A Systematic Review: Fibrin Glue in Drainless Rhytidoplasty

Area of Science:

• Plastic Surgery
• Surgical Innovation
• Evidence-Based Medicine

Background:

• Hematoma and seroma are common complications following rhytidoplasty (facelift surgery).
• Traditional rhytidoplasty often involves surgical drains and pressure dressings to manage fluid accumulation.
• Exploring alternative methods like fibrin glue aims to improve patient outcomes and reduce complication rates.

Purpose of the Study:

• To evaluate the efficacy of fibrin glue in drainless rhytidoplasty compared to standard treatment.
• To determine if fibrin glue reduces hematoma and seroma prevalence, increases patient satisfaction, or decreases hospital stay.

Main Methods:

• A systematic review and meta-analysis of five studies involving 1277 participants undergoing rhytidoplasty.
• Searched multiple databases including PubMed, Google Scholar, and Embase.
• Assessed risk of bias using the Cochrane Risk of Bias Tool 2.0 and certainty of evidence with GRADEpro GDT.

Main Results:

• Fibrin glue use was associated with a significantly lower cumulative hematoma rate (OR 0.47; 95% CI 0.26-0.84).
• Insufficient data were available to assess the impact on seroma rate, patient satisfaction, or length of hospital stay.
• The risk of bias was judged as low to moderate, with high certainty for the use of fibrin sealant versus drainage.

Conclusions:

• Fibrin glue demonstrates a clear benefit in reducing hematoma prevalence in rhytidoplasty patients compared to traditional drainage methods.
• While promising for hematoma reduction, further investigation is required to ascertain the effects of fibrin glue on other key outcomes.
• The findings support the consideration of fibrin glue as a viable alternative to drains in specific rhytidoplasty procedures.