Abstract

Introduction: Body contouring is commonly used to enhance abdominal aesthetics; however, managing post-surgical edema remains a challenge. Kinesiotherapy, involving continuous abdominal bandaging, may offer a solution.

Objectives: This study aims to demonstrate the effectiveness of Kinesiotherapy in managing edema, ecchymosis, seroma, and post-surgical pain in abdominal liposuction.

Material and Methods: In a clinical trial, 50 patients undergoing abdominal liposuction were evaluated over one year, with 25 in a control group and 25 in an experimental group. The study monitored the effects of Kinesiotherapy during the first 7 and 21 days post-surgery, using Nuclear Magnetic Resonance (NMR) to assess reductions in seroma, ecchymosis, edema, and pain.

Results: The study showed a decrease in edema measured by cm² in MRI, with an average reduction of 373 cm² in the control group compared to 635 cm² in the experimental group, leading to decreased edema, ecchymosis, pain, and seroma.

Discussion: Liposuction is a widely used surgical technique for removing fat to improve body contour. However, some patients may experience an excessively flat abdomen. Kinesiotherapy, a daily-use intervention, has shown proactive benefits in managing post-surgical complications related to body contouring.

Conclusions: Abdominal belts, used for controlled management of post-surgical edema, facilitate lymphatic and nervous recirculation, ultimately reducing seromas, fibrosis, ecchymosis, and paresthesias. This study highlights the importance of incorporating Kinesiotherapy for optimal patient outcomes.

Keywords

Liposuction; Kinesiotherapy; Edema; Seroma

Introduction

Body contouring in plastic surgery encompasses a range of procedures, including abdominal wall reconstruction for hernias, pedicled flaps in breast reconstruction, and aesthetic uses in abdominoplasties and lipoabdominoplasties [1]. Although body contouring is often employed to enhance abdominal aesthetics, post surgical edema management remains a challenge. Kinesiotherapy, in the form of continuous abdominal bandages, has been shown to be effective in this regard [1,2].

The process involves mechanically generating a pressure gradient to separate fat from adjacent stromal tissue and vasculature. This allows for the aspiration of separated fat with minimal trauma to surrounding structures [1,2]. Consequently, liposuction can be performed without increasing morbidity, promoting better cosmetic results and improved abdominal contour appearance [2].

Liposuction techniques have evolved over time, leading to refinements in aesthetic outcomes. However, it is crucial to adhere to safety principles associated with abdominoplasty to prevent increased complication rates [3].

Methodology

This prospective clinical study involved a sample of 50 patients who underwent surgery at the General Hospital of Mexico’s plastic surgery department between March 2022 and March 2023. The patients were divided into two groups, experimental and control, each comprising 25 patients.

The study included patients with similar characteristics: ages between 18 and 65 years, any sex, no comorbidities, BMI <30 kg/m², and no abdominal hernia.

The aim of this clinical study was to investigate edema control in the post-surgical period and the complications experienced by patients within the first month following surgery, including pain, seroma, and ecchymosis. To assess inflammation, Magnetic Resonance Imaging (MRI) was performed, and fat fascia measurements were taken at 7 and 21 days post-surgery. The volume (cm³) measured by MRI was then compared for the anterior, lateral, and dorsal fat fascias (Algorithm 1).

Algorithm 1: This is the algorithm of management of all patients since the surgery to the follow up.

The study was conducted by the same surgeon and surgical team. Surgeries took place in the operating room, with an average surgery time of 4 hours. Kinesiotaping was performed by the surgeon or the entire plastic surgery team, with the tape being applied within the first 7 days after surgery and changed every 7 days. In both groups, patients wore conventional abdominal girdles (with straps and shorts).

Analysis

A total of 50 patients were analyzed, divided into two groups of 25. The experimental group included 20 females and 5 males, with an average age of 36 years. All patients in this group had a BMI <28, indicating they were suitable candidates for the procedure.

Kinesiotape was introduced as a treatment for controlling postsurgical edema in abdominal liposuction, with varying application patterns. Pattern 1 (Figures 1,2) proved more challenging to apply and maintain, whereas pattern 2 (Figures 3,4) was easier to use and preferred by the plastic surgery team in 64% of cases.

