From the Research
Preserving Scarpa's fascia during abdominoplasty is crucial for maintaining the integrity of lymphatic pathways and reducing the risk of postoperative seroma formation and lymphedema, as evidenced by the most recent and highest quality study 1.
Significance of Scarpa's Fascia
Scarpa's fascia plays a vital role in the lymphatic drainage of the abdominal wall, containing numerous lymphatic vessels that help drain lymph from the abdominal skin and subcutaneous tissues.
Benefits of Preservation
Preserving Scarpa's fascia during abdominoplasty has several benefits, including:
- Reducing the risk of postoperative seroma formation and lymphedema
- Providing better support for the overlying skin flap
- Improving the aesthetic outcome by creating a smoother contour
- Reducing the total drain output, time to drain removal, and seroma rate without compromising the aesthetic result, as shown in studies 2, 1, 3
Technique
The technique typically involves careful dissection above Scarpa's fascia in the upper abdomen while preserving it in the lower abdomen, especially near the inguinal regions where lymphatic drainage is most critical.
Evidence
Studies have consistently shown that preserving Scarpa's fascia during abdominoplasty reduces the incidence of seroma and other complications, with the most recent study 1 demonstrating a significant reduction in seroma occurrence and drainage duration. Additionally, a meta-analysis 3 found that abdominoplasty with Scarpa fascia preservation significantly reduced the incidence of seroma, length of hospital stay, time to drain removal, and total drain output.
Recommendation
Based on the most recent and highest quality evidence, preserving Scarpa's fascia during abdominoplasty is recommended to reduce the risk of postoperative complications and improve patient outcomes 1.