title: Abdominoplasty flap elevation in a more superficial plane: decreasing the need for drains.
abstract: BACKGROUND
  Abdominoplasty has continued to become more frequently performed in the post-bariatric surgery and aesthetic patient populations. With the increase in these procedures, there is a need to decrease the length of drains for patient comfort and postoperative recovery. The authors' hypothesis was that a more superficial plane of abdominal flap elevation during abdominoplasty would decrease the postoperative need for drains.
  
  
  METHODS
  The authors reviewed 202 consecutive abdominoplasties with 99 procedures performed using a standard suprafascial dissection (group I) and 103 procedures using a modified plane of flap elevation that preserves the thin areolar tissue along the abdominal wall (group II). Patient demographics, perioperative complications, and drain data were recorded.
  
  
  RESULTS
  Patient characteristics did not differ significantly, with the mean age of group I and group II (44 +/- 8.9 years and 44 +/- 9.6 years, respectively) and body mass index of group I and group II (24 +/- 3.8 and 24 +/- 3.8, respectively) being similar. Perioperative complications included seven seromas in group I and two seromas in group II. There were two minor hematomas in group I and two minor hematomas in group II. The drains for patients in group II met criteria for removal 3 days earlier than those for group I (p < 0.0001). On average, patients in group II had drains removed at postoperative days 4 to 5.
  
  
  CONCLUSIONS
  Flap elevation in a plane superficial to the standard suprafascial approach during abdominoplasty may decrease the length of time required for drains in the postoperative period in the abdominoplasty patient. Decreasing the length of time for postoperative drains may improve patient comfort and expedite recovery.
authors.affiliation: Chicago, Ill.; and Boston, Mass. From the Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, and the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Fang
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Lin
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Mustoe
mesh_terms: D034861:Abdominal Wall / Q000502:physiology / Q000601:surgery*; D000328:Adult; D050110:Bariatric Surgery; D004322:Drainage / Q000379:methods*; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D008208:Lymphatic System / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control* / Q000628:therapy; D049291:Seroma / Q000517:prevention & control* / Q000628:therapy; D013518:Surgery, Plastic / Q000379:methods*; D013524:Surgical Flaps