Long Drainers After Abdominoplasty: A Risk Analysis.

[BACKGROUND] Suction drains are still one of the most accepted strategies for lowering abdominoplasty postoperative complications. Long periods with drains have been reported after a full abdominoplasty and are associated with patient discomfort, limited mobility, and slower recovery. The clinical profile of Long drainers has yet to be investigated.

[OBJECTIVE] Identify risk factors that increase the number of days with drains.

[METHODS] A single-center retrospective observational study of patients submitted to classical abdominoplasty was performed. Patients were allocated to one of two groups: Long drainers (≥ 6 days with drains) and Short drainers (< 6 days with drains). Several variables were determined: age, sex, body mass index, medical comorbidities (hypertension and diabetes mellitus), previous surgical procedures, specimen weight, time to suction drain removal, and drain output.

[RESULTS] In total, 418 patients were included in this study, and 36% were Long drainers. There was a statistically significant difference between groups regarding total drain output, time until drain removal, body mass index, previous bariatric procedures, and specimen weight, with lower values for Short drainers. No significant differences were found in age, sex, arterial hypertension, diabetes mellitus, and previous abdominal surgery. Specimen weight ≥ 750 g, body mass index ≥ 28 kg/m, and previous bariatric surgery accounted for 75% of Long drainers and increased Long drainer risk by 3.5 times, 3.0 times, and 2.6 times, respectively.

[CONCLUSION] The high-risk profile for long drainage after classical full abdominoplasty is a body mass index ≥ 28 kg/m, previous bariatric procedure, and specimen weight ≥ 750 g. These characteristics may justify using surgical strategies for Long drainer prevention, such as quilting sutures or Scarpa sparing abdominoplasty.

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