Evaluation of the Number of Progressive Tension Sutures Needed to Prevent Seroma in Abdominoplasty with Drains: A Single-Blind, Prospective, Comparative, Randomized Clinical Trial
Evaluation of the Number of Progressive Tension Sutures Needed to Prevent Seroma in Abdominoplasty with Drains: A Single-Blind, Prospective, Comparative, Randomized Clinical Trial
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DOI：
10.1007/s00266-018-1227-6
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发表时间：
2018-12-01
影响因子：
2.4
通讯作者：
Charles-de-Sa, Luiz
中科院分区：
文献类型：
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作者：
Bromley, Miluska;Marrou, Walter;Charles-de-Sa, Luiz
背景：血肿形成已成为腹部整形术后报道最多的并发症。2000年，渐进式张力缝合（PTS）被描述并报道与0.1%的血肿率相关。全世界的外科医生都使用PTS来预防血肿；然而，通常使用的PTS数量存在差异，从5到35针不等。缺乏标准化可能会导致血清肿预防的缺失，手术时间的增加，以及对实施该技术的普遍犹豫。目的探讨11次PTS是否足以预防腹部整形术后血清肿的发生。方法我们于2017年1月至12月对63例健康患者进行了单盲、前瞻性、比较、随机临床试验。患者分为两组：第一组，不使用PTS和引流管的经典腹部成形术；第二组，腹部成形术，使用11个PTS和引流管；第三组，腹部成形术，使用22个PTS和引流管。评估手术技术的持续时间、临床血肿的存在、抽吸次数和引流天数。统计分析采用Cochran-Armitage检验、Fisher exact检验、Kruskal-Wallis检验和t检验。结果PTS使血清形成率降低至3.5%。结果显示，使用11个PTS比使用22个PTS有好处，因为使用更多的缝合线会增加手术时间（30分钟对13分钟）和可能的并发症。与PTS患者相比，那些没有PTS的患者有更多的血肿和延迟引流。结论经典腹部成形术应采用11次PTS。
Background Seroma formation has become the most reported complication after abdominoplasties. In 2000, progressive tension sutures (PTS) were described and reported to be associated with a seroma rate of 0.1%. Surgeons worldwide use PTS to prevent seroma; however, there are discrepancies in the number of PTS commonly used, starting from five up to 35 sutures. The absence of standardization may cause a lack of seroma prevention, increased surgical time, and general hesitation to perform the technique.Objective To determine whether 11 PTS are sufficient to prevent seroma in abdominoplasties.Methods We performed a single-blind, prospective, comparative, randomized clinical trial of 63 healthy patients from January to December 2017. Patients were divided into groups: group 1, classic abdominoplasty without the use of PTS and drains; group 2, abdominoplasty with the use of 11 PTS and drains; and group 3, abdominoplasty with the use of 22 PTS and drains. The duration of the surgical technique, presence of clinical seroma, number of aspirations, and days to drain removal were evaluated. The Cochran-Armitage, Fisher exact, Kruskal-Wallis, and t tests were used in the statistical analyses.Results PTS reduced the rate of seroma formation to 3.5%. Results showed that there is a benefit in using 11 PTS instead of 22 PTS because using more sutures led to an increased surgical time (30 min vs. 13 min) and possible complications. Compared to patients with PTS, those without PTS underwent more seroma aspirations and delayed drain removal.Conclusions Eleven PTS should be used in classic abdominoplasties.