Ischemic defect of the anterior abdominal wall after abdominoplasty: a clinical case

Introduction. Impaired healing of postoperative wounds after abdominoplasty remains a relevant clinical problem. One of the main causes of complications is skin ischemia resulting from impaired microcirculation and reduced tissue perfusion. The risk increases with extensive incisions and significant tissue tension.
Objective. To present the clinical course and outcomes of staged treatment of ischemic skin changes after abdominoplasty using a clinical case.
Materials and methods. A clinical case of a 42-year-old female patient who underwent abdominoplasty is presented. Clinical follow-up, analysis of medical records, and photographic documentation were performed. The condition of the postoperative wound, severity of ischemia, dynamics of reparative processes, and effectiveness of conservative and surgical treatment were assessed.
Results and discussion. In the early postoperative period, skin ischemia developed in the area of the vertical scar while the sutures remained intact. Systemic therapy did not result in a significant improvement in tissue trophism. Subsequently, the ischemic tissue was rejected, resulting in localized wound defects. Surgical wound debridement followed by secondary closure resulted in satisfactory clinical and aesthetic outcomes. These findings indicate the feasibility of a staged approach involving dynamic monitoring and timely surgical correction.
Conclusion. A comprehensive staged approach to the treatment of ischemic complications after abdominoplasty can promote favorable wound healing and satisfactory aesthetic outcomes.

1. Shiryaeva A.V., Kozelichkin A.V., Fedorovtsev V.A. Simultaneous operations in plastic surgery. A clinical case of combined hernia abdominoplasty. Collection of abstracts of the 55th interregional interdisciplinary scientific and practical conference based on the results of industrial practice with international participation. Nizhny Novgorod, October 19–20, 2023. Nizhny Novgorod; Privolzhsky Research Medical University Publishing House, 2023, рр. 130–131. (In Russ.).

2. Mamedov O.M. Abdominoplasty as a method of body contour correction after massive weight loss. 11th Final Scientific Session. Rostov-on-Don, October 23, 2024. Rostov-on-Don; Rostov State Medical University, 2024, рр. 71–79. (In Russ.).

3. Belov Yu.V., Vaganov A.G., Shono A.A., Aslanov A.D. Experimental study of the effectiveness of skin-fat flap harvesting under fluorescence spectroscopy control. Ambulatory Surgery, 2025, no 22(2), pp.172–181. (In Russ.). https://doi.org/10.21518/akh2025-038

4. Murkamylov I.T., Aitbaev K.A., Ymankulov D.S., Khakimov N.S., Rayimzhanov S.Z., Yusupov R.Z. et al. Therapeutic aspects of lipofilling, abdominoplasty combined with body liposuction and bariatric surgery. Bulletin of Science and Practice, 2024, no 10(7), pp. 188–228. (In Russ.). https://doi.org/10.33619/2414-2948/104/22

5. Tran D.V., Nguyen T.T., Le A.L., Lam A.Q. Subjective and objective evaluation for lipoabdominoplasty. Plastic Surgery and Aesthetic Medicine, 2024, no 3, pp. 62–69. https://doi.org/10.17116/plast.hirurgia202403162

6. Pakhomova R.A., Folomeeva L.I., Murtuzalieva A.S., Zatsarinny V.V., Efimova N.M., Ilchenko F.N. et al. Prediction of flap ischemia during abdominoplasty in patients after bariatric treatment. Moscow Surgical Journal, 2025, no 1, pp. 37–43. (In Russ.). https://doi.org/10.17238/2072-3180-2025-37-43