Strategies for postoperative seroma prevention: A systematic review

Jeffrey E. Janis, Lara Khansa, Ibrahim Khansa

Research output: Contribution to journalReview article

24 Citations (Scopus)

Abstract

Background: There is conflicting evidence on the effectiveness of the various strategies to prevent postoperative seroma. Many high-quality studies have been performed to evaluate those strategies, but the numbers of patients included in those studies have been small. The authors' goal was to perform a systematic review of all Level I and II studies on the prevention of postoperative seroma. Methods: A PubMed search was performed of all Level I and II studies that evaluated strategies for the prevention of postoperative seroma. Only English-language comparative studies on humans, defining seroma as a postoperative serous fluid collection detectable on physical examination, were included. Data from all the studies were compiled, and a systematic review was performed to evaluate the effectiveness of each strategy. Results: Seventy-five studies comprising 7173 patients were included. Effective strategies for seroma prevention included the use of closed-suction drains; keeping the drains until their output volume was minimal; maintaining a high pressure gradient in the drains; using sharp or ultrasonic dissection rather than cautery; dissecting the abdomen in a place superficial to the Scarpa fascia; ligating blood vessels with sutures or clips; using quilting or progressive tension sutures; using fibrin, thrombin, or talc; and immobilizing the surgical site postoperatively. Surgical-site compression did not prevent seroma accumulation. The use of sclerosants at the initial operation actually increased the risk of seroma. Conclusions: Seroma is a common and frustrating complication in plastic surgery. This study demonstrates that simple strategies can be used to lower the risk of seroma.

Original languageEnglish (US)
Pages (from-to)240-252
Number of pages13
JournalPlastic and Reconstructive Surgery
Volume138
Issue number1
DOIs
StatePublished - Jul 1 2016

Fingerprint

Seroma
Sutures
Sclerosing Solutions
Talc
Cautery
Fascia
Suction
Plastic Surgery
Fibrin
Surgical Instruments
PubMed
Ultrasonics
Thrombin
Abdomen
Physical Examination
Blood Vessels
Dissection
Language
Pressure

ASJC Scopus subject areas

  • Surgery

Cite this

Strategies for postoperative seroma prevention : A systematic review. / Janis, Jeffrey E.; Khansa, Lara; Khansa, Ibrahim.

In: Plastic and Reconstructive Surgery, Vol. 138, No. 1, 01.07.2016, p. 240-252.

Research output: Contribution to journalReview article

Janis, Jeffrey E. ; Khansa, Lara ; Khansa, Ibrahim. / Strategies for postoperative seroma prevention : A systematic review. In: Plastic and Reconstructive Surgery. 2016 ; Vol. 138, No. 1. pp. 240-252.
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