-
Views
-
Cite
Cite
Todd A Pollock, Commentary on: Reduced Seroma Risk in Drainless Abdominoplasty Using Running Barbed Sutures: A 10-Year, Multicenter Retrospective Analysis, Aesthetic Surgery Journal, Volume 40, Issue 5, May 2020, Pages 538–540, https://doi.org/10.1093/asj/sjz315
Close - Share Icon Share
Extract
Almost 24 years ago, I joined my father in practice and observed him placing sutures from the abdominal flap to the muscle fascia in an abdominoplasty and not utilizing drains. I inquired about this and pointed out that this was not a technique of which I was aware. He explained that he felt it was a basic surgical principle to close dead-space. He went on to say that he had been doing this for as long as he could remember and could not recall when he had last utilized a drain. (Later we found an operative report from 1978 that described placement of these sutures and no mention of drain placement.) He also could not recall when he had last seen a seroma. This conversation sparked a 20-year collaboration that would be one of the most rewarding of both our careers.
We began to consider the technique in terms of mechanism and repeatability. In regard to mechanism, we initially considered this to be simply a result of closing dead-space. With further thought, observation, and literature review, however, we came to realize that these sutures also added secure fixation of the flap to the underlying muscle fascia to prevent repeated disruption of the weak early healing from the inherent strong and multidirectional motion of the abdomen. Although suction drains have a similar effect, the strength of the suction can vary with the amount of fluid in the bulb and they are prone to mechanical failure. As well, the strength of the vacuum created by suction drains is not likely great enough to overcome the forces of the abdominal musculature.
