Dissection Technique for Abdominoplasty With Scarpa Fascia Preservation: Comparative Study on Avulsion Technique Versus Diathermocoagulation.

BACKGROUND Many strategies have been developed to lower the high complications rate associated with a full abdominoplasty. The dissection technique may have a role to achieve this goal. OBJECTIVES The present study compares two different dissection techniques to perform a full abdominoplasty with Scarpa fascia preservation: avulsion technique and electrodissection. METHODS A retrospective observational cohort study was performed in two health institutions from January 2005 to January 2019. A total of 251 patients were involved: 122 patients submitted to abdominoplasty using the avulsion technique (Group A) and 129 with diathermocoagulation (coagulation mode) (Group B). The latter was further divided into group B1(57 patients with device settings according to surgeon's preferences) and B2(72 patients with a specific regulation aiming at minimal tissue damage). Several variables were analyzed: population characteristics, time of hospital stay, time to drain removal, total and daily drain output, emergency department visits, readmission, reoperation, local and systemic complications. RESULTS There were no statistically significant differences between the general characteristics of both groups, except for previous abdominal surgery. The diathermocoagulation group had a significantly lower length of hospital stay and time to drain removal. Moreover, these advantages were maximized when electrocautery was done with a specific low voltage setting as significant differences were found. The other outcomes were identical. CONCLUSIONS Limiting the extension of electrodissection with the avulsion technique didn´t present any advantage. Using diathermocoagulation (coagulation mode) during a full abdominoplasty with Scarpa fascia preservation, especially when it's aimed at minimal tissue damage, reduces patients' time with drains.