Dallas, Texas; and Newark, N.J. From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; and Division of Plastic Surgery, Rutgers New Jersey Medical School.
Plast Reconstr Surg. 2013 Sep;132(3):352e-360e. doi: 10.1097/PRS.0b013e31829acc60.
Steroids have been used in cosmetic plastic surgery to reduce postoperative edema and ecchymosis. We performed a systematic review of the literature addressing postoperative steroid use after rhinoplasty. Due to a paucity of studies, a review of the literature was also performed for postoperative steroid use in rhytidectomy and body contouring surgery.
An exhaustive literature search was performed using: MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and PubMed. A total of 12 articles were chosen to be included in the rhinoplasty systematic review. Cohen's kappa for level of agreement between the two reviewers was 1.0. Data recorded from each of the studies included: author, year, sample size, age, follow-up, statistical analyses, eyelid/edema assessment, significant findings, p values, and steroid regimens. A general review of the current rhytidectomy and body contouring literature associated with corticosteroids was performed as well.
No statistically significant long-term reduction in postoperative edema or ecchymosis after rhinoplasty. Significant reductions were noted in the short term (<2 days). Review of the rhytidectomy literature described no significant decrease in postoperative edema or ecchymosis. Steroid use was noted to reduce postoperative nausea and vomiting when combined with other therapies in body contouring.
Steroid use is not warranted in the postoperative period and only reduces transient edema and ecchymosis. A significant benefit for steroid use after rhytidectomy is not evident as well. Steroid use may benefit in postoperative nausea and vomiting.
类固醇已被用于美容整形手术中，以减少术后水肿和瘀斑。我们对隆鼻术后使用类固醇的文献进行了系统评价。由于研究较少，我们还对除皱术和身体塑形术后使用类固醇的文献进行了综述。
使用 MEDLINE、Cochrane 系统评价数据库、Cochrane 对照试验中心注册库和 PubMed 进行全面的文献检索。共有 12 篇文章被选入隆鼻术系统评价。两位审稿人之间的一致性 Cohen's kappa 值为 1.0。从每项研究中记录的数据包括：作者、年份、样本量、年龄、随访、统计分析、眼睑/水肿评估、重要发现、p 值和类固醇方案。还对与皮质类固醇相关的当前除皱术和身体塑形文献进行了一般性综述。
隆鼻术后，术后水肿或瘀斑无统计学意义的长期减轻。短期内（<2 天）有明显减少。对除皱术文献的回顾显示，术后水肿或瘀斑无明显减少。在身体塑形中与其他疗法联合使用时，类固醇可减少术后恶心和呕吐。
术后使用类固醇没有必要，只会减少短暂的水肿和瘀斑。除皱术后使用类固醇也没有明显的益处。类固醇的使用可能有助于术后恶心和呕吐。
