Abstract

Background: In abdominoplasty, violation of deep lymphatics that run just superficial to the abdominal wall muscular fascia is thought to further compromise lymphatic drainage of the serous fluid produced at the surface of undermined tissue. The potential role for preserving Scarp’s fascia and/or the deep fat compartment during abodminoplasty is to decrease complication rate especially seroma.

Patients and Methods: Between August 2010 to February, 45 patients were submitted to full abdominoplasty. These patients were divided into groups (according to the plane of dissection in infra-umbilical region): 15 patients of supra-fascial plane (Group I), 15 patients of subscarpal plane (Group II) and 15 patients of suprascarpal plane (Group III). Post-operative assessment was done six months through which clinical examination for postoperative complications, patient satisfaction and flap thickness via superficial abdominal U/S will be mentioned.

Results: There is a higher mean duration till drain removal in group I (7.6 days) compared to (4.8 days) in group II and (3.4 days) in group III. That’s why 20% of patients of group I developed seroma. There is higher mean flap thickness after 2 weeks and until 3 months of surgery in group I compared to other groups. While there is no significant difference between the three groups after 6 months. There is higher grade of satisfaction among cases in group II and group III compared to group I.

Conclusion: The superficial group of patients wasn’t pleased by long hospital stay and downtime, prolonged edema formation, prolonged duration till drain removal and supra epigastric higher leveling compared to the infraumbilical level. In contrary of that, the subscarpal and suprascarpal groups of patients gave more satisfactory results.

Keywords: Abdominoplasty; Seroma; Abdominal wall flap edema; Abdominal wall lymphatics; Scarpa’s fascia