title: The use of a fibrin glue with a low concentration of thrombin decreases seroma formation in postbariatric patients undergoing circular abdominoplasty.
abstract: BACKGROUND
  The serum collection under the abdominal flap is the most common complication after a lipo-abdominoplasty. The frequency of seroma increases further among obese patients, who have achieved massive weight loss after bariatric surgery. The purpose of this study is to demonstrate the effectiveness of fibrin glues with a low concentration of thrombin in reducing seroma formation after a lipo-abdominoplasty.
  
  
  METHODS
  Thirty patients, that had achieved a significant weight loss after an intervention of laparoscopic adjustable gastric banding (LAGB), underwent a circular lipo-abdominoplasty at our bariatric surgery department. Patients were divided into two groups of 15 subjects each: group A underwent traditional surgery; in group B, we applied a slow-clotting variant of fibrin glue (ARTISS, Baxter) under the abdominal flap. All subjects were evaluated clinically using an ultrasound device on postoperative day 15. We considered positive for seroma, those cases with a liquid collection greater than 20 cc.
  
  
  RESULTS
  The groups were homogeneous for age, BMI, male/female ratio, and diabetic or smoker patients. The mean hospital stay was significantly longer in group A than in group B. We found eight cases of serum collection >20 cc in group A and only one case in group B. Hematoma, umbilicus necrosis, and surgical site infection occurred in both groups, but overall complication rate was lower in group B.
  
  
  CONCLUSIONS
  The use of a fibrin glue with a low concentration of thrombin could be useful during wound closure and may decrease seroma formation in postbariatric patients undergoing lipo-abdominoplasty.
authors.affiliation: Department of Medicine and Surgery, University of Salerno, Via Giovanni Paolo II, 132, 84084, Fisciano Salerno, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pilone
authors.forename: Antonio
authors.initials: A
authors.lastname: Vitiello
authors.forename: Ciro
authors.initials: C
authors.lastname: Borriello
authors.forename: Stefano
authors.initials: S
authors.lastname: Gargiulo
authors.forename: Pietro
authors.initials: P
authors.lastname: Forestieri
mesh_terms: D061645:Abdominoplasty / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D050110:Bariatric Surgery; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D006801:Humans; D007902:Length of Stay; D015187:Lipectomy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D011184:Postoperative Period; D049291:Seroma / Q000453:epidemiology / Q000517:prevention & control*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000453:epidemiology; D013917:Thrombin / Q000008:administration & dosage*; D015431:Weight Loss
chemical_list: D015718:Fibrin Tissue Adhesive; D013917:Thrombin