Prevention of seroma after abdominoplasty.

[BACKGROUND] Seroma is one of the most troubling complications after abdominoplasty; incidence rates of up to 25% have been reported. If it is correct that shearing forces between the two separated abdominal layers play a key role in the development of seroma, postoperative immobilization of the patient until the layers are sufficiently adhered may be a solution to the problem.

[OBJECTIVE] The authors examine the association between length of immobilization and the development of seroma.

[METHODS] This retrospective study included 60 patients; half were immobilized for 24 hours (group 1) and the other half were immobilized for at least 48 hours (group 2). For thromboembolism prophylaxis, all patients received low molecular weight heparin and compression stockings. Postoperative follow-up for detection of seroma continued for at least three months.

[RESULTS] Mobilization after 24 hours led to a seroma rate of 13%, whereas immobilization of at least 48 hours decreased the seroma rate to 0%.

[CONCLUSIONS] For abdominoplasty patients with a low or moderate thromboembolic risk, the data suggest that immobilization for at least 48 hours with chemical and mechanical thromboembolism prophylaxis significantly reduces the risk of seroma.