Chatel Harold, Madar Yoni, Leyder Patrick, Bonneau Claire, Barrat Christophe, Quilichini Julien
Department of Plastic Surgery, CH Ballanger, 93600 Aulnay-sous-Bois, France.
Department of Plastic Surgery, CH Ballanger, 93600 Aulnay-sous-Bois, France.
J Plast Reconstr Aesthet Surg. 2016 May;69(5):700-5. doi: 10.1016/j.bjps.2016.01.008. Epub 2016 Feb 2.
Persistent postsurgical pain (PPP) has been reported by patients following various surgeries. Body contouring procedures are being performed more frequently, but no data are available regarding the effects of these procedures. Long-term disability occurring after performing "functional" procedures on healthy subjects is a particular concern. The aim of this study was to describe the risk factors, prevalence, characteristics, and effects of persistent pain after body contouring procedures.
Patients who underwent body contouring surgery (e.g., abdominoplasty, lower body lift, medial thigh lift, brachioplasty, and abdominal liposuction) between January 1 2009 and December 31 2013 were included in this retrospective, monocentric cohort study. Pain evaluation was performed using a visual analog pain scale (VAS) and the Douleur Neuropathique 4 (DN4) questionnaire. Major risk factors previously identified in the literature were evaluated.
The study included 199 patients. Pain was reported by 42 patients (21%). Seventy-one percent (n = 30) of these 42 patients presented with neuropathic pain. Risk factors that were significantly associated with PPP were acute postoperative pain (p = 0.0003), medical history of bariatric surgery (p = 0.002), longer period of hospitalization (p = 0.04), depressive status during the operative period (p = 0.03), substantial stress before surgery (p = 0.03), and major complications after surgery (p = 0.03).
Persistent chronic pain is frequent after body contouring procedures. Preemptive approaches and early postoperative diagnosis are important measures that can be used to limit the effects of this complication on the patient's quality of life.
据报道，各类手术后患者会出现持续性术后疼痛（PPP）。身体塑形手术的开展越来越频繁，但关于这些手术效果的数据却尚无可用。在健康受试者身上进行“功能性”手术后出现的长期残疾是一个特别令人担忧的问题。本研究的目的是描述身体塑形手术后持续性疼痛的危险因素、患病率、特征及影响。
本回顾性单中心队列研究纳入了2009年1月1日至2013年12月31日期间接受身体塑形手术（如腹壁成形术、下半身提升术、大腿内侧提升术、上臂成形术和腹部吸脂术）的患者。使用视觉模拟疼痛量表（VAS）和神经病理性疼痛4（DN4）问卷进行疼痛评估。对先前文献中确定的主要危险因素进行评估。
该研究纳入了199名患者。42名患者（21%）报告有疼痛。这42名患者中有71%（n = 30）表现为神经性疼痛。与PPP显著相关的危险因素有术后急性疼痛（p = 0.0003）、减肥手术病史（p = 0.002）、住院时间较长（p = 0.04）、手术期间的抑郁状态（p = 0.03）、手术前的巨大压力（p = 0.03）以及手术后的主要并发症（p = 0.03）。
身体塑形手术后持续性慢性疼痛很常见。预防性措施和术后早期诊断是可用于限制这种并发症对患者生活质量影响的重要措施。