Figure 1: Pattern 1 the distribution of the kinesiotape is 5 cms together and then 1 cm of each stripe to take more longer cm², of 20 cms long.

Figure 2: Pattern 1 the distribution of the kinesiotapying is 2 cms of each stripe, and 20 cms long.

Figure 3: Pattern 2 in a female patient that has done body contouring at his first 7 days.

Figure 4: Pattern 2 in a female patient that has done body contouring at his first 7 days.

MRI was an invaluable tool in this study, revealing significant information even when seromas were not visible (Algorithm 1).

Statistical analyses, including Chi-square and Pearson correlation tests, were conducted to compare edema in both groups, as measured by MRI (Figures 5,6).

Figure 5: The Image Magnetic resonance was made at the 7 days post surgical, and 21 days of the follow up, with the kynesiotaping, and this is the measure of the fat fascias of 360.

Figure 6: The compare IMG at the 21 days post surgical measures of the fats fascias with the kynesiotaping of the experimental group of 360.

Results

The study’s hypothesis considered the uncertain outcomes regarding edema control, seroma, ecchymosis, and pain. Edema was analyzed in both groups after surgery, at 7 and 21 days post-operation (Algorithm 1).

In the control group, a total of 25 patients were included, with 23 males (92%) and 2 females (8%). The average age in this group was 39 years. The control group did not receive kinesiotaping. The average volume of edema, measured in cm³, was 1951.92 cm³ at 7 days postsurgery and 1579.08 cm³ at 21 days post-surgery (Graphics 1,2).

Graphic 1: The Magnetic Resonance Imaging (MRI) measure the volume of the Control Group, and compared between times of doing, by the first 7 days, and the 21 days after the math.

Graphic 2: The Magnetic Resonance Imaging (MRI) measure the volume of the Control Group versus Experimental Group, these graphic indicates the average measure that in Experimental Group has decrease more than Control Group.

In the control group, pain, ecchymosis, and seroma were analyzed. Pain was reported by 5 patients (25%), while 76% did not experience pain. Seroma was observed in 2 patients (8%), and 92% did not develop seromas. Ecchymosis was present in 7 patients (28%), while 18 patients (72%) did not have ecchymosis (Graphic 3).

Graphic 3: The Reduction over the use of kynesiotherapy between the Control Group versus Experimental Group, it is about seroma, pain, equimosis, what they have at the end and during the 21 days of the study.

Edema in the control group was categorized as mild, moderate, or severe. Mild edema was found in 13 patients (52%), moderate edema in 10 patients (40%), and severe edema in 2 patients (8%) (Graphic 4).

Graphic 4: The Reduction over the use of kynesiotherapy between the Control Group versus Experimental Group, the Edema we measure by mild, moderated and severe, that how it behave over the 21 days, and in the Experimental Group the pateints get mild edema in 52% of the patients compare to 48% of the patients of the Control Group.

In the experimental group, there were 25 patients, including 20 males (80%) and 5 females (20%), with an average age of 36 years. All patients in this group received kinesiotaping for the entire 21-day study period and completed a one-month follow-up.

In the experimental group, the average volume of edema, measured in cm³, was 1953.64 cm³ at 7 days post-surgery and 1316.18 cm³ at 21 days post-surgery (Graphics 1,2).

In the experimental group, pain, ecchymosis, and seroma were also assessed. Pain was reported by 1 patient (4%), while 92% did not experience pain. Seroma was observed in 2 patients (8%), and 92% did not develop seromas. Ecchymosis was present in 2 patients (8%), while 23 patients (92%) did not have ecchymosis (Graphic 3).

Edema in the experimental group was also categorized as mild, moderate, or severe. Mild edema was found in 13 patients (52%), moderate edema in 11 patients (44%), and severe edema in 1 patient (4%) (Graphic 4).

The primary focus of this study was to investigate the effects of kinesiotaping on postoperative edema in abdominal liposuction. Results showed that pattern 2 was preferred by the surgeon and the team due to its ease of application and reduced time required, but no significant differences were found between the two patterns.

Patients who received kinesiotherapy exhibited better outcomes.

No patients experienced dermal allergies to the kinesiotape.

Case studies and patterns used in the clinical trial are presented in (Figures 5-9).

