Hemostatic Agents Do Not Significantly Affect Seroma Formation in Abdominal Body Contouring
Hayeem Rudy, Peter Shamamian, Julia Grande, Fei Wang, Yi-Hsueh Lu*, Joseph A. Ricci
Division of Plastic Surgery, Montefiore Medical Center, Bronx, NY
Postoperative seroma after abdominal body contouring
surgery is a plaguing complication. The aim of this study was to investigate the association between hemostatic agent use and seroma development following abdominal body contouring surgery.
A retrospective review of all patients who underwent abdominal body
contouring in a single institute between 2010 and 2020 was completed. Patients who received a hemostatic agent intraoperatively were matched to the controls (1:2) based on potential confounders including age, BMI, and ASA score. Patient demographics, operative details, and postoperative complications were compared.
A total of 707 patients who met inclusion criteria were included in the study.
Sixty-five patients (9.2%) were identified as having received at least one hemostatic agent intraoperatively. The most used agents were topical thrombin (n=33, 50.1%), followed by dry matrices which included oxidized cellulose, microporous polysaccharides, and absorbable gelatin matrices (n=15, 23.1%) followed by combination fibrin sealant/thrombin preparations (n=9, 14.0%). The overall cohort was 93% female with an average age of 45 an average ASA of 2 and an average BMI of 29.8 kg/m2. There were no significant differences with respect to demographic data or medical comorbidities between the cases and controls. Bivariate analysis demonstrates no significant difference in the rate of development of seroma (OR: 0.83, 95% confidence interval [CI]= 0.23-1.99, p=.781), hematoma (OR: 3.72, 95% confidence interval [CI]= 0.95-14.65, p=.060), venous thromboembolism (OR:0.40, 95% confidence interval [CI]= 0.44-3.81, p=.433). There were no significant differences in delayed wound healing (OR: 2.42, 95% confidence interval [CI]= 0.438-13.446, p=.310) or wound dehiscence (OR: 1.52, 95% confidence interval [CI]= 0.627-3.699, p=.353).
Hemostatic agent use, regardless of type, does not significantly affect the risk of seroma, hematoma and venous thromboembolism development, nor does it influence the rates of delayed wound healing or wound dehiscence.
Case-control Matched Analysis of Postoperative Complications
| OR | Standard Error | z | P>|z| | 95% CI | |
| Seroma | 0.83 | 0.54 | -0.28 | 0.781 | 0.23-2.99 |
| Hematoma | 3.72 | 2.60 | 1.88 | 0.060 | 0.95-14.7 |
| VTE | 0.41 | 0.47 | -0.78 | 0.433 | 0.44-3.81 |
| Delayed Wound Healing | 2.43 | 2.12 | 1.02 | 0.310 | 0.43-13.4 |
| Wound Dehiscence | 1.52 | 0.69 | 0.93 | 0.353 | 0.62-3.70 |
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