The review question and inclusion criteria were broadly defined. The literature search involved three databases, but as it was restricted to articles in English, language bias may have been introduced. The authors did not state that they undertook each stage of the review process in duplicate, which meant that reviewer error and bias could not be ruled out.
The quality of the included studies was not formally assessed, but the authors acknowledged the limitations of retrospective data. The authors also acknowledged the limitations in combining findings due to the different patient populations and surgeon techniques. However, the statistical comparison undertaken was very simplistic and did not take into account the direct comparisons performed in the individual studies, or factors that may have differed across studies. Thus the results presented did not provide any useful direct evidence to determine the effectiveness of the interventions in comparison to each other. There were discrepancies in the number of venous thromboembolic events and frequency (%) presented in the tables, with the figures suggesting that similar frequencies occurred in patients undergoing abdominoplasty plus concomitant plastic surgery or an intra-abdominal procedure, which did not reflect the authors' conclusions.
Given the limitations with the review process, the unknown quality of the included studies, the simplistic statistical comparison undertaken, and the uncertainty regarding the results presented, the authors' conclusions should be interpreted with extreme caution.