Dissection Technique for Abdominoplasty: A Prospective Study on Scalpel versus handheld electrocautery.

Abstract

Background: Abdominoplasty, colloquially known as "tummy tuck," is a surgical procedure aimed at removing excess skin and fat around the abdomen while strengthening the muscles of the abdominal wall. Numerous recent studies have delved into the comparison between employing a surgical scalpel and handheld electrocautery for dissecting a skin-lipofacial flap, highlighting the variations in complications and the duration of the surgical procedure, given the distinct advantages and drawbacks of each technique.

Aim: The primary goal of this research is to assess outcomes and complications post-complete surgical abdominoplasty by comparing the dissection methods employing a surgical scalpel versus an electrical clipping technique utilizing a unipolar handheld electrocautery device.

Materials and Methods: Informed consent was obtained from participating patients who underwent surgery under general anesthesia using the conventional tummy tuck approach. Subjects were randomly grouped into Group A, where skin adipose flap dissection was performed using a surgical scalpel, and Group B, where dissection was executed using electrocautery.

Key variables scrutinized encompassed surgical duration, pain intensity evaluations, daily and overall drainage through the drain, drain removal timing, hospitalization, local and systemic complications (e.g., delayed wound healing, infection, thrombotic incidents), seroma occurrences (including frequency and drained volumes), readmissions, and emergency visits. The Numeric Rating Scale (NRS) was utilized to gauge pain intensity, with subsequent data entry and statistical analysis performed using SPSS Version 26.

Results: Patient ages in the study ranged from 31 to 60 years, with an average BMI of 29.4 among participants. The mean surgical duration was 146.2 minutes in Group A and 117.3 minutes in Group B. Postoperative pain scores averaged 5.5 in Group A and 5.1 in Group B. Daily drainage through the drain measured an average of 57.4 ml in Group A and 75.5 ml in Group B. Seroma formations were reported in one and three patients in Groups A and B, respectively, with varying drainage frequencies and volumes. The main volume of seroma aspiration in group A was 20.6 ml, and 45 ml in group B.

Conclusion: Employing a surgical scalpel for dissection mitigates seroma occurrence, reduces drainage rates, and alleviates postoperative pain severity. Meanwhile, handheld electrocautery dissection aids in minimizing surgical duration, cost reduction, procedural complexities, and intervention rates, albeit with potential complications like bleeding.