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在更浅的层面上进行腹部整形皮瓣提升:减少引流的需求。

Abdominoplasty flap elevation in a more superficial plane: decreasing the need for drains.

机构信息

Chicago, Ill.; and Boston, Mass. From the Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, and the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School.

出版信息

Plast Reconstr Surg. 2010 Feb;125(2):677-682. doi: 10.1097/PRS.0b013e3181c82f78.

Abstract

BACKGROUND

Abdominoplasty has continued to become more frequently performed in the post-bariatric surgery and aesthetic patient populations. With the increase in these procedures, there is a need to decrease the length of drains for patient comfort and postoperative recovery. The authors' hypothesis was that a more superficial plane of abdominal flap elevation during abdominoplasty would decrease the postoperative need for drains.

METHODS

The authors reviewed 202 consecutive abdominoplasties with 99 procedures performed using a standard suprafascial dissection (group I) and 103 procedures using a modified plane of flap elevation that preserves the thin areolar tissue along the abdominal wall (group II). Patient demographics, perioperative complications, and drain data were recorded.

RESULTS

Patient characteristics did not differ significantly, with the mean age of group I and group II (44 +/- 8.9 years and 44 +/- 9.6 years, respectively) and body mass index of group I and group II (24 +/- 3.8 and 24 +/- 3.8, respectively) being similar. Perioperative complications included seven seromas in group I and two seromas in group II. There were two minor hematomas in group I and two minor hematomas in group II. The drains for patients in group II met criteria for removal 3 days earlier than those for group I (p < 0.0001). On average, patients in group II had drains removed at postoperative days 4 to 5.

CONCLUSIONS

Flap elevation in a plane superficial to the standard suprafascial approach during abdominoplasty may decrease the length of time required for drains in the postoperative period in the abdominoplasty patient. Decreasing the length of time for postoperative drains may improve patient comfort and expedite recovery.

摘要

背景

在减重手术后和美容患者群体中,腹部整形术的实施频率继续增加。随着这些手术的增加,需要减少引流管的长度,以提高患者舒适度和术后恢复。作者的假设是,在腹部整形术中,腹部皮瓣抬高的平面更深,术后对引流管的需求就会减少。

方法

作者回顾了 202 例连续腹部整形术,其中 99 例采用标准的皮下筋膜分离术(I 组),103 例采用改良的皮瓣提升平面,保留腹壁上的薄纤维组织(II 组)。记录患者的人口统计学特征、围手术期并发症和引流数据。

结果

患者特征无显著差异,I 组和 II 组的平均年龄分别为 44 +/- 8.9 岁和 44 +/- 9.6 岁,I 组和 II 组的体重指数分别为 24 +/- 3.8 和 24 +/- 3.8。围手术期并发症包括 I 组 7 例血清肿和 II 组 2 例血清肿。I 组有 2 例小血肿,II 组有 2 例小血肿。II 组的引流管符合提前 3 天移除的标准,而 I 组则不符合(p < 0.0001)。平均而言,II 组患者在术后第 4 至 5 天拔除引流管。

结论

在腹部整形术中,皮瓣抬高到标准皮下筋膜分离术的浅层平面,可能会减少术后腹部整形患者引流管的留置时间。减少术后引流管的留置时间可以提高患者舒适度,加快恢复。

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