Objective
To evaluate the safety and effectiveness of a lysine-derived urethane adhesive as a noninvasive alternative to closed suction drains in a commonly performed large flap surgical procedure.
: Examination of abdominal contour surgery candidates permits categorization of patients (the abdominolipoplasty system of classification and treatment) according to their treatable soft tissue layers of skin, fat, and muscle into the appropriate treatment level. Typically, postpartum abdominal wall changes are most thoroughly addressed by abdominoplasty. The indications and goals for abdominoplasty with liposuction (lipoadminoplasty) or without liposuction are presented. Surgical markings, tech...
Introduction Post-mastectomy seromas are a common problem in modern oncological surgery. Occurrence rates of up to 59% have been reported in the literature. High-risk patients, that is, those who have received previous surgeries, radiation or chemotherapy, present a particular challenge. Several surgical techniques, including progressive tension suture application, have shown promise. Noninvasive measures such as fibrin-based adhesives have thus far not been able to prevent seroma occurrence eff...
Last. J. Peter Rubin(University of Pittsburgh)H-Index: 60
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Summary Background Seroma formation is a common postoperative complication following many surgical procedures including abdominoplasty. Recently, a lysine-derived urethane (LDU) surgical adhesive was shown to prevent seroma formation in short term studies in a canine model of abdominoplasty. This current study evaluates efficacy of the adhesive (TissuGlu®, Cohera Medical, Inc.) in the same model at longer time points, and examines the histological tissue response to extended exposure to the adhe...
#2Holger Bannasch(University Medical Center Freiburg)H-Index: 24
Last. J. Peter Rubin(University of Pittsburgh)H-Index: 60
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Background Wound drainage and seroma formation following abdominoplasty remain significant concerns to both surgeons and patients due to the resulting increased need for patient follow-up and delays in returning to normal function. While a number of approaches are used to reduce wound drainage and seroma formation, there is still no definitive solution. A promising strategy to reduce these complications is the development of an effective method for closing dead space between tissue layers in ord...
Objectives: Infectionfollowingmajorlowerlimbamputationiscommonbutsurgicalinfluencesontherates of infection are not known. We aim to assess the influence of peri-operative surgical factors on outcome. Design and methods: Review of a prospective database included all patients undergoing a major lower limb amputation from March 2008 to July 2010. Infection was classified using Centre for Disease Control criteria and multivariate analysis performed to identify significant risk factors. Results: 127 ...
Introduction Laparoscopic techniques are being used increasingly in the repair of ventral hernias, but different incidences and complications have been described as potential risks of this approach. Seroma formation has been documented as one of the most common complication, although most of the time remains asymptomatic and it can be considered just an incident. The incidence of seroma after laparoscopic ventral hernia repair has not been properly documented and analyzed since the definition us...
ic s. co m Seroma is one of, if not the most frustrating problem that plagues abdominoplasty. Many theories have been proposed as to the cause of seroma, and various techniques have been suggested to control this complication. These techniques range from operative variations, such as limitation of undermining, elimination of concurrent liposuction and tissue glues; to postoperative practices such as extended bed rest, limitation on upright posture, and use of compressive garments. All of these m...
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. Objectives: The authors examine the association between length of immobilization and the development of seroma. Methods:...
Background: Over the past 30 years, the preferred techniques and settings for abdominoplasty have evolved considerably, but controversy remains regarding the surgical and postoperative approaches that best limit serious complications such as seroma. Objectives: The authors evaluate their 28-year experience with abdominoplasty and suggest a technique (progressive tension sutures without placement of drains) for reducing the overall complication rate, most significantly with regard to seroma. Meth...
Abstract High- and low-pressure vacuum drains are commonly used after surgical procedures. High-pressure vacuum drains (ie, sealed, closed-circuit systems) are efficient and allow for easy monitoring and safe disposal of the drainage. Low-pressure vacuum drains use gentle pressure to evacuate excess fluid and air, and are easy for patients to manage at home because it is easy to reinstate the vacuum pressure. Perioperative nurses should be able to identify the various types of commonly used drai...
Postoperative seromas are a problem in the surgical treatment of breast cancer. The aim of the study was to evaluate whether the lysine-urethane-based tissue adhesive TissuGlu® without drainage is equal/ non-inferior to standard mastecomy with drainage. The study was designed as a prospective, randomized, multicentre non-inferiority study comparing the use of TissuGlu® without drainage with standard wound care with a drain insertion in ablative breast procedures. The number of clinical intervent...
