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肿胀技术在门诊腹壁成形术及其他同期身体塑形手术中的应用:对65例连续患者的回顾

Use of Tumescence for Outpatient Abdominoplasty and Other Concurrent Body Contouring Procedures: A Review of 65 Consecutive Patients.

作者信息

Holzman Nathaniel L, Singh Mansher, Caterson Stephanie A, Eriksson Elof, Pomahac Bohdan

机构信息

Langhorne Plastic & Reconstructive Surgery, Langhorne, Pa.

Division of Plastic Surgery, Brigham & Women's Hospital, Boston, Mass.

出版信息

Eplasty. 2015 Sep 1;15:e38. eCollection 2015.

Abstract

INTRODUCTION

Abdominoplasty is being increasingly performed as an outpatient procedure. The role of tumescent technique in decreasing postoperative pain and hospital stay has not been extensively studied.

METHODS

We reviewed 65 consecutive patients who underwent tumescent abdominoplasty over 20 months by a single surgeon. All the patients were followed up for at least 1 year. The outcomes were evaluated in terms of systemic complications such as deep vein thrombosis and pulmonary embolism and local complications such as seroma, wound infection, and skin necrosis.

RESULTS

Of the 65 patient records analyzed, 61 were of females and 4 of males. Average age for the patient population was 45.2 years. Mean follow-up was at least 1 year for all the patients. Ninety-five percent of patients could be discharged the same day with tumescent abdominoplasty, whereas 71% of the patients who underwent concurrent procedures with abdominoplasty were also able to go home the same day. All the patients reported excellent postoperative pain control. There was no report of deep vein thrombosis or pulmonary embolism in any of these patients. Wound complications occurred in 14 patients (21.6%), of which 12 patients had seroma (18.5%) and 2 had wound infection (3.1%). The seromas were treated with repeated aspirations or Jackson-Pratt drain placement, whereas the wound infections resolved with outpatient antibiotics.

CONCLUSIONS

The safety and efficiency of outpatient abdominoplasty can be further facilitated by utilizing tumescence. Tumescence helps the patients be discharged sooner, usually the same day, mobilize sooner, and rely less on oral narcotics at home.

摘要

引言

腹壁成形术作为一种门诊手术越来越多地被开展。肿胀技术在减轻术后疼痛和缩短住院时间方面的作用尚未得到广泛研究。

方法

我们回顾了由一位外科医生在20个月内连续进行肿胀麻醉腹壁成形术的65例患者。所有患者均接受了至少1年的随访。对全身并发症如深静脉血栓形成和肺栓塞以及局部并发症如血清肿、伤口感染和皮肤坏死等结果进行了评估。

结果

在分析的65例患者记录中,女性61例,男性4例。患者群体的平均年龄为45.2岁。所有患者的平均随访时间至少为1年。95%的患者在肿胀麻醉腹壁成形术后当天即可出院,而71%同时进行腹壁成形术相关手术的患者也能够在当天回家。所有患者均报告术后疼痛得到良好控制。这些患者中无一例报告有深静脉血栓形成或肺栓塞。14例患者(21.6%)出现伤口并发症,其中12例有血清肿(18.5%),2例有伤口感染(3.1%)。血清肿通过反复抽吸或放置杰克逊-普拉特引流管进行治疗,而伤口感染通过门诊使用抗生素得以解决。

结论

利用肿胀麻醉可进一步提高门诊腹壁成形术的安全性和效率。肿胀麻醉有助于患者更快出院,通常是在当天,更快活动,并且在家中减少对口服麻醉药的依赖。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/244d/4559067/9e3b0e22ae6e/eplasty15e38_fig1.jpg

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