Salamat Arsalan, Connolly Mark, Wiesman Irvin
Department of Surgery, Presence Health Saint Joseph Hospital, Chicago, Ill.
Plast Reconstr Surg Glob Open. 2015 Feb 6;3(1):e289. doi: 10.1097/GOX.0000000000000262. eCollection 2015 Jan.
The intramuscular technique has been the most popular technique among plastic surgeons for gluteal implantation. Complication rates of up to 30% including infection, hematoma, seromas, and dehiscence are reported in several studies. One main question that arises is whether the wound dehiscence occurs first followed by infection or vice versa. We present a case study of 3 patients who received gluteal augmentation. We used an alternative technique in closure of the gluteal flap which included the use of retention sutures along the sacral incision. Follow-up included postoperative day 2, every week for 6 weeks, and then every month for 6 months. Postoperatively patients were advised to not sleep in supine position for 3 weeks and avoid pressure to the area. The 3 patients remained infection free at 2 days and weekly for 6 weeks. The use of retention sutures along the flap closure site may be a useful and simple technique to avoid high gluteal implant infection rates that have been reported in the literature. We plan to apply this technique to all of our future gluteal augmentations and track long-term results. Preventing complications will result in improved aesthetic results, increased patient satisfaction, less frequent office visits, and less financial cost to both patient and physician.
肌肉注射技术一直是整形外科医生进行臀肌植入时最常用的技术。多项研究报告称，其并发症发生率高达30%，包括感染、血肿、血清肿和伤口裂开。出现的一个主要问题是，伤口裂开是先发生然后继发感染，还是反之。我们展示了3例接受臀肌增大手术患者的病例研究。我们在臀肌皮瓣闭合中采用了一种替代技术，包括在骶骨切口处使用保留缝线。随访包括术后第2天、6周内每周一次，然后6个月内每月一次。术后建议患者3周内不要仰卧睡觉，并避免对该区域施加压力。这3例患者在术后2天及6周内每周检查时均未发生感染。在皮瓣闭合部位使用保留缝线可能是一种有用且简单的技术，可避免文献中报道的高臀肌植入感染率。我们计划将此技术应用于我们未来所有的臀肌增大手术，并跟踪长期效果。预防并发症将带来更好的美学效果、提高患者满意度、减少门诊就诊频率，并降低患者和医生的经济成本。
