Dessy Luca Andrea, Fallico Nefer, Serratore Francesco, Ribuffo Diego, Mazzocchi Marco
1 Department of Plastic and Reconstructive Surgery, "Sapienza" University of Rome, Rome, Italy ; 2 Department of Plastic and Reconstructive Surgery, University of Perugia, Via S. Andrea delle Fratte, Perugia, Italy.
Gland Surg. 2016 Jun;5(3):287-94. doi: 10.21037/gs.2015.09.02.
We present our experience in using a disposable wound retractor commonly used in abdominal surgery named Alexis(®) (Applied Medical Resources Corporation, Rancho Santa Margarita, CA, USA), during breast augmentation in order to improve outcomes, particularly final scar length.
Between January 2010 and November 2012, 40 patients undergoing breast augmentation with an inframammary approach were enrolled in the present study. Patients were randomly assigned to two groups: group 1 underwent breast augmentation with the standard technique; group 2 underwent breast augmentation by using the Alexis(®) (Applied Medical Resources Corporation) device. Patients were followed-up for a 12-month period. The time of surgery, the days of drain duration and the length of the incisions were recorded for both groups and statistical significance was evaluated with the Wilcoxon rank sum test. Also, final scar appearance was evaluated using a visual analogue scale (VAS).
Patients in group 2 reported a lower incidence of hematomas and had shorter drain duration. The difference in scar length between the two groups was statistically significant (P<0.05). Surgeons and patients were mostly satisfied with the final appearance of the scar.
The use of the Alexis(®) (Applied Medical Resources Corporation) device has proven useful in reducing the length of the inframammary incision. Interestingly, the increased visibility obtained with the use of the Alexis device allowed a better hemostasis, as suggested by the shorter drain duration and lower incidence of hematomas. However, its use prolongs the operative time, for which we recommend surgeons to allow themselves some time to become familiar with the device.
level I, evidence obtained from at least one properly designed randomized controlled trial.
我们介绍了在隆乳手术中使用一种腹部手术常用的一次性伤口牵开器Alexis®（应用医疗资源公司，美国加利福尼亚州兰乔圣玛格丽塔）的经验，以改善手术效果，特别是最终瘢痕长度。
2010年1月至2012年11月，40例行乳房下皱襞入路隆乳术的患者纳入本研究。患者被随机分为两组：第1组采用标准技术行隆乳术；第2组使用Alexis®（应用医疗资源公司）设备行隆乳术。对患者进行为期12个月的随访。记录两组的手术时间、引流天数和切口长度，采用Wilcoxon秩和检验评估统计学意义。此外，使用视觉模拟量表（VAS）评估最终瘢痕外观。
第2组患者血肿发生率较低，引流时间较短。两组间瘢痕长度差异有统计学意义（P<0.05）。外科医生和患者对瘢痕的最终外观大多满意。
已证明使用Alexis®（应用医疗资源公司）设备有助于缩短乳房下皱襞切口的长度。有趣地是，使用Alexis设备获得的视野增加使得止血效果更好，这从引流时间较短和血肿发生率较低可以看出。然而，其使用会延长手术时间，为此我们建议外科医生给自己一些时间来熟悉该设备。
I级，从至少一项设计合理的随机对照试验中获得的证据。
