Xu Zhicheng, Zhang Ruhong, Zhang Qun, Xu Feng
Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, School of Medicine, Shanghai JiaoTong University.
Can J Plast Surg. 2012 Winter;20(4):218-22. doi: 10.1177/229255031202000401.
Negative suction drainage is commonly used for the prevention of seromas or hematomas in auricular reconstruction surgery; however, there are few reports regarding the quantitative measurement of negative suction and its relation to disposed time, patient age or microtia type. In the present study, the authors recorded the volume of suction exudate in microtia reconstruction and elaborate on the relevant details of controlling negative suction. A negative suction drainage system was applied in 96 microtia patients between 2007 and 2010. Two small polyethylene drains were inserted adjacent to the concha and the scapha, respectively. The volume of exudate was recorded for three days after surgery and was analyzed according to disposed time, patient age and microtia type. The drains were removed on the third postoperative day, when only a small amount of exudate remained. A significant change in drainage was observed over three days postoperatively, and the quantity decreased progressively on the third postoperative day. Comparison of age groups showed that the volume of drainage from adults was greater than that from children or adolescents in the first two postoperative days, regardless of whether the drains were inserted in the scapha or concha. No statistical differences were found on the third postoperative day. A comparison of drain types revealed no statistically significant differences between scapha and concha drains three days postoperatively. The analysis demonstrated that drainage quantity is related to disposed time and patient age, but not to microtia type. The authors recommend removal of suction drains on the third postoperative day. Moreover, individualized negative suction treatment according to age or microtia type provides a safe and consistent approach to achieving acceptable results and fewer complications.
负压引流常用于耳廓再造手术中预防血清肿或血肿;然而,关于负压的定量测量及其与放置时间、患者年龄或小耳畸形类型的关系的报道较少。在本研究中,作者记录了小耳畸形再造术中的引流量,并详细阐述了控制负压的相关细节。2007年至2010年间,对96例小耳畸形患者应用了负压引流系统。在耳甲腔和耳舟附近分别插入两根小的聚乙烯引流管。术后三天记录引流量,并根据放置时间、患者年龄和小耳畸形类型进行分析。术后第三天,当仅有少量渗出物时,拔除引流管。术后三天引流情况有显著变化,术后第三天引流量逐渐减少。年龄组比较显示,在前两天,无论引流管插入耳舟还是耳甲腔,成人的引流量均大于儿童或青少年。术后第三天未发现统计学差异。引流管类型比较显示,术后三天耳舟引流管和耳甲腔引流管之间无统计学显著差异。分析表明,引流量与放置时间和患者年龄有关,但与小耳畸形类型无关。作者建议术后第三天拔除负压引流管。此外,根据年龄或小耳畸形类型进行个体化负压治疗,为获得可接受的结果和减少并发症提供了一种安全且一致的方法。