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循证医学:抽脂术

Evidence-Based Medicine: Liposuction.

作者信息

Chia Christopher T, Neinstein Ryan M, Theodorou Spero J

机构信息

New York, N.Y.

From the Manhattan Eye, Ear & Throat Hospital.

出版信息

Plast Reconstr Surg. 2017 Jan;139(1):267e-274e. doi: 10.1097/PRS.0000000000002859.

Abstract

LEARNING OBJECTIVES

After studying this article, the participant should be able to: 1. Review the appropriate indications and techniques for suction-assisted lipectomy body contouring surgery. 2. Accurately calculate the patient limits of lidocaine for safe dosing during the tumescent infiltration phase of liposuction. 3. Determine preoperatively possible "red flags" or symptoms and signs in the patient history and physical examination that may indicate a heightened risk profile for a liposuction procedure. 4. Provide an introduction to adjunctive techniques to liposuction such as energy-assisted liposuction and to determine whether or not the reader may decide to add them to his or her practice.

SUMMARY

With increased focus on one's aesthetic appearance, liposuction has become the most popular cosmetic procedure in the world since its introduction in the 1980s. As it has become more refined with experience, safety, patient selection, preoperative assessment, fluid management, proper technique, and overall care of the patient have been emphasized and improved. For the present article, a systematic review of the relevant literature regarding patient workup, tumescent fluid techniques, medication overview, and operative technique was conducted with a practical approach that the reader will possibly find clinically applicable. Recent trends regarding energy-assisted liposuction and body contouring local anesthesia use are addressed. Deep venous thromboembolism prophylaxis is mentioned, as are other common and less common possible complications. The article provides a literature-supported overview on liposuction techniques with an emphasis on preoperative assessment, medicines used, operative technique, and outcomes.

摘要

学习目标

在学习本文后,参与者应能够:1. 回顾吸脂辅助体型雕塑手术的适当适应症和技术。2. 在吸脂肿胀浸润阶段准确计算利多卡因的安全给药患者限量。3. 在患者病史和体格检查中确定术前可能表明吸脂手术风险较高的“红旗”或症状及体征。4. 介绍吸脂辅助技术,如能量辅助吸脂,并确定读者是否可能决定将其纳入自己的业务范围。

总结

随着人们对自身审美外观的关注度不断提高,自20世纪80年代引入以来,吸脂术已成为世界上最受欢迎的美容手术。随着经验的积累,吸脂术变得更加精细,安全、患者选择、术前评估、液体管理、正确技术以及患者的整体护理都得到了重视和改进。在本文中,对有关患者检查、肿胀液技术、药物概述和手术技术的相关文献进行了系统回顾,并采用了读者可能会发现具有临床适用性的实用方法。讨论了能量辅助吸脂和体型雕塑局部麻醉使用的最新趋势。提到了深静脉血栓栓塞的预防,以及其他常见和不太常见的可能并发症。本文提供了一篇有文献支持的吸脂技术概述,重点是术前评估、所用药物、手术技术和结果。

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