Use of the anterior rectus sheath for abdominal wall reconstruction: A study in cadavers

Our aim was to evaluate the amount of tension present after incision and undermining of the anterior rectus sheaths and the external oblique muscles in 20 fresh adult cadavers. Resistance to traction of the anterior and posterior rectus sheaths towards the midline was measured at three stages of dissection: before any aponeurotic undermining; after incision and undermining of the anterior rectus sheaths; and after incision and undermining of the external oblique muscles associated with the previous dissection. Significance of differences was assessed using non-parametric tests. There was a significant reduction in tension in the anterior and posterior sheaths on both levels after each stage of dissection. the incision and undermining of the anterior rectus sheaths and the external oblique muscles promoted a progressive reduction in tension at the aponeurotic edges of the abdominal wall.Universidade Federal de São Paulo, Div Plast Surg, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Prevent Med, São Paulo, BrazilUniversidade Federal de São Paulo, Div Plast Surg, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Prevent Med, São Paulo, BrazilWeb of Scienc

A variation in the component separation technique that preserves linea semilunaris: a study in cadavers and a clinical case

The purpose of this study is to evaluate and compare the effect of the incision of the external oblique aponeurosis along the semilunaris in amount of tension present after the undermining of the anterior rectus sheaths. Forty fresh adult cadavers were studied and divided into two groups: group A (n = 20) and group B (n = 20). Traction indexes were compared in three situations: (1) before any aponeurotic undermining (similar on both groups); (2) after incision and undermining of the anterior rectus sheaths (similar on both groups) and (3) group A: after undermining of the external oblique muscles with the incision of their aponeurosis along the semilunaris and group B: undermining of a continuous layer of the anterior rectus sheaths and the external oblique aponeurosis, after release of the lateral aspect of the rectus sheaths. Significance of differences was assessed using non-parametric tests. There was a significant tension reduction after each stage of dissection in both supra-and infra-umbilical levels and on both groups. Comparisons between groups A and B did not show statistically significant differences in all sites and stages of the dissections. Therefore, both techniques showed similar aponeurotic tension reduction after each stage of the dissections in cadavers. (C) 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier B.V. All rights reserved.Universidade Federal de São Paulo, Dept Surg, Div Plast Surg, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Surg, Div Plast Surg, BR-04024002 São Paulo, BrazilWeb of Scienc

Seroma in Lipoabdominoplasty and Abdominoplasty: A Comparative Study Using Ultrasound

Background: Abdominoplasty is one of the most frequently performed cosmetic procedures, and its combination with liposuction has become more common. Seroma is one of the most common complications in abdominoplasty. the aim of this study was to compare the rate of seroma formation in patients who underwent either abdominoplasty with or without the use of quilting sutures or lipoabdominoplasty.Methods: Fifty-eight female patients were divided into three groups and underwent one of the following procedures: group A (n = 21), abdominoplasty without quilting sutures; group B (n = 17), abdominoplasty with quilting sutures; and group C (n = 20), lipoabdominoplasty. To investigate seroma formation, abdominal ultrasound was performed in five regions of the abdominal wall (epigastrium, umbilical, hypogastrium, right iliac fossa, and left iliac fossa) at two postoperative periods (P1, between postoperative days 11 and 14; and P2, between postoperative days 18 and 21).Results: the rate of seroma formation at both P1 and P2 was significantly higher in group A. It was observed that in group A at P1, the regions of right iliac fossa and left iliac fossa developed larger fluid collections. in group B, there were no significant differences with respect to fluid collections among the five study regions at both P1 and P2. in group C, there were significantly larger fluid collections in the hypogastrium region at P1 and in the umbilical and hypogastrium regions at P2.Conclusion: Abdominoplasty with quilting sutures and lipoabdominoplasty are effective techniques for the prevention of seromas compared with abdominoplasty without quilting sutures. (Plast. Reconstr. Surg. 126: 1742, 2010.)Universidade Federal de São Paulo, Div Plast Surg, Dept Surg, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Diagnost Imaging, BR-04024002 São Paulo, BrazilUniv Santo Amaro, Dept Stat, São Paulo, BrazilUniversidade Federal de São Paulo, Div Plast Surg, Dept Surg, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Diagnost Imaging, BR-04024002 São Paulo, BrazilWeb of Scienc