Abdominoplasty without closed-suction drains: a randomised controlled trial

Introduction There is insufficient scientific evidence from randomised controlled trials to support the routine use of closed-suction drains in body contouring procedures. The aim of this study was to evaluate cumulative seroma volume, length of hospital stay and complication rates in abdominoplasty patients without drains in direct comparison with a cohort receiving drains. Material and Methods Abdominoplasty patients were prospectively randomised in two study groups with (MD) and without (OD) placement of closed-suction drains. Patients with a BMI <= 30 kg/m(2)undergoing horizontal or combined horizontal/vertical incision abdominoplasty were included. Scarpa's fascia was preserved during dissection. Exclusion criteria comprised simultaneous liposuction, coagulation disorders and ASA score >= 3. Cumulative seroma volume over a four-week follow-up period was assessed as the primary outcome measure. Secondary outcome measures were complications requiring surgical revision and length of hospital stay. Results This trial did not identify a statistically significant difference in cumulative seroma volume between the MD (30/53) and OD (23/53) cohorts in 53 patients (M(MD)493 +/- SD 407 ml; M(OD)459 +/- SD 624 ml; p = 0.812). However, a significantly shorter average length of hospital stay was observed in the OD population (M(MD)5.1 +/- SD 1.4 d; M(OD)4.2 +/- SD 1.5 d; p = 0.023). Complication rates were equal in both study groups (n(MD) = 1; n(OD) = 1). Conclusion The results of this trial do not justify routine placement of closed-suction drains in abdominoplasty procedures (horizontal or combined horizontal/vertical incision) in the pre-obese patient cohort (BMI <= 30 kg/m(2)). Drain placement should be evaluated on an individual patient-specific basis.

Automated summary

This study found that not using closed-suction drains in abdominoplasty procedures for patients with a BMI <= 30 did not increase the risk of seroma accumulation or complications, but significantly reduced the length of hospital stay.