinded evaluators. Punctures, volumes, nonseroma complications, and aesthetic outcome were also measured.


RESULTS
Surgical time was 50 minutes longer in groups 2 and 4. Drain outputs were higher in group 3 than in group 4. The clinical and ultrasound seroma frequency was 35 percent and 90 percent respectively, without significant differences among the groups. The control group was interrupted at 10 patients because of considerably larger seromas and an increased amount of punctures needed for treatment. No differences were found in the other groups. There were no differences with respect to complication rates and aesthetic outcome after follow-up.


CONCLUSIONS
Progressive tension sutures increase surgical time, reduce drain outputs, and have the same clinical and ultrasound seroma frequency as the use of drains alone. The combination of both methods simultaneously does not add any advantages. However, complications and interventions increase if at least one of them is not used. The mechanism of action of progressive tension sutures could be the compartmentalization of the fluid collection under the flap facilitating absorption.
Andrades
Patricio
P
Santiago, Chile From the Plastic Surgery Division, Department of Surgery, Jose Joaquin Aguirre Clinical Hospital, University of Chile School of Medicine.
Prado
Arturo
A
Danilla
Stefan
S
Guerra
Claudio
C
Benitez
Susana
S
Sepulveda
Sergio
S
Sciarraffia
Carlos
C
De Carolis
Vicente
V
D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D004311:Double-Blind Method; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D049291:Seroma / Q000517:prevention & control*; D013536:Suture Techniques / Q000295:instrumentation*; D013718:Tensile Strength; D016896:Treatment Outcome