Prevention of seromas after abdominoplasty

Abdominoplasty is a popular surgical procedure for re-shaping and reconstruction of anterior abdominal wall and waist. This is the 4th most common procedure and often combined with liposuction. Seroma is the most common complication after abdominoplasty and can lead to unsatisfactory aesthetic results, prolonged rehabilitation, infection and redo surgery. This review is devoted to prevention of seromas after abdominoplasty. Searching for data was conducted in the PubMed, Cochrane Library, eLibrary databases between 2020 and 2024. We preferred systematic reviews, meta-analyses and randomized clinical trials in English and Russian. Pathogenesis of this complications was analyzed. The authors systematized the methods for prevention of seromas. According to statistical data, the incidence of seromas is 10.9%, among post-bariatric patients — 13.3—16.4%. The incidence of seromas is significantly higher among patients with BMI >30 kg/m2. Effectiveness of intraoperative preventive methods, such as preserving the Scarpa’s fascia, active drainage and closure of space under the flap with sutures was assessed. The authors analyzed the effect of various dissection methods and some drugs on the incidence of complication. Effectiveness of postoperative tissue compression was estimated. No thermal tissue damage during dissection, preserving the Scarpa’s fascia, suture closure of space under the flap, active drainage and local tissue adhesives are evidence-based methods for reducing the incidence of seromas.