The effect of fibrin sealant on the prevention of seroma formation after postbariatric abdominoplasty

Seroma formation remains one of the most common complications following abdominoplasty (1). The presence of a seroma may lead to the development of infection and cause significant disability by delaying recovery times and impairing normal wound healing (2). Current modalities for prevention and treatment of seroma include needle aspiration, doxycycline or bleomycin sclerotherapy, and the placement of drainage catheters (2). Although effective, these modalities are not without consequence. Prolonged drain placement can significantly increase the likelihood of bacterial infection and may become obstructed in the course of treatment, necessitating replacement. Furthermore, drains may directly interfere with proper wound healing (3). Lowering the risk of seroma formation and the duration of drain placement can further reduce complications of infection and impaired wound healing. Fibrin sealant/glue is a readily available preparation that is believed to function by promoting closure of microvascular leaks caused by surgical trauma (4). Its use as a method for seroma prevention has been studied – with varying results – in mastectomy and rhytidectomy patients (3–8). In Germany, Toman et al (9) suggested that low-concentration fibrin sealant may be effective in reducing seroma formation in the population undergoing abdominoplasty (9). Although fibrin application has been used by surgeons worldwide for seroma prevention in abdominoplasty, no studies involving the United States postbariatric population currently exist to provide evidence for or against the use of fibrin sealant in this fashion (10). The purpose of the present study was to determine whether there is a significant reduction in seroma formation and immediate postoperative drainage output in postbariatric patients who have undergone abdominoplasty using fibrin sealant.