EXPERIMENTAL Lysine-Derived Urethane Surgical Adhesive Prevents Seroma Formation in a Canine Abdominoplasty Model Thomas W. Gilbert, Ph.D. Stephen F. Badylak, D.V.M., M.D., Ph.D. Jeffrey Gusenoff, M.D. Eric J. Beckman, Ph.D. Dottie M. Clower, Ph.D. Patrick Daly J. Peter Rubin, M.D. Pittsburgh, Pa. Background: Seroma formation is a common postoperative complication fol- lowing many surgical procedures, including abdominoplasty. Several ap- proaches have been investigated to prevent seroma formation by draining fluid or attempting to eliminate dead space, but these approaches have limited effectiveness. Methods: A canine model of abdominoplasty was developed that reliably pro- duced seroma formation. Bilateral subcutaneous pockets were created in the ventrolateral abdominal wall and additional tissue damage was inflicted using electrocautery. On one side, the tissue layers were treated with a lysine-derived urethane adhesive before closure, whereas the control side received no treat- ment before standard closure of the incision. Results: Seroma formation (60  45 ml) was observed on the control side, whereas the treated side had adherence between the tissue layers and minimal if any fluid accumulation (1.7  1.4 ml) (p  0.01) (n = 7). The adhesive invoked little or no cellular response, based on histologic examination of the tissue. Conclusion: The urethane surgical adhesive was effective in preventing the formation of seroma in this canine abdominoplasty model. (Plast. Reconstr. Surg. 122: 95, 2008.) A bdominoplasty is one of the five most com- mon cosmetic procedures performed in the United States. 1 A frequent complication of abdominoplasty is the formation of seroma, with reported complication rates ranging from 15 to 52 percent. 2–8 A postoperative seroma can result in patient discomfort, in addition to frequent visits to the office, unfavorable change in aesthetic con- tour, requirement for needle aspiration and/or placement of new drains, increased risk of infec- tion, and possible need for reoperation. A number of approaches have been used to prevent seroma formation, including the placement of closed suc- tion drains that remain in place during the early postoperative period (several days to weeks), the use of compression garments around the tissue, the use of progressive tension sutures, and the application of fibrin sealants or other surgical ad- hesives between the tissue layers. 6,7,9 –13 However, none of these methods, alone or in combination, has been recognized as a definitive treatment to avoid seroma formation, and several of these ap- proaches are associated with further complica- tions. In particular, the use of drains has been associated with many problems, including patient discomfort, leakage from drain sites, clogging of drain tubes, skin necrosis from pressure exerted on the drain tubes by tight surgical garments, and infection. 14 –16 The use of most sealants and surgi- cal adhesives has led to inconsistent adhesion be- tween the tissue layers or tissue necrosis. 17–20 As new treatment modalities are developed, there is a need for appropriate animal models with From the McGowan Institute for Regenerative Medicine and the Division of Plastic Surgery, Department of Surgery, Uni- versity of Pittsburgh, and Cohera Medical, Inc. Received for publication August 18, 2007; accepted October 22, 2007. Copyright ©2008 by the American Society of Plastic Surgeons DOI: 10.1097/PRS.0b013e31817743b8 Disclosure: Cohera Medical was solely responsible for funding the present study. Eric J. Beckman, Ph.D., Dottie M. Clower, Ph.D., and Patrick Daly are associated with Cohera Medical, Inc., and have a financial interest in the commercialization of the surgical adhesive. Eric J. Beckman, Ph.D., has pat- ents issued and pending related to the surgical adhesive. Dr. J. Peter Rubin is a paid advisor to Cohera Medical, Inc. www.PRSJournal.com 95