Gusenoff Jeffrey A, Coon Devin, Nayar Harry, Kling Russell E, Rubin J Peter
Pittsburgh, Pa.; and Baltimore, Md. From the Department of Plastic Surgery, University of Pittsburgh Medical Center; and the Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital.
Plast Reconstr Surg. 2015 Jan;135(1):98-106. doi: 10.1097/PRS.0000000000000772.
Complication profiles of medial thighplasty in the massive weight loss population are not well described. The authors present their experience with these procedures in the massive weight loss population.
Thighplasty patients from 2003 to 2012 were assessed. Variables included age, sex, body mass index, method of weight loss, comorbidities, and smoking status. Outcomes included seroma, dehiscence, infection, hematoma, edema, and revision. Statistical analysis was performed as appropriate.
One hundred six subjects (90 women and 16 men) underwent thighplasty. Fourteen patients underwent horizontal thighplasty, with a complication rate of 43 percent; 24 underwent short-scar thighplasty, with a complication rate of 67 percent; and 68 underwent full-length vertical thighplasty, with a complication rate of 74 percent. Seventy-two subjects (68 percent) had at least one complication. Complications included dehiscence (51 percent), seroma (25 percent), infection (16 percent), and hematoma (6 percent). Overall, 25 patients (23 percent) developed edema, which did not resolve in two patients by 12 months. Hypertension was significantly associated with postoperative seroma (p = 0.02). Age (p = 0.01), hypothyroidism (p = 0.01), and liposuction outside the area of resection (p = 0.025) were associated with postoperative infections. A full-length vertical incision was associated with increased lower extremity edema (p = 0.007).
Medial thighplasty has a high rate of minor wound healing problems. Full-length vertical thighplasty is associated with prolonged edema. Concomitant liposuction may also increase complications. Patients should be counseled appropriately about the potential for minor wound healing problems.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
在大量减重人群中，大腿内侧整形术的并发症情况尚无详尽描述。作者介绍了他们在大量减重人群中开展这些手术的经验。
对2003年至2012年期间接受大腿整形术的患者进行评估。变量包括年龄、性别、体重指数、减重方法、合并症和吸烟状况。结果包括血清肿、伤口裂开、感染、血肿、水肿和修复手术。进行了适当的统计分析。
106名受试者（90名女性和16名男性）接受了大腿整形术。14名患者接受了水平大腿整形术，并发症发生率为43%；24名接受了短瘢痕大腿整形术，并发症发生率为67%；68名接受了全长垂直大腿整形术，并发症发生率为74%。72名受试者（68%）至少出现一种并发症。并发症包括伤口裂开（51%）、血清肿（25%）、感染（16%）和血肿（6%）。总体而言，25名患者（23%）出现水肿，其中两名患者在12个月时水肿仍未消退。高血压与术后血清肿显著相关（p = 0.02）。年龄（p = 0.01）、甲状腺功能减退（p = 0.01）和切除区域外的抽脂术（p = 0.025）与术后感染相关。全长垂直切口与下肢水肿增加相关（p = 0.007）。
大腿内侧整形术有较高的轻微伤口愈合问题发生率。全长垂直大腿整形术与水肿持续时间延长相关。同时进行抽脂术也可能增加并发症。应向患者适当告知轻微伤口愈合问题的可能性。
临床问题/证据级别：治疗性，III级
