Continuous-infusion local anesthetic pain pump use and seroma formation with abdominal procedures: is there a correlation?
BACKGROUND
Seroma formation is the most commonly occurring complication in plastic surgery abdominal procedures. Continuous local anesthetic pain pump delivery systems are often used to decrease postoperative pain. An unreported concern with use of these devices in abdominal procedures is the effect of continuous fluid infiltration of the surgical site and a possible increase in the incidence of seroma formation.


METHODS
The authors performed a retrospective chart review to evaluate all patients (n = 159) who underwent abdominal procedures (abdominoplasty, panniculectomy, and transverse rectus abdominis myocutaneous flap harvest) over a 3-year period. Patient charts were evaluated for sex, age, body mass index, procedure performed, surgeon, operation length, pain pump use, postoperative seroma formation, and any complications. In cases with pain pump use, catheter placement location, anesthetic medication and strength, continuous-infusion rate, and duration of pain pump use were also reviewed. If a postoperative seroma formation was identified, treatment and outcomes were also recorded.


RESULTS
The overall seroma formation rate was 11.3 percent (18 of 159 patients). Other complications occurred at a rate of 2.5 percent (four of 159). The incidence of seroma was 11.0 percent (11 of 100) in patients with pain pump use versus 11.9 percent (7 of 59) in those who did not use a pain pump. There was no statistically significant difference (p = 0.9) in the incidence of seroma formation between those who did and did not use a pain pump device.


CONCLUSIONS
There was no correlation between increased rate of seroma formation and use of a continuous-infusion local anesthetic pain pump system in our patient population.
Smith
Melissa M
MM
Orange, Calif. From the Aesthetic and Plastic Surgery Institute, University of California, Irvine.
Hovsepian
Raffi V
RV
Markarian
Mark K
MK
Degelia
Amber L
AL
Paul
Malcolm D
MD
Evans
Gregory R D
GRD
Wirth
Garrett A
GA
D000005:Abdomen / Q000601:surgery; D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects* / Q000706:statistics & numerical data*; D000772:Anesthesia, Local / Q000009:adverse effects / Q000706:statistics & numerical data; D015992:Body Mass Index; D005260:Female; D006801:Humans; D015994:Incidence; D007260:Infusion Pumps; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy* / Q000453:epidemiology*; D017568:Rectus Abdominis / Q000601:surgery; D012189:Retrospective Studies; D049291:Seroma / Q000453:epidemiology* / Q000209:etiology; D013524:Surgical Flaps