Last. Ilkka Koskivuo(UTU: University of Turku)H-Index: 12
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BACKGROUND AND AIMS:: The most effective dissection technique for raising the flap in abdominoplasty is still controversial, particularly in high-risk massive-weight-loss patients. LigaSure Impact™ vessel-sealing system (Medtronic, Dublin, Ireland) is an energy device commonly used among different surgical specialties to reduce morbidity and implement outcomes. The aim of this study was to investigate the effectiveness of LigaSure Impact in abdominoplasty compared with the conventional technique...
Last. Xia Zhengbin(SCUT: South China University of Technology)H-Index: 1
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Abstract Based on the stealth behavior of castor oil and poly(ethylene glycol), we selected a polyurethane system to obtain an ideal surgical adhesive. The polyurethane adhesives with varying concentrations of castor oil were investigated by Fourier transform infrared spectrometer, differential scanning calorimetry, scanning electron microscopy, goniometer, and universal testing machine. Curing results show that a 7-min to 25-min room temperature curing can be achieved, providing one possibility...
BACKGROUND: Current guidelines for randomized controlled trial reporting do not require authors to justify their choice of time horizon. This is concerning, as the time horizon when an outcome is assessed has important implications for the interpretation of study results, and resources allocated to an investigation. Therefore, this study seeks to examine the standards of time horizon reporting in the plastic surgery literature. METHODS: This is a systematic review of plastic surgery randomized c...
Background: Fluid accumulation is a common complication after abdominoplasty procedures, and is typically managed by the placement of post-surgical drains. Progressive tension sutures (PTS) have been shown to be an effective approach to reduce the dead space by point-wise mechanical fixation, allowing for drain-free procedures. Lysine-derived urethane surgical adhesive provides an alternative approach for mechanical fixation and reduction of dead space, and may reduce surgery time compared to PT...
#1Daniel J. Gould(SC: University of Southern California)H-Index: 18
#2Luis H. Macias(SC: University of Southern California)H-Index: 7
Last. W. Grant Stevens(SC: University of Southern California)H-Index: 23
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Background: Several studies have demonstrated that progressive tension sutures (PTS) reduce seroma. Many fear that adding liposuction to abdominoplasty will increase seroma rates and avoid drainless abdominoplasty when performing concomitant liposuction. Objectives: We sought to identify whether liposuction increases seroma in PTS and non-PTS abdominoplasty. Methods: In this retrospective study, 619 patients underwent abdominoplasty between 2009 and 2017, of which 299 patients had drainless abdo...
BACKGROUND/AIM: Using drains after breast surgery is a preventive, but invasive measure to reduce seroma formation. A polyurethane-based tissue adhesive (TissuGlu®) might facilitate drainage-free wound healing after mastectomy in a non-invasive manner. PATIENTS AND METHODS: Retrospectively, data from 84 patients (42 receiving TissuGlu®, 42 receiving a drainage) who underwent mastectomy, were collected (90 days postoperative follow-up). Study endpoints were defined as the number of fluid-related ...
Context: Seroma formation is a common complication after lipoabdominoplasty. Conventionally, drains have been placed to prevent seroma; however, there are problems with drains, namely, pain, compromised mobilisation, breakage, tissue irritation and infection. Strategies to prevent seroma, such as the use of glue or quilting sutures have all been attempted with variable and unpredictable benefit. Aims: The author extrapolated the experience with own liposuction protocols to lipoabdominoplasty and...
: The use of closed suction drains in the abdominal wall is a common practice in abdominal wall reconstruction (AWR) operations. Drains can be a conduit for bacteria and can cause pain and discomfort for patients after surgery. A single hernia program has implemented the principles of clinical quality improvement in an attempt to improve outcomes for hernia patients. An attempt at a process improvement was implemented to eliminate the use of drains in AWR by adapting the technique. A total of 10...
Early complications such as dehiscence, seroma and flap failure requiring revision are a troubling aspect of flap repair surgery for Stage IV pressure ulcers. They increase patient suffering in an already difficult context and place a great burden on the health care provider as well. Reduction or elimination of the dead space between tissue planes has been shown to aid in wound healing in tissue flap procedures involving extensive undermining. In late 2013 we began using a new lysine-based ureth...