Bennett Katelyn G, Gilman Robert H
Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, Mich.
Plast Reconstr Surg Glob Open. 2017 Feb 21;5(2):e1225. doi: 10.1097/GOX.0000000000001225. eCollection 2017 Feb.
Breast reduction is one of the most commonly performed plastic surgery procedures, and pedicle deepithelialization remains a time-consuming step of the operation. This is especially true when using an inferior pedicle. We present a novel technique of intradermal infiltration of the breast pedicle with local anesthetic to facilitate efficient, bloodless deepithelialization. The senior author uses a 20-ml syringe to inject 0.25% lidocaine and 1:400,000 epinephrine just beneath the epidermis of the breast pedicle to create a series of wheals. Approximately 20 ml of local anesthetic is used per pedicle. After injection of local anesthetic, the breast pedicle is deepithelialized in less than 3 minutes. The plane is bloodless, allowing improved visualization secondary to the epinephrine-induced hemostasis. The senior author has had only one case of nipple necrosis in 20 years of experience. Intradermal infiltration of local anesthetic with epinephrine hydrodissects between the epidermis and dermis and provides hemostasis to facilitate rapid deepithelialization.
乳房缩小术是最常施行的整形手术之一，而蒂部去上皮化仍是该手术耗时的步骤。使用下蒂时尤其如此。我们介绍一种用局部麻醉剂对乳房蒂部进行皮内浸润的新技术，以促进高效、无血的去上皮化。资深作者使用20毫升注射器在乳房蒂部的表皮下注射0.25%利多卡因和1:400,000肾上腺素，形成一系列皮丘。每个蒂部大约使用20毫升局部麻醉剂。注射局部麻醉剂后，乳房蒂部在不到3分钟内完成去上皮化。手术层面无血，由于肾上腺素诱导的止血作用，视野得以改善。资深作者在20年的经验中仅有1例乳头坏死病例。含肾上腺素的局部麻醉剂皮内浸润在表皮和真皮之间进行水分离，并提供止血作用，以促进快速去上皮化。
