New Haven, Conn. From the Section of Plastic Surgery, Yale University School of Medicine.
Plast Reconstr Surg. 2010 Feb;125(2):683-690. doi: 10.1097/PRS.0b013e3181c82fb0.
Concerns over the safety of combining extensive liposuction with abdominoplasty in a one-stage lipoabdominoplasty procedure persist. This study reports a comparison of the perfusion-related complication rates between lipoabdominoplasty and traditional abdominoplasty among high-risk patients, those more susceptible to complications secondary to a smoking history or previous significant supraumbilical abdominal scar.
The authors conducted a chart review of 161 patients from the Yale University Cosmetic Clinic who had undergone either lipoabdominoplasty (n = 93) or traditional abdominoplasty (n = 68) between 2004 and 2009. Patients were classified as high-risk patients if they were active smokers or had undergone previous abdominal surgery resulting in a significant supraumbilical abdominal scarring. Specific vascularity-related complications were compared between the techniques.
Patients undergoing lipoabdominoplasty had a perfusion-related complication rate of 4.30 percent compared with 11.76 percent in those undergoing traditional abdominoplasty (p = 0.126). Among high-risk patients (26 smokers and 19 patients with significant supraumbilical scars), there was no statistically significant difference for perfusion-related complications, including skin necrosis, wound infection, and wound dehiscence. The need for surgical revision was 10.75 percent in patients undergoing lipoabdominoplasty, whereas 20.58 percent of patients undergoing traditional abdominoplasty needed revision surgery (p = 0.116).
Lipoabdominoplasty is not associated with a statistically significant increase in perfusion-related complication rates as compared with traditional abdominoplasty, despite the fact that it involves potential trauma to the vascularity of the elevated abdominoplasty flap. This holds true even in patients who are at increased risk for perfusion-related complications secondary to a history of active smoking or a previous supraumbilical scar.
人们对在一个阶段的吸脂腹部整形手术中将广泛吸脂与腹部整形结合的安全性仍存在担忧。本研究报告了在有吸烟史或先前有明显脐上腹部疤痕的高危患者中，吸脂腹部整形术与传统腹部整形术的灌注相关并发症发生率的比较。
作者对 2004 年至 2009 年在耶鲁大学美容诊所接受吸脂腹部整形术（n = 93）或传统腹部整形术（n = 68）的 161 例患者进行了图表回顾。如果患者是活跃的吸烟者或先前的腹部手术导致明显的脐上腹部疤痕，则将其归类为高危患者。比较两种技术之间的特定血管相关并发症。
接受吸脂腹部整形术的患者的灌注相关并发症发生率为 4.30％，而接受传统腹部整形术的患者为 11.76％（p = 0.126）。在高危患者（26 名吸烟者和 19 名有明显脐上疤痕的患者）中，灌注相关并发症（包括皮肤坏死，伤口感染和伤口裂开）没有统计学差异。接受吸脂腹部整形术的患者需要手术修正的比例为 10.75％，而接受传统腹部整形术的患者则为 20.58％（p = 0.116）。
尽管吸脂腹部整形术涉及到提升腹部整形皮瓣的血管潜在创伤，但与传统腹部整形术相比，其灌注相关并发症发生率并没有统计学上的显著增加。即使在因吸烟史或先前的脐上疤痕而有灌注相关并发症风险增加的患者中也是如此。
