Drainless Abdominoplasty in the Bariatric Patient
There have been several recent studies describing techniques that allow abdominoplasty to be performed safely without the need for drains. This has not however been described in the case of the bariatric patient who is often considered to be a higher risk patient. We describe our experience of drainless abdominoplasty in patients who have undergone massive weight loss after a bariatric procedure.
Methods/Technique: A database of all drainless abdominoplasties performed using the progressive tension suture technique over a 2-year period was analyzed retrospectively. Patients were divided into 2 groups- Group A were those who had undergone massive weight loss after bariatric surgery and Group B, those who had not.
Patient demographics, intraoperative and postoperative outcomes, including BMI at time of surgery, weight of tissue removed complication rate and rate of re-operation were compared in the 2 groups using t test and fishers exact test.
Results/Complications: 74 patients were assigned to group A and 14 to group B. The patients in group B were an older group (mean age 49 yrs. vs. 42yrs.) with a higher BMI (29 vs. 24). They also had a significantly larger amount of tissue excised (p=0.0002). Yet despite these differences they did not have a statistically higher incidence of complications. There was no significant difference in the rate of seroma (p=0.4), wound infection (p=1.0), wound dehiscence Group A 1 Group B 0 and all other complications (p=0.2) between the 2 groups. There was no difference in the rate of re-operation either (p=0.1).
Conclusion:
Although bariatric patients who have undergone massive weight loss are a less favorable group, drainless abdominoplasty employing a progressive tension suture technique can be safely offered to this group.