Produção Nacional
Revisado por pares
The Use of Suction Drains in Abdominal Dermolipectomy: A Randomized Clinical Trial
2008; Lippincott Williams & Wilkins; Volume: 121; Issue: 4 Linguagem: Inglês
10.1097/01.prs.0000305389.29451.b0
ISSN1529-4242
AutoresGiuliano Borile, Michel Pavelecini, Rodrigo Dreher, Eduardo Mainieri Chem, Roberto Corrêa Chem,
Tópico(s)Facial Rejuvenation and Surgery Techniques
ResumoSir: We conducted a randomized trial with 63 abdominal dermolipectomy procedures performed at the Department of Plastic Surgery at Santa Casa Hospital Center–Fundação Faculdade Federal de Ciências Médicas de Porto Alegre between January 1, 2003, and April 20, 2004. After assessment and indication for abdominal dermolipectomy, patients were randomly allocated to two groups. Both groups underwent conventional surgery. Patients in group 1 (n = 30) received closed tubular drainage with negative pressure for the time needed to stabilize drainage volumes at 30 to 50 ml/day. Patients in group 2 (n = 33) did not receive any kind of drainage and were only made to wear a compressive garment during the postoperative period. Both groups received follow-up after hospital discharge and were examined on a weekly basis in the first 6 weeks after surgery and then fortnightly up to the third postoperative month. From the third to the sixth postoperative months, the patients were examined monthly. Those patients who presented clinical signs suggestive of fluid collections, such as swelling, contour deformities, extensive hematomas, or fluid waves, were treated with needle puncture and the volume of fluid collected was recorded.1,2 All patients were assessed according to the research protocol. Statistical analysis used the chi-square and Fisher’s exact tests, and p < 0.05 was considered significant. Group 1 presented one case of fluid collection (seroma), which was diagnosed and drained around the tenth postoperative day. Group 2 presented three cases of fluid collection (one hematoma and two seromas), which were diagnosed on the seventh (hematoma) and ninth (seromas) postoperative days. There was no statistically significant difference between groups 1 and 2 with regard to fluid collection in the postoperative period. We believe that because of their late presentation (between the sixth and tenth postoperative days), use of aspiration drains seems to have no effect on seroma prevention. In the case of the hematomas, it is believed that use of drains has an important role in monitoring bleeding in the first 24 hours after surgery. Later hematomas, such as the ones identified in this study, are not prevented by the use of drains, which are removed around the first or second postoperative day (when drainage volumes are less than 50 ml/24 hours). In addition, use of drains for extended periods is not advisable, as they increase discomfort and reduce patient mobility, which contributes to a higher incidence of morbidities such as local infections and thromboembolic accidents.3,4 The patient population in this study consisted of young women with early first pregnancy and multiple pregnancies and a history of recent weight loss. It was seen that the formation of fluid collections was not significantly affected by the use of drains. Giuliano Borile, M.D. Department of Plastic Surgery and Reconstructive Microsurgery Santa Casa Hospital Center Michel Pavelecini, M.D. Rodrigo Dreher, M.D. Department of Plastic Surgery and Reconstructive Microsurgery Santa Casa Hospital Center School of Plastic Surgery Fundação Faculdade Federal de Ciências Médicas de Porto Alegre Eduardo Chem, M.D. Department of Plastic Surgery and Reconstructive Microsurgery Santa Casa Hospital Center Roberto Corrêa Chem, M.D., Ph.D. Department of Plastic Surgery and Reconstructive Microsurgery Santa Casa Hospital Center School of Plastic Surgery Fundação Faculdade Federal de Ciências Médicas de Porto Alegre Porto Alegre, Brazil
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