Does the Addition of Progressive Tension Sutures to Drains Reduce Seroma Incidence After Abdominoplasty? A Systematic Review and Meta-Analysis.

[BACKGROUND] Progressive tension sutures (PTS) are commonly utilized to reduce postoperative seroma in abdominoplasty. However, current evidence regarding PTS in abdominoplasty is limited to small series and the findings of single institutions.

[OBJECTIVES] The authors reviewed the available literature concerning the effects of PTS and drains on seroma formation following abdominoplasty, and summarized the different techniques that have been described to date.

[METHODS] We conducted a systematic review of the Medline, Embase, and Cochrane databases. We identified randomized controlled trials (RCTs) and observational studies in which the numbers of patients who had postoperative seroma were indicated. We applied the Cochrane Collaboration's tool for assessing the risk of bias.

[RESULTS] Seven studies were included (three RCTs and four retrospective studies). Patients who had PTS and drains following abdominoplasty had a significantly lower rate of postoperative seroma than those who had drains only. The mean surgical time difference between the two groups was 23 minutes. There was no difference in postoperative seroma rate in patients who had PTS and drains placed following abdominoplasty compared to those who had PTS only.

[CONCLUSIONS] Addition of PTS to drains reduces the risk of postoperative seroma in standard abdominoplasty. More RCTs with larger sample sizes and better comparability are warranted to confirm with more confidence the impact of PTS in abdominoplasty.