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Drain-free abdominoplasty

Researchers say their new study showing that the use of progressive tension sutures without drains decreases seroma rates adds to mounting evidence that surgeons should consider abandoning drain use in abdominoplasty and use the progressive tension suture technique.

Published papers have suggested seroma rates are higher, ranging from 2% to 26% with drains, versus 0.1% to 4% with progressive tension sutures without drains, according to the study’s abstract.

In this study, plastic surgeons reported on a single surgery center experience with 451 abdominoplasties from 2009 to 2015, after they adopted progressive tension sutures without drains.

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Retrospectively, they compared seroma, wound complication, scar revision, hematoma and follow up between those patients who received progressive tension sutures without drains and those with a traditional abdominoplasty using drains.

They found seroma rates with progressive tension sutures decreased to 2% versus 9% in the drain group. Hematoma rates and wound complications were similar between the groups, but scar revision was higher among progressive tension suture patients at 17%, compared to 10% for those that had traditional abdominoplasty.

Dr. MaciasThe study’s lead author Luis Humberto Macias, M.D., clinical assistant professor of surgery and director of aesthetic surgery at Keck School of Medicine, University of Southern California, Los Angeles, tells Cosmetic Surgery Times that the study offers key messages for surgeons who perform abdominoplasty.

“Use of progressive tension sutures in the No-Drain Tummy Tuck instead of drains (which is why drains were placed) decreases seroma rate by over four-fold,” Dr. Macias says. “The use of drains in abdominoplasty will be a thing of the past as surgeons gain experience with the progressive tension technique.”

Dr. Macias, who practices at Marina Plastic Surgery in Marina del Rey, Calif., says that patients experience easier recoveries when surgeons don’t use drains.

“There is some evidence that the No-Drain Tummy Tuck will lead to quicker recovery and return to work,” he says.

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