Efficacy of Progressive Tension Sutures without Drains in Reducing Seroma Rates of Abdominoplasty: A Systematic Review a
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ORIGINAL ARTICLE
BODY CONTOURING
Efficacy of Progressive Tension Sutures without Drains in Reducing Seroma Rates of Abdominoplasty: A Systematic Review and Meta-Analysis Ming Li1
•
Keke Wang2
Received: 12 June 2020 / Accepted: 3 August 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract Background Abdominoplasty using progressive tension sutures (PTS) without drains has been reported to lower seroma risk. However, evidence regarding the reproducibility of PTS drainless abdominoplasty in lowering seroma risk is inconsistent and limited to a few studies. Objectives The purpose of this review and meta-analysis was to assess the efficacy of PTS without drains in reducing seroma rates associated with abdominoplasty. Methods PubMed, EMBASE, and Cochrane databases were searched with no restrictions for randomized controlled trials (RCTs) and observational studies in which the number of patients who experienced postoperative seroma was indicated. The keywords included ‘‘progressive tension sutures,’’ ‘‘quilting sutures,’’ ‘‘drain,’’ and ‘‘abdominoplasty.’’ Review Manager software (RevMan, version 5.3) was utilized to compute the pooled effect estimate using a random-effects Mantel–Haenszel model. The outcomes were expressed as odds ratios (OR) and 95% confidence intervals (CI). Subgroup analysis was conducted based on whether abdominoplasty was combined with liposuction. Results Five studies were included (one RCT and four retrospective studies) involving a total of 1255 adult patients. Patients who underwent abdominoplasty using & Ming Li [email protected] Keke Wang [email protected] 1
Beijing Medical Aesthetic Plastic Clinic, Chaoyang, Beijing, China
2
Beijing Medical Aesthetic Plastic Hospital, Chaoyang, Beijing, China
PTS without drains experienced a significantly lower rate of postoperative seroma compared to those with drains (D) only (OR, 0.36; 95% CI, 0.19–0.70; P = 0.002; I2 = 9%). There was no significant difference in postoperative seroma rates between the PTS and PTS ? D groups (OR, 1.03; 95% CI, 0.30–3.54; P = 0.96; I2 = 0%). The data analysis for the subgroup that included liposuction showed that compared with the use of drain only, PTS were associated with a significantly reduced number of seromas (OR, 0.24; 95% CI, 0.11–0.49; P = 0.0001; I2 = 0%). Conclusion Abdominoplasty using PTS without drain and combined with liposuction was effective in reducing seroma rates. Additional RCTs with larger sample sizes and better comparability are needed to confirm the safety and effectiveness of the drainless abdominoplasty technique using progressive tension sutures. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Keywords Progressive tension suture Drain Abdominoplasty Seroma Meta-analysis
Introduction A
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