Lipoabdominoplasty with Progressive Traction Sutures

Background: Proactively preserving Scarpa's fascia and thus its intrinsic lymphatic drainage and tensile strength for suture placement can eliminate the need for drains after lipoabdominoplasty and therefore reduce the rate of seroma development. In this article, we describe the effectiveness of a modified progressive traction suture (PTS) technique, which enables us to lessen the most common complications and avoid hospital readmission; these sutures take 3–5 minutes of additional surgery time. Methods: Two hundred seventy-six patients (mean age, 38 years; range, 19–67 years), with a mean body mass index of 25 were included in this study. All patients underwent complete lipoabdominoplasty with ultrasound-assisted liposuction (VASER) throughout the abdomen and flanks. Abdominal rectus plication was performed in 100% of cases. All patients were operated on under spinal anesthesia and stayed overnight in hospital. Results: Of the 276 patients, 1.8% developed postoperative seromas. No patients developed hematomas. New wound closure was needed in 1.4% of patients, performed within 7–10 days of surgery, scar revision in 4.7%, residual liposuction under local anesthesia in 9.7%, and liposuction under sedation in 1%; deep vein thrombosis without thromboembolic phenomenon developed in 1%, none resulting in death. In addition, the use of a PTS technique is a time-saving procedure because it takes the surgeons between 3–5 minutes of operative time, unlike that of adhesion and/or separate traction, which takes between 30 and 45 minutes. Conclusions: The use of PTSs helped diminish complications such as seroma and hematoma and prevent additional cost involving hospital readmission and/or further surgery. Furthermore, use of these sutures required only 3–5 minutes of additional operative time.

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