Abdominoplasty is one of the most popular procedures performed in plastic surgery practices today. Over time, with the improvement in anatomical understanding of vasculature current dogma that perforator sparing procedures with limited undermining of the abdominal skin flap laterally improves the overall skin perfusion to the abdominal flap decreasing the potential for wound healing problems and complications.
Methods/Technique:
A prospective randomized trial was performed with 20 abdominoplasty patients (Age 31-55, all non-smoker, non-diabetic patients) from two senior authors (JMK, FEB) utilizing wide undermining (above the costal margins bilaterally) vs. limited undermining (up to the medial borders of the rectus bilaterally) with suction assisted liposuction of the abdominal flap. Using the SPY-Elite system perfusion studies were performed pre-op, and immediately post-op and recorded. Patients were followed for one month using standardized digital photography documenting any wound healing complications, or dehiscence in the 2 groups.
Results/Complications:
Preliminarily there was no abdominal perfusion differences identified between the two groups with or without undermining and liposuction. There was no difference in wound healing complications in either group regardless of technique performed
Conclusion:
Wide undermining in abdominoplasty failed to create decreased abdominal flap perfusion and did not correlate with an increased incidence of wound healing problems or complications. Despite the perceived benefit of limited undermining and perforator sparing abdominoplasty we failed to identify any clinical advantage or improvement in abdominal wall perfusion between the two groups so abdominoplasty patients.