Brazilian Society of Plastic Surgery, Clinica Aleixo Neto, Rua Aleixo Netto, 1666, Praia do Canto, Vitória, ES, CEP 29055-260, Brazil,
Aesthetic Plast Surg. 2013 Oct;37(5):1034-9. doi: 10.1007/s00266-013-0084-6. Epub 2013 Feb 14.
Despite the use of many different strategies and techniques and notwithstanding recent advances such as fibrin glue and short scar operations, hematoma remains the most common complication in rhytidectomies.
This study analyzed 383 patients who underwent cervicofacial rhytidectomies between September 2006 and March 2012. The patients were distributed into three groups.
Group 1 comprised patients who had classic face-lifts with epinephrine in the anesthetic solution used to infiltrate the face and neck. The incidence of hematomas in this group was 12 % (24 of 200 patients). Group 2 comprised patients who underwent face-lifts without epinephrine in the solution used to infiltrate the midface and neck. The incidence of hematomas in this group was reduced to 3.6 % (3 of 83 patients). Group 3 comprised the remaining 100 patients, who underwent rhytidectomies with internal and external quilting sutures used in conjunction with other ancillary procedures listed in this report. The incidence of hematomas in this group was reduced to 0 %.
The most important single procedure that reduced hematoma cases to zero in cervicofacial rhytidectomies was the use of quilting sutures in conjunction with other procedures. Furthermore, the use of these sutures did not cause flap ischemia or necrosis, and there was no adverse impact on the quality of the facial rejuvenation.
尽管采用了许多不同的策略和技术，并且最近取得了诸如纤维蛋白胶和短疤痕手术等进展，但血肿仍然是面部除皱术中最常见的并发症。
本研究分析了 2006 年 9 月至 2012 年 3 月期间进行颈面部除皱术的 383 名患者。患者分为三组。
第 1 组包括在麻醉溶液中使用肾上腺素浸润面部和颈部的经典面部除皱术患者。该组血肿发生率为 12%（200 例中有 24 例）。第 2 组包括在浸润中面部和颈部的溶液中不使用肾上腺素的面部除皱术患者。该组血肿发生率降低至 3.6%（83 例中有 3 例）。第 3 组包括其余 100 名患者，他们接受了内部和外部绗缝缝线的除皱术，并结合本报告中列出的其他辅助手术。该组血肿发生率降低至 0%。
在颈面部除皱术中，将血肿病例减少到零的最重要的单一操作是使用绗缝缝线结合其他手术。此外，使用这些缝线不会导致皮瓣缺血或坏死，并且对面部年轻化的质量没有不利影响。
