A recently published study suggests that pre-existing scars, both supra-umbilical and infraumbilical, did not significantly predispose to abdominoplasty complications. Smoking and diabetes were independent risk factors, a finding of clinical importance. The study results were first presented at the 43rd Congress of the European Society for Surgical Research, in Nimes, France, in May 2009; and were subsequently published in July 2010 in the Journal of Plastic, Reconstructive & Aesthetic Surgery.
Over the past decade, abdominoplasty has become an increasingly popular aesthetic procedure both in improving anterior abdominal contour and scar revisions. The associated postoperative complications have been widely reported. Many factors such as obesity, smoking, and pre-existing abdominal wall scars are hypothesised to increase the risk of these problems. However, there are no published data analyzing the effect of segmental interruption to the blood supply that may have been caused by pre-existing scars. This study attempts to quantify the effect of pre-existing scars on the incidence of complications after abdominoplasty.
All 123 abdominoplasties under the care of a single surgeon (dating from 2000 to 2007) were reviewed retrospectively with respect to indications, presence of abdominal scars, and postoperative complications. Patients with pre-existing scars were compared with unmatched "controls" (no scars) by univariate analysis using the Student’s t-tests, Mann–Whitney U, and Fisher’s Exact tests; as well as by multivariate analysis employing a simple logistic regression.
One hundred and twenty-three patients (97% female, median age 40 years) underwent abdominoplasties for abdominal laxity (46%), multiple scars (22%) and "diastasis recti" (11%). Seventy per cent (87 of 123) had pre-existing scars (29% single, 71% multiple) of which 32 patients have supraumbilical scars, 55 patients with infraumbilical scars, and 36 patients with no pre-existing scar. A quarter of patients developed complications, such as infection (14.6%), delayed wound healing (8.1%), and wound dehiscence (4.9%). Smoking and diabetes were the only independent risk factors for complications following an abdominoplasty.
[Source: Journal of Plastic, Reconstructive & Aesthetic Surgery]