Article
Clinical study – postoperative outcome after abdominoplasty surgery
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Published: | September 3, 2014 |
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Backround: Abdominoplasty is one of the most frequently performed plastic surgical procedure that restores abdominal contouring after significant weight loss. This procedure addresses skin and abdominal wall laxity, hernia formation and muscle rectus diastasis. By this procedure variable amounts of fat and skin are resected followed by changes in cutaneous sensitivity, seroma formation and postoperative scarring influencing patients’ satisfaction and the postoperative outcome. The purpose of this study was to investigate the clinical outcome of patients after abdominoplasty surgery with regard to sensitivity of the abdominal wall, seroma accumulation, scarring, aesthetic outcome, re-operations, postoperative complications and overall patients’ satisfaction.
Patients and methods: This is a prospective study of up till now 15 patients operated on between October 2013 and March 2014. The abdominoplasty technique used in our study is the low horizontal W skin excision and umbilical transposition technique (Regnault 1972). Changes in sensitivity of the abdominal wall were evaluated using Semmes-Weinstein monofilaments within an area extending over 3 different zones of the abdominal wall using the Cedidi Sensitivity Zone Classification (CSZC) of the abdominal wall. The measurements were carried out preoperatively, 1 and 6 weeks and 6 months postoperatively.
Results: Sensitivity measurements showed on average a minimal decrease in sensory thresholds ranging from 2.41 to 2.43 mm. Six weeks postoperatively, measurement points with the highest decrease in sensitivity were the new infra-umbilical points in Zone 1, cranial to the resection area originating from the supra-umbilical area prior to surgery, from 2.36 to 4.08 mm and 2.36 to 3.86 mm, respectively. Varying results were found for Zone 2 measurements with similar thresholds. There was no significant change in the sensitivity thresholds in Zone 3.
Summary and conclusions: Our results showed different changes of sensitivity after abdominoplasty depending on CSZC. The most susceptible area to nerve damage following abdominoplasty surgery is located to the supra-umbilical Zone 1 area where most mobilisation and undermining of tissue occurs. In conclusion, nerve injuries with decreased postoperative sensitivity can have significant long-term impact on the patients’ body image, safety and quality of life due to higher risk of injury. Therefore, it is recommended to inform patients thoroughly prior to surgery about possible sensitivity changes around the future scar.