Fibrin glue doesn't prevent seromas after tummy tuck

Seroma - a post-operative fluid collection - is the most common complication after a tummy tuck.  It happens in about 5-10% of abdominoplasties.  Surgeons generally try to prevent this problem by using one of three strategies - suction drains, internal "quilting" sutures or fibrin glue. Each technique has its advocates, and arguments about which technique is best persist at the plastic surgery meetings.

So, a comparison study of the techniques was inevitable. In the study I'm reviewing today, published in Aesthetic Plastic Surgery, 43 tummy tuck patients were divided into 3 groups, receiving either drains, quilting sutures or fibrin glue during closure of their tummy tuck. Ultrasound scanning was then used to check for the presence or absence of fluid at 15 and 30 days post-op.

Results: both quilting sutures and drains worked significantly better than fibrin glue.  Seromas were less common at 30 days than at 15 days in all treatment groups.

Comment:  This result pleases me, since I use one of the better techniques (drains) when I perform a tummy tuck.  Also, fibrin glue is quite expensive,so avoiding its use saves some money for the patient.  The fibrin glue, even though it sounds high-tech and modern, failed to perform here.  The results of using fibrin glue during facelift surgery have also been unimpressive in other studies.

In general, seromas are more common if:

- liposuction is performed at the same time as a tummy tuck,

- in patients that are having an abdominoplasty following gastric bypass surgery with massive weight loss

Fortunately, most of the time, even if a seroma appears, it's a minor, short-term nuisance, and is easily handled.