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大腿整形术的术前风险因素及并发症发生率:1493例患者的分析

Preoperative Risk Factors and Complication Rates of Thighplasty: Analysis of 1,493 Patients.

作者信息

Afshari Ashkan, Gupta Varun, Nguyen Lyly, Shack R Bruce, Grotting James C, Higdon K Kye

机构信息

Drs Afshari and Nguyen are Plastic Surgery Research Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is the Chair, Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN. Dr Afshari is also a General Surgery Resident, Department of General Surgery, University of South Carolina, Columbia, SC. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal.

出版信息

Aesthet Surg J. 2016 Sep;36(8):897-907. doi: 10.1093/asj/sjv275. Epub 2016 May 23.

Abstract

BACKGROUND

Despite a rise in thighplasties, outcomes and risk factors have not been well described.

OBJECTIVES

This study investigated the incidence and risk factors of major complications following thighplasty in a large, prospective, multicenter database. It further evaluated the safety of combined procedures.

METHODS

Patients undergoing thighplasty between 2008 and 2013 were identified within the CosmetAssure database (Birmingham, AL). The primary outcome was the occurrence of major complication(s) requiring emergency department visit, hospital admission, or reoperation within 30 days postoperatively. Age, gender, body mass index, smoking, diabetes, type of facility, and combination procedures were evaluated as risk factors.

RESULTS

Among the 129,007 patients enrolled in CosmetAssure, 1493 (0.8%) underwent thighplasty. One thousand and eighty-eight (72.9%) thighplasties were combined with other procedures. Ninety-nine (6.6%) developed at least one complication. The most common complications were infection (2.7%), hematoma (2.1%), suspected venous thromboembolism (VTE) (1.1%), fluid overload (0.5%), and confirmed VTE (0.3%). Thighplasties performed in a hospital had higher complications (8.1%) than ambulatory surgical center (6.2%) and office-based surgical suite (3.1%). When thighplasty was performed alone, smoking was an independent risk factor to develop at least one complication (RR = 9.51) and hematoma (RR = 13.48). Compared to thighplasty alone, complication rate did not increase with the addition of concomitant procedures (4.7% vs 7.4%, P = .079).

CONCLUSION

Infection and hematoma are the most common major complications. In thighplasty alone, smoking is the only independent risk factor for overall complications and hematoma formation. The addition of concomitant cosmetic procedures does not increase complication rates.

LEVEL OF EVIDENCE

2 Risk.

摘要

背景

尽管大腿整形手术的数量有所增加,但其手术效果和风险因素尚未得到充分描述。

目的

本研究在一个大型、前瞻性、多中心数据库中调查了大腿整形术后主要并发症的发生率和风险因素。它还进一步评估了联合手术的安全性。

方法

在CosmetAssure数据库(阿拉巴马州伯明翰)中识别出2008年至2013年间接受大腿整形手术的患者。主要结局是术后30天内发生需要急诊就诊、住院或再次手术的主要并发症。将年龄、性别、体重指数、吸烟、糖尿病、医疗机构类型和联合手术作为风险因素进行评估。

结果

在CosmetAssure登记的129,007例患者中,1493例(0.8%)接受了大腿整形手术。1088例(72.9%)大腿整形手术与其他手术联合进行。99例(6.6%)发生了至少一种并发症。最常见的并发症是感染(2.7%)、血肿(2.1%)、疑似静脉血栓栓塞(VTE)(1.1%)、液体超负荷(0.5%)和确诊VTE(0.3%)。在医院进行的大腿整形手术并发症发生率(8.1%)高于门诊手术中心(6.2%)和门诊手术套房(3.1%)。当单独进行大腿整形手术时,吸烟是发生至少一种并发症(RR = 9.51)和血肿(RR = 13.48)的独立风险因素。与单独进行大腿整形手术相比,联合手术的并发症发生率并未增加(4.7%对7.4%,P = 0.079)。

结论

感染和血肿是最常见的主要并发症。在单独进行大腿整形手术时,吸烟是总体并发症和血肿形成的唯一独立风险因素。联合进行美容手术不会增加并发症发生率。

证据水平

2级风险。

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