【 文献重点摘要 】
 

Background: Despite the popularity of these procedures, there are limited published prospective studies evaluating liposuction and abdominoplasty. Lipoabdominoplasty is a subject of recent attention. Several investigators have recommended alternative techniques that preserve the Scarpa fascia in an effort to reduce complications, particularly the risk of seromas.

Methods: Over a 5-year period, 551 consecutive patients were treated with ultrasonic liposuction alone (n = 384), liposuction/abdominoplasty (n = 150), or abdominoplasty alone (n = 17). In lipoabdominoplasties, the abdomen and flanks were first treated with liposuction. A traditional flap dissection was used for all abdominoplasties. Scalpel dissection was used rather than electrodissection. A supine “jackknife” position was used in surgery to provide maximum hip flexion, allowing a secure deep fascial repair.

Results: The complication rate after liposuction was 4.2% vs 50% for patients treated with an abdominoplasty. Approximately half of the abdominoplasty complications were minor scar deformities, including widened umbilical scars (17.3%) that were revised. The seroma rate after abdominoplasties was 5.4%; there were no seromas after liposuction alone.

Conclusions: Lipoabdominoplasty may be performed safely, so that patients may benefit from both modalities. The seroma rate is reduced by avoiding electrodissection, making Scarpa fascia preservation a moot point. A deep fascial repair keeps the abdominoplasty scar within the bikini line. Deep venous thrombosis and other complications may be minimized with precautions that do not include anticoagulation.

背景：尽管这些手术很受欢迎，但评估抽脂和腹部成形术的前瞻性研究发表的很有限。腹脂成形术是最近备受关注的话题。一些研究人员已经推荐了保留疤痕筋膜的替代技术，以努力减少并发症，特别是血清瘤的风险。

方法：在5年的时间里，连续551名患者接受了单独的超声吸脂术(n=384)、抽脂/腹部成形术(n=150)或单独的腹部成形术(n=17)。
在腹部脂肪整形术中，首先对腹部和腹部进行抽脂治疗。所有腹部整形手术均采用传统的皮瓣剥离。使用手术刀解剖，而不是电切。在手术中使用仰卧“折刀”姿势，以提供最大的髋关节屈曲，从而实现安全的深筋膜修复。

结果：腹部整形术后并发症发生率分别为4.2%和50%。大约一半的腹部成形术并发症是轻微的瘢痕畸形，包括矫正过的增宽的脐部瘢痕(17.3%)。腹部手术后血清肿大率为5.4%，单纯抽脂后未见血清肿块。

结论：腹脂成形术可以安全地进行，因此患者可以从这两种方法中获益。避免电切开可降低浆液瘤率，使疤痕筋膜保存成为一个值得商榷的问题。深层筋膜修复将腹部整形疤痕保留在比基尼线内。深静脉血栓和其他并发症可以通过不包括抗凝的预防措施来最小化。