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腹壁成形术的解剖技术:手术刀与透热凝固法(凝固模式)的前瞻性研究

Dissection Technique for Abdominoplasty: A Prospective Study on Scalpel versus Diathermocoagulation (Coagulation Mode).

作者信息

Valença-Filipe Rita, Martins Apolino, Silva Álvaro, Vásconez Luis O, Amarante José, Costa-Ferreira António

机构信息

Department of Plastic, Reconstructive and Aesthetic Surgery, Maxillofacial Surgery and Burn Unit, Centro Hospitalar de São João, Porto University Medical School, Porto, Portugal; and Division of Plastic Surgery, University of Alabama, Birmingham, Ala.

出版信息

Plast Reconstr Surg Glob Open. 2015 Feb 6;3(1):e299. doi: 10.1097/GOX.0000000000000222. eCollection 2015 Jan.

Abstract

BACKGROUND

The purpose of this study was to evaluate the effect of the dissection technique on outcomes and complications after a full abdominoplasty, comparing 2 different techniques used to raise the abdominal flap: the steel scalpel and the diathermocoagulation device on coagulation mode.

METHODS

A prospective study was performed at a single center from January 2009 to December 2011 of patients submitted to abdominoplasty with umbilical transposition. Two groups were identified: group A, abdominoplasty performed with steel scalpel/knife; and group B, abdominoplasty performed with diathermocoagulation on coagulation mode. Several variables were determined: general characteristics, time until drain removal, daily and total volume of drain output, length of hospital stay, operative time, readmission, reoperation, emergency department visits, and local and systemic complications.

RESULTS

A total of 119 full abdominoplasties were performed in women (group A, 39 patients; group B, 80 patients). There were no statistically significant differences between groups with respect to general characteristics, except for body mass index, comorbidities, and weight of the surgical specimen; there were no differences for operative time, systemic complications, hematoma, and necrosis incidence. The scalpel group had a highly significant reduction of 54.56% on total drain output, and a 2.65 day reduction on time to drain removal and no reported cases of seroma or healing problems (difference of 81.25% and 90.00%, respectively, between the 2 groups).

CONCLUSIONS

Performing abdominal dissection with scalpel had a beneficial effect on patient recovery, as it reduced time requested for drain removal, total drain output, and incidence of seroma and wound healing problems.

摘要

背景

本研究旨在评估全腹壁成形术后解剖技术对手术效果和并发症的影响,比较两种用于掀起腹部皮瓣的不同技术:手术刀和处于凝血模式的高频电凝设备。

方法

2009年1月至2011年12月在单一中心对接受脐移位腹壁成形术的患者进行了一项前瞻性研究。确定了两组:A组,用手术刀进行腹壁成形术;B组,在凝血模式下用高频电凝进行腹壁成形术。确定了几个变量:一般特征、拔引流管时间、每日和总引流量、住院时间、手术时间、再次入院、再次手术、急诊就诊以及局部和全身并发症。

结果

共对女性患者进行了119例全腹壁成形术(A组39例患者;B组80例患者)。除体重指数、合并症和手术标本重量外,两组在一般特征方面无统计学显著差异;手术时间、全身并发症、血肿和坏死发生率也无差异。手术刀组的总引流量显著减少了54.56%,拔引流管时间缩短了2.65天,且未报告血清肿或愈合问题病例(两组之间分别相差81.25%和90.00%)。

结论

用手术刀进行腹部解剖对患者恢复有有益影响,因为它减少了拔引流管所需时间、总引流量以及血清肿和伤口愈合问题的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a59a/4323403/16df90d63a98/gox-3-e299-g003.jpg

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