Modification of the abdominoplasty technique in overweight patients: evaluation of the effectiveness for reducing postoperative local wound complications

Purpose of a study: to evaluate the efficacy of a modified abdominoplasty technique aimed at reducing the dissection area and preserving tissue perfusion in patients with overweight (BMI 25,0–29.9 kg/m²) in reducing the incidence of postoperative wound complications.

Material and methods. A prospective study included 30 female patients with BMI 25,0–29.9 kg/m² who underwent abdominoplasty using the proposed technique in the period of 2022–2023. The technique essence: preoperative one-stage determination of resection volume, limitation of dissection to the area of the rectus abdominis projection ("bell shape"), preservation of subcutaneous tissue in the suprapubic region, flap fixation to the wound bed. Operating time, length of hospital stay, incidence of seromas, hematomas, ligature fistulas, and pain syndrome (subjective scale) were assessed.

Results. The mean operating time was (120.0 ± 28.1) min. Complications: seroma – 1 case (3%), ligature fistulas – 2 cases (6%), no hematomas were recorded. Pain syndrome resolved by day 14 in all patients. A statistically significant reduction in mean operating time (by 60 min), hematoma rate (by 100%), and seroma rate (30 times) was observed compared to a retrospective group operated on using the standard technique (p ≤ 0.05).

Conclusion. The proposed modification of abdominoplasty, minimizing tissue trauma, is effective and safe for overweight patients, significantly reducing the risk of local wound complications, which may be associated with reduced impact on areas of chronic low-grade inflammation in the subcutaneous tissue.

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