Abdominoplasty

 Definition

Removal of loose, redundant abdominal skin and underlying subcutaneous fat, and repair of the rectus muscle as necessary.

Discussion

• The procedure is performed for cosmetic purposes, to reduce a disproportionately large collection of fat in the abdomen.
• It should not be performed for weight reduction.
• A variety of techniques can be used according to the fat distribution and the surgeon’s preference.

Positioning

• Supine, with arms extended on armboards.

Packs/ Drapes

• Basic pack with transverse Lap sheet.

Instrumentation

• Basic plastic tray
• Extra Criles or Kochers may be needed.

Supplies/ Equipment

• Basin set
• Suction
• Scales for weighing specimens
• Blades
• Needle counter
• Drainage unit

 

Procedure

1. An incision is made just above the inguinal fold, “aW” which is extended on the umbilicus, creating a diamond shape.
2. The umbilicus is preserved for later replacement under the flap.
3. Dissection is usually begun at the lower portion of the W incision and progress upward, leaving a fine layer of areolar tissue over the fascia.
4. Each lateral branch of tissue is excised.
5. The amount predetermined before removal so that the defect can be closed with moderate tension.
6. If there is a separation of the rectus muscle, it is repaired by taking “tucks” to shorten the muscle.
7. If a large ventral hernia is present, it may be repaired with synthetic mesh.
8. The wound is closed with heavy absorbable suture (deep fat) and a running subcutaneous suture.
9. The vertical branches are closed first, and the umbilicus is repositioned in the vertical scar.
10. The use of drains is according to the surgeon’s preference.

Perioperative Nursing Considerations

1. Strict aseptic technique must be maintained.
2. Weigh and record the weight of the specimen.
3. Encourage the patient not to make strenuous activities.