Fibrin Sealant and Abdominoplasty: An Ally Against Complications?

Abdominoplasty is a common aesthetic and reconstructive procedure frequently complicated by postoperative seroma formation, with reported incidences between 5 and 30%. While strategies like closed-suction drainage and quilting sutures are standard, fibrin sealants have emerged as a biological alternative to reduce dead space. This study aimed to evaluate whether the application of ARTISS® (a low-thrombin fibrin sealant) reduces the incidence of seroma and other postoperative complications following abdominoplasty.

A retrospective, single-center study was conducted on 40 patients undergoing primary abdominoplasty between August 2022 and June 2025. Patients were divided into two groups: the ARTISS group (n = 21), receiving 4 mL of sprayed fibrin sealant prior to flap redraping, and the control group (n = 19), receiving standard surgery without sealant. Neither group received quilting sutures, and all procedures were performed by a single surgeon using a standardized technique. Statistical comparisons were performed using appropriate parametric or non-parametric tests, with significance set at p < 0.05.

Baseline characteristics were comparable between groups. Postoperative complications occurred in 14.3% of the ARTISS group versus 31.6% of the control group (p = 0.265). Notably, seroma formation was observed exclusively in the control group (10%, n = 4) compared to 0% in the ARTISS group (p = 0.042). There were no significant differences in hematoma, wound dehiscence, or infection rates. In a subgroup analysis of uncomplicated cases, the ARTISS group had a shorter mean drain duration (5.94 vs. 7.80 days), though this did not reach statistical significance (p = 0.161). Mean length of hospital stay remained similar between groups (2.14 vs. 2.21 days, p = 0.861).

The intraoperative application of ARTISS^® fibrin sealant was associated with a significantly lower incidence of postoperative seroma without an increase in other complications. Although no significant differences were observed in drain duration or length of hospital stay, these findings support a potential role for fibrin sealant as an adjunct to dead space management, particularly when quilting sutures are not used. Larger prospective studies are warranted to confirm these findings and evaluate the clinical and cost-effectiveness of fibrin sealant use in abdominoplasty.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .