title: Progressive tension sutures in abdominoplasty: a review of 597 consecutive cases.
abstract: BACKGROUND
  Although abdominoplasty and other body-contouring procedures are being performed more frequently, the incidence of seroma and other complications has remained relatively unchanged. In 2000, a small retrospective series introduced progressive tension sutures (PTS) in abdominoplasty to reduce seroma without the use of drains.
  
  
  OBJECTIVE
  The authors review the PTS technique and their experience with the procedure.
  
  
  METHODS
  A retrospective chart review of 597 consecutive abdominoplasty patients treated over 12 years was performed. Collected data included surgical setting, concomitant procedures, and complications.
  
  
  RESULTS
  Of the 597 abdominoplasties, 52.4% were performed in the hospital and 47.6% in an American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)-accredited facility. In 63.7% of cases, abdominoplasty was combined with another procedure(s). Liposuction was performed on the abdominoplasty flap or an adjacent area to the abdominoplasty dissection in 67% of patients. The average amount fat aspirate from these areas was 953 mL. No drains were placed. The rate of local complications was 4.2%; all but one of these complications (seroma; 0.1%) were minor. There were no systemic complications related to PTS and no venous thromboembolisms.
  
  
  CONCLUSIONS
  PTS are an adjunct to abdominoplasty that can minimize seroma and potentially decrease other local complications. They provide secure fixation of the flap to eliminate motion and broadly transfer tension to the superficial fascial system. Drains can safely be eliminated from abdominoplasty, even when liposuction is performed. Systemic complications may be avoided and patient recovery expedited.
authors: Department of Plastic Surgery, University of Texas Southwestern, Dallas, 75231, USA. tap@drpollock.com
authors: Todd A
authors: TA
authors: Pollock
authors: Harlan
authors: H
authors: Pollock
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D005260:Female; D006801:Humans; D007297:Inpatients; D015187:Lipectomy; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000295:instrumentation*; D012189:Retrospective Studies; D049291:Seroma / Q000209:etiology / Q000517:prevention & control; D013524:Surgical Flaps; D013536:Suture Techniques / Q000009:adverse effects / Q000295:instrumentation*; D013537:Sutures; D013781:Texas; D013997:Time Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control; D055815:Young Adult