The effect of scarp fascia preservation during abdominoplasty on immediate and long-term postoperative outcomes

Background. The growth of morbid obesity worldwide has led to an increase in abdominoptosis, which occurs both as a result of the disease and bariatric surgery. This has led to an increase in the number of operations to restore the abdominal shape configuration. Accordingly, the number of complications developing in the early postoperative period after abdominoplasty has increased.

The aim. Compare the effect of preserving the Scarpa fascia during abdominoplasty on the immediate and long-term results of the surgery.

Materials and methods. The conducted examination included 48 patients who underwent an abdominoplasty operation. All patients were divided into 2 groups: group 1 – the operation was performed without preserving the Scarpa fascia, in group 2 – with preservation. To determine complications, instrumental diagnostics in the form of ultrasound examination was used, and changes in skin color, lumps on palpation, drainage discharge counts, and the nature of the evacuated fluid during puncture were determined.

Results. In the early postoperative period, the overall complication rate was significantly higher in group 1 (without Scarpa fascia preservation) – 20 complications in 26 patients (76.9 %) versus 9 complications in 22 patients (40.9 %) in group 2 (with preservation) (p < 0.05). The difference was most pronounced in patients with previous bariatric surgery. Seroma and lymphorrhea predominated among the complications that occurred in 14 patients (53.8 %) in group 1, and in 6 patients (27.3 %) in group 2. At 6-month follow-up, most patients (92–95 %) were satisfied with the surgical outcome. Recurrence of abdominoptosis was noted in 2 patients (one in each group).

Conclusion. The results of this study are consistent with the international literature on the preservation of the Scarpa’s fascia. Preservation of the Scarpa’s fascia helps reduce the incidence of postoperative seromas and improves immediate postoperative outcomes. However, the number of patients included in the study is insufficient to draw definitive conclusions. Preservation of the Scarpa fascia did not affect long-term outcomes. The current high rate of early postoperative complications necessitates further research into ways to reduce them.

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