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Orgun et al. Regenerative mechanisms of adipose-derived stem cells

A B

C D

Figure 1: (A) Anterior pre-operative marking, arrows illustrate the border of the extension of abdominoplasty; (B) the upper flap of
adipocutaneous excess marked; (C) extension of the incision line dorsally; (D) posterior pre-operative marking, in evidence the pre-sacral
area non-interested by incision lines
be marked for the correct alignment of the upper and is performed with a resorbable suture whenever is
lower flaps during the suture. needed. The navel is externalized, and two additional
drains are placed in the anterior trunk. The surgical
Surgical technique wound is closed again in three levels, as in the dorsal
The patient is anaesthetised and then placed in prone incision.
position. Pressure sore protections are placed under
shoulders, knees and ankles. The patient is prepared Postoperative care
from scapula to buttocks with povidoneiodine. Skin All patients received compression stockings and
and subcutaneous soft tissues are incised following daily prophylactic low-molecular-weight heparin
the preoperative markings to the lumbar fascia without subcutaneously, until 1 week after discharge. The
undermining of the non-resected tissues. Haemostasis patients were mobilized from the first day after surgery.
is carefully performed by electrocautery. After the Antibiotics were administered intravenously during the
excision of the adipocutaneous tissue, two drains surgery and continuedorally until discharge. Drains
are placed. Three layer closure is performed: Vicryl were removed after 4-5 days.
2/0 (Ethicon Inc, Somerville, New Jersey) for fascia
superficialis, Monocryl 3/0 (Ethicon Inc, Somerville, Follow-up
New Jersey) for the deep dermis and Monocryl 4/0 for The patients were discharged after a few days and
endodermic suture. followed up at 15 days, 1, 2, 3 and 6 months and 1 year,
or more frequently in the presence of complications.
Then the patient is placed in the supine position;
skin and subcutaneous tissues are incised down RESULTS
to the anterior abdominal wall fascia respecting the
preoperative markings. Umbilicus is isolated and We performed the extended abdominoplasty technique
preserved and the flap is elevated to the chest and the on 21 post-bariatric patients from September 2014 to
xiphoid area. Adipocutaneous excess is removed by a November 2015 and circumferential abdominoplasty
flute mouthpiece incision from the subcutaneous tissue or torsoplasty on 21 postbariatric patients during the
to the superficial fascia. Plication of the muscular fascia same period.

Plastic and Aesthetic Research ¦ Volume 4 ¦ April 21, 2017 59