title: Efficacy and Safety of Scarpa Fascia Preservation During Abdominoplasty: A Systematic Review and Meta-analysis.
abstract: BACKGROUND
  Scarpa fascia preservation might be a promising approach to reduce seroma and other complications after abdominoplasty. However, the results remained controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of scarpa fascia preservation in patients with abdominoplasty.
  
  
  METHODS
  PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials and clinical controlled trials assessing the effect of scarpa fascia preservation versus control (without scarpa fascia) during abdominoplasty were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcomes were seroma and hematoma/bleeding. Meta-analysis was performed using random-effect model.
  
  
  RESULTS
  Four studies involving 630 patients were included in the meta-analysis. Overall, compared with the control group, scarpa fascia preservation was associated with a significant reduced seroma (OR 0.16; 95% CI 0.06-0.43; P = 0.0004), time until drain removal (std. mean difference = -0.92; 95% CI -1.31 to -0.54; P<0.00001;), drain output (std. mean difference = -0.92; 95% CI -1.38 to -0.45; P = 0.0001), and hospital stay (std. mean difference = -0.93; 95% CI -1.48 to -0.39; P = 0.0008), but it failed to alter hematoma/bleeding (OR 0.46; 95% CI 0.09-2.38; P = 0.36), infection (OR 0.38; 95% CI 0.11-1.25; P = 0.11), and suture rupture (OR 0.67; 95% CI 0.12-3.73; P = 0.65) in patients with abdominoplasty.
  
  
  CONCLUSIONS
  Scarpa fascia preservation was associated with a significant decreased seroma, time until drain removal, drain output, and hospital stay, but could not change hematoma/bleeding, infection and suture rupture following abdominoplasty. Scarpa fascia preservation should be recommended during abdominoplasty.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Department of Burn and Plastic Surgery, Guizhou Provincial People's Hospital, Guiyang, China. 499081944@qq.com.
authors.forename: Xiangyang
authors.initials: X
authors.lastname: Xiao
authors.affiliation: Gastrointestinal Department of Internal Medicine, Guizhou Provincial People's Hospital, Guiyang, China.
authors.forename: Limin
authors.initials: L
authors.lastname: Ye
mesh_terms: D061645:Abdominoplasty / Q000009:adverse effects / Q000379:methods*; D005205:Fascia; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D059351:Organ Sparing Treatments / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D049291:Seroma / Q000517:prevention & control*; D013718:Tensile Strength; D014945:Wound Healing / Q000502:physiology
keywords: Abdominoplasty; Complication; Meta-analysis; Scarpa fascia preservation; Seroma