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腹壁成形术中使用褥式缝线预防血清肿形成:它们真的有效吗?

Use of Quilting Sutures During Abdominoplasty to Prevent Seroma Formation: Are They Really Effective?

作者信息

Sforza Marcos, Husein Rodwan, Andjelkov Katarina, Rozental-Fernandes Paulo Cesar, Zaccheddu Renato, Jovanovic Milan

机构信息

Dr Sforza Directs the Elective Internship Program in Plastic Surgery at Dolan Park Hospital in Bromsgrove, United Kingdom, and is an Examiner for the Royal College of Surgeons of Edinburgh. Mr Husein is a Medical Student at Leeds Medical School in the United Kingdom. Dr Andjelkov is a plastic surgeon in private practice in Belgrade, Serbia. Dr Rozental-Fernandes is a Surgical Resident at the Hospital do Servidor Público Municipal de São Paulo in São Paulo, Brazil. Dr Zaccheddu is a Plastic Surgeon at Dolan Park Hospital in Bromsgrove, United Kingdom. Dr Jovanovic is the Chair of the Department of Plastic and Reconstructive Surgery, University of Belgrade School of Medicine, Belgrade, Serbia.

出版信息

Aesthet Surg J. 2015 Jul;35(5):574-80. doi: 10.1093/asj/sju103. Epub 2015 May 7.

Abstract

BACKGROUND

Abdominoplasty surgery is one of the most popular cosmetic procedures performed in plastic surgery. As with any surgical procedure, it is associated with risks and complications, primarily that of seroma formation. Quilting sutures are a recent development in abdominoplasty surgery that aim to prevent the incidence of seroma.

OBJECTIVES

The aim of this article was to assess the effectiveness of quilting suturing in the prevention of seroma formation.

METHODS

In our retrospective clinical study, 414 female patients underwent abdominoplasty surgery with liposculpture contouring. The patients were divided in to three groups. The first group, comprising of 100 patients, were fitted with two drains postoperatively and no quilting sutures. The second group of 226 patients underwent quilting suturing in addition to receiving two drains. And the final group of 88 patients also underwent quilting suturing, but received only one drain. Post-operative seroma diagnosis was confirmed with the presence of clinical signs and symptoms.

RESULTS

The data was analysed using Fisher's exact test. With P < .000, we rejected our null hypothesis that there is no difference in results between the procedure with sutures and that without sutures. We calculated that the probability of having seroma with sutures to be <0.02. In contrast, abstinence from quilting sutures resulted in a 12% risk of seroma formation.

CONCLUSIONS

The use of quilting sutures is a significantly effective measure for the prevention of seroma formation.

LEVEL OF EVIDENCE

4 Therapeutic.

摘要

背景

腹壁成形术是整形外科中最常见的美容手术之一。与任何外科手术一样,它存在风险和并发症,主要是血清肿形成。褥式缝合是腹壁成形术的一项新进展,旨在预防血清肿的发生。

目的

本文旨在评估褥式缝合在预防血清肿形成方面的有效性。

方法

在我们的回顾性临床研究中,414名女性患者接受了腹壁成形术及脂肪雕塑塑形。患者被分为三组。第一组100名患者术后安装两根引流管,未进行褥式缝合。第二组226名患者除安装两根引流管外还进行了褥式缝合。最后一组88名患者也进行了褥式缝合,但只安装了一根引流管。术后血清肿的诊断通过临床体征和症状来确认。

结果

使用Fisher精确检验对数据进行分析。P <.000,我们拒绝了原假设,即缝合手术和未缝合手术的结果没有差异。我们计算出缝合后发生血清肿的概率<0.02。相比之下,不进行褥式缝合血清肿形成的风险为12%。

结论

使用褥式缝合是预防血清肿形成的一种非常有效的措施。

证据级别

4 治疗性。

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