Scuderi N, Paolini G, Grippaudo F R, Tenna S
Aesthetic Plast Surg. 2000 Nov-Dec;24(6):395-400. doi: 10.1007/s002660010066.
Recently ultrasound assisted liposuction (UAL) and pneumatic assisted liposuction (PAL) have been introduced as an attempt to improve the results and reduce the pitfalls of standard liposuction (SAL). Until now no studies comparing, at the same time, UAL, PAL, and SAL have been published. The aim of this study was to analyze these methods from the surgeon's point of view, focusing not only on aesthetic results but also on local and systemic trauma, efficacy, handling, and cost. Forty-five cosmetic patients affected by local lipodystrophy, divided into three equal groups, have undergone liposuction with the three above-mentioned techniques. Quantitative and qualitative analysis of lipoaspirates, together with blood chemistry, local and systemic complications, time to aspirate 100 cm3, distress, fatigue, and costs of the procedures, has been recorded. Our results showed bloodier lipoaspirates in SAL and a higher percentage of triglycerides in UAL lipoaspirates. Blood tests revealed a slight decrease in the postoperative Hb in SAL only. Early complications observed were four erythemas in PAL, three ecchymoses in SAL, and one long-lasting edema in UAL. Aesthetic results rated by independent viewers were similar for all methods. Efficacy was higher in the PAL group (4 min x 100 cm3 fat aspirated) than in SAL (7 min x 100 cm3 fat) and UAL (10 min x 100 cm3 fat). Surgeon's distress was higher in PAL than in SAL and UAL. Surgeon's fatigue was much lower in the PAL group than in the others. Costs expressed as multiples of 1 unit (1 unit = $500 U.S.) were highest for UAL, low for PAL, and lowest for SAL. In conclusion, PAL and UAL caused reduced vascular injury, UAL being more selective for adipocyte removal. Complications of UAL and PAL were mostly related to the longer learning curve of these methods. The UAL procedure was much more expensive than PAL and, especially, SAL. PAL proved to be a handy technique, with the most favorable cost/benefit ratio, and seems to be the best option for busy liposuction practices or fast office procedures, even though the choice of the ideal technique always depends on the surgeon's preference.
最近，超声辅助吸脂术（UAL）和气动辅助吸脂术（PAL）已被引入，旨在改善手术效果并减少标准吸脂术（SAL）的弊端。到目前为止，尚未发表同时比较UAL、PAL和SAL的研究。本研究的目的是从外科医生的角度分析这些方法，不仅关注美学效果，还关注局部和全身创伤、疗效、操作和成本。45名患有局部脂肪营养不良的美容患者被平均分为三组，分别接受了上述三种技术的吸脂手术。记录了吸脂物的定量和定性分析结果，以及血液化学指标、局部和全身并发症、抽吸100 cm³所需时间、痛苦程度、疲劳程度和手术成本。我们的结果显示，SAL的吸脂物出血更多，UAL的吸脂物中甘油三酯百分比更高。血液检测仅显示SAL术后血红蛋白略有下降。观察到的早期并发症包括PAL组的4例红斑、SAL组的3例瘀斑和UAL组的1例持续性水肿。独立观察者对所有方法的美学效果评分相似。PAL组的疗效（每抽吸100 cm³脂肪需4分钟）高于SAL组（每抽吸100 cm³脂肪需7分钟）和UAL组（每抽吸100 cm³脂肪需10分钟）。PAL组外科医生的痛苦程度高于SAL组和UAL组。PAL组外科医生的疲劳程度远低于其他组。以1个单位的倍数表示的成本（1个单位 = 500美元），UAL最高，PAL较低，SAL最低。总之，PAL和UAL导致的血管损伤减少，UAL对脂肪细胞的去除更具选择性。UAL和PAL的并发症大多与这些方法较长的学习曲线有关。UAL手术比PAL，尤其是SAL昂贵得多。PAL被证明是一种方便的技术，成本效益比最有利，似乎是繁忙的吸脂手术或快速门诊手术的最佳选择，尽管理想技术的选择始终取决于外科医生的偏好。
