Housman Tamara Salam, Lawrence Naomi, Mellen Beverly G, George Mary Noel, Filippo James San, Cerveny K Andrew, DeMarco Mario, Feldman Steven R, Fleischer Alan B
Department of Dermatology, Wake Forest University School of Medicine,Winston-Salem, North Carolina 27157, USA.
Dermatol Surg. 2002 Nov;28(11):971-8. doi: 10.1046/j.1524-4725.2002.02081.x.
Liposuction procedures are increasing in frequency and may be performed in hospitals, ambulatory surgery centers, or physician offices. Deaths associated with liposuction and previous surveys of liposuction safety have raised concern about the safety of office-based surgery.
To determine the safety of office-based, tumescent liposuction among dermatologic surgeons.
A survey mailed out to dermatologic surgeons in August 2001 requested retrospective information regarding the number of patients undergoing liposuction, the setting in which the procedures were performed, and the complications that occurred during the 7-year period from 1994 to 2000. A detailed complication record was requested for each serious adverse event or death reported. Surveys were mailed to 517 worldwide members of the American Society for Dermatologic Surgery (ASDS) listed as performing liposuction; 505 had adequate contact information. The main outcome mesure was the rate of serious adverse events (SAEs) or deaths per 1000 liposuction procedures for each service setting and for each level of conscious sedation.
The overall response rate was 89% (450/505), and of these, 78% (349/450) perform liposuction. A total of 267 dermatologic surgeons completed the survey; 261 provided data on 66,570 liposuction procedures. No deaths were reported. The overall serious adverse event rate was 0.68 per 1000 cases. The SAE rates were higher for hospitals and ambulatory surgery centers than for nonaccredited office settings. SAE rates were also higher for tumescent liposuction combined with intravenous or intramuscular sedation than combined with oral or no sedation.
Office-based tumescent liposuction performed by dermatologic surgeons is safe, with a lower complication rate than hospital-based procedures. Future legislation should recognize the proven safety of this procedure as performed by dermatologic surgeons in their offices.
抽脂手术的频率在不断增加，可在医院、门诊手术中心或医生办公室进行。与抽脂相关的死亡以及先前对抽脂安全性的调查引发了对门诊手术安全性的担忧。
确定皮肤科医生进行的门诊肿胀抽脂术的安全性。
2001年8月向皮肤科医生邮寄了一份调查问卷，要求提供1994年至2000年7年间接受抽脂手术的患者数量、手术实施地点以及发生的并发症等回顾性信息。对于每例报告的严重不良事件或死亡，要求提供详细的并发症记录。调查问卷邮寄给了美国皮肤科外科学会（ASDS）全球517名列出的进行抽脂手术的会员；505名有足够的联系信息。主要结局指标是每种手术地点以及每种清醒镇静水平下每1000例抽脂手术的严重不良事件（SAE）发生率或死亡率。
总体回复率为89%（450/505），其中78%（349/450）进行抽脂手术。共有267名皮肤科医生完成了调查；261名提供了66570例抽脂手术的数据。未报告死亡病例。总体严重不良事件发生率为每1000例0.68例。医院和门诊手术中心的SAE发生率高于未经认可的办公室环境。肿胀抽脂术联合静脉或肌肉注射镇静的SAE发生率也高于联合口服或无镇静的情况。
皮肤科医生进行的门诊肿胀抽脂术是安全的，并发症发生率低于医院手术。未来的立法应认可皮肤科医生在其办公室进行的该手术已证实的安全性。