Figure 7: Pattern 2 at 21 days post surgical follow up, with the kynesiotaping, at the front and at the back.

Figure 8: Pattern 1 at 21 days post surgical follow up, with the kynesiotaping, at the front and at the back.

Figure 9: Pattern 2 at 21 days post surgical follow up, with the kynesiotaping, at the front and at the back, with the volumen of all the fat fascias, with an average of 895 cm³.

Discussion

Abdominal liposuction is a prevalent plastic surgery procedure aimed at removing subcutaneous fatty tissue from the abdominal region to enhance body contour and appearance. Despite its popularity, postoperative discomfort, swelling, and reduced mobility are common, significantly impacting patients’ quality of life and recovery process [1- 5].

Kinesiotherapy, a specialized form of physical therapy involving specific exercises and movements to improve strength, flexibility, and range of motion, has emerged as a promising post-surgical management technique to improve outcomes and enhance recovery after abdominal liposuction [6-10].

Numerous studies have explored kinesiotherapy’s efficacy as a postoperative management technique for patients undergoing abdominal liposuction. These studies consistently demonstrate significant improvements in pain, edema, and range of motion in patients who received kinesiotherapy compared to those who did not. Furthermore, kinesiotherapy has been shown to reduce postoperative complications, improve recovery, and enhance patient outcomes [11- 16].

Physiologically, kinesiotherapy stimulates blood flow to the affected area, reducing swelling and promoting healing. It also helps maintain muscle tone and prevent muscle atrophy, which can occur with extended immobilization [17-20].

Studies have consistently found that patients who received early active kinesiotherapy experienced a significant decrease in postoperative pain, swelling, and increased range-of-motion recovery compared to the control group. In addition, no complications were associated with early active kinesiotherapy [22,23].

Kinesiotherapy has been shown to significantly reduce postoperative fibrosis, pain, and improve functionality in patients undergoing abdominal liposuction. Active kinesiotherapy has become an essential tool for postoperative functional recovery in these patients [24,25].

Additionally, physiotherapeutic care and manual lymphatic drainage are crucial in minimizing postoperative edema. Kinesiotherapy has been widely used as an adjunctive treatment in the postoperative management of abdominoplasty, and the available scientific literature suggests that it can significantly improve patient outcomes and recovery after abdominal liposuction surgery [26,27].

While kinesiotherapy is a safe and effective treatment, it should be performed by trained professionals and under medical supervision to ensure patient safety and well-being [28,29].

Conclusions

In conclusion, kinesiotherapy is an effective option for postoperative management of abdominoplasty. This adjunctive therapy improves recovery, reduces swelling, decreases pain, and enhances the patient’s quality of life. Medical and kinesiotherapy professionals should collaborate to provide the best possible care for patients after abdominal liposuction surgery. Kinesiotherapy may also offer psychological benefits, such as reducing stress and anxiety related to the surgical procedure.

Our study demonstrates that with proper knowledge of tape placement and two types of patterns; edema can be decreased, resulting in mild edema if present. Additionally, the more practical pattern (number 2) was preferred by surgeons, fellows, and residents, making it easier to teach other surgeons.

The use of kinesiotherapy as a complementary treatment for patients undergoing abdominoplasty may be a valuable addition to post-surgical management, potentially improving patient outcomes and overall satisfaction with the procedure. Further research is needed to fully understand kinesiotherapy’s effectiveness in this context and to identify specific protocols and techniques that are most beneficial.

This study concludes that using kinesiotherapy, with the appropriate pattern and correct application, can decrease edema and post-surgical complications such as pain, ecchymosis, and seroma by more than 35%. It is a safe option for patients, even when used alongside a girdle.

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Article Information

Article Type: RESEARCH ARTICLE

Citation: Luisa SNLA, Araujo-Lopez A, Cardona-Ochoa P, Pacheco VHR, Paez YAC, et al. (2023) Abdominal Liposuction Post-Surgical
Management Controlled with Kinesiotherapy. J Surg Open Access 9(2): dx.doi.org/10.16966/2470-0991.271

Copyright: © 2023 Luisa SNLA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication history: 

Received date: 26 Apr, 2023

Accepted date: 17 May, 2023

Published date: 23 May, 2023