Ouar N, Guillier D, Moris V, Revol M, Francois C, Cristofari S
Service de chirurgie plastique reconstructrice et esthétique, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France.
Service de chirurgie plastique reconstructrice et esthétique, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France; UFR des sciences de santé, 7, boulevard Jeanne-d'Arc, 21000 Dijon, France; CHU de Dijon, 14, rue Paul-Gaffarel, 21000 Dijon, France.
Ann Chir Plast Esthet. 2017 Jun;62(3):219-223. doi: 10.1016/j.anplas.2017.02.005. Epub 2017 Mar 9.
Labia minora reduction interventions rise in Europe and in North America. Several techniques are described. The objective of this study was to compare postoperative complications of the two most practiced interventions: wedge resection and edge resection.
Primary labia minora reductions realized in our unit between October 2009 and July 2016 have been retrospectively identified. Two techniques were used by two surgeons: edge resection technique and wedge resection technique. The main evaluation criterion was the occurrence and the quantity of wound dehiscence: superior to 50% (total or subtotal) and inferior to 50% (partial). Patients were systematically examined at 1 week, 1 month and 6 months postoperatively. Data analysis between both groups was made with an exact Fisher test.
Mean follow-up was 5.3 months after intervention. Sixty-four patients have been included, 42 wedge resections (group C) and 22 edge resections (group L). Global complication rate at 1 month was 13% (n=8). Among wedge resections 14% (n=6) developed complication and 2% (n=9) among edge resection. Seven surgical revisions were necessary: 5 for wound dehiscence (4 in the group C and 1 in the group L) and 2 for hematoma, one in each group. Three (5%) partial wound dehiscence (inferior to 50%) have been identified and let in secondary intention healing: 2 (19%) in the group C and 1 (27%) in the group L. Complication rates between both techniques were not significantly different.
Postoperative wound dehiscence is the main labia minora reduction complication. Our global complication rate, 13%, matches with the current literature. A tendency can be shown where wedge resection is more likely to develop wound dehiscence than edge resection.
在欧洲和北美，小阴唇缩小手术的实施有所增加。已有多种技术被描述。本研究的目的是比较两种最常用手术方式的术后并发症：楔形切除术和边缘切除术。
对2009年10月至2016年7月在我们科室进行的原发性小阴唇缩小手术进行回顾性分析。两位外科医生使用了两种技术：边缘切除技术和楔形切除技术。主要评估标准是伤口裂开的发生情况和程度：超过50%（完全或部分）和低于50%（部分）。术后1周、1个月和6个月对患者进行系统检查。两组间的数据分析采用精确费舍尔检验。
干预后的平均随访时间为5.3个月。共纳入64例患者，42例行楔形切除术（C组），22例行边缘切除术（L组）。1个月时的总体并发症发生率为13%（n = 8）。楔形切除术中14%（n = 6）出现并发症，边缘切除术中2%（n = 9）出现并发症。需要进行7次手术修复：5次用于伤口裂开（C组4次，L组1次），2次用于血肿，每组各1次。已确认3例（5%）部分伤口裂开（低于50%），让其二期愈合：C组2例（19%），L组1例（27%）。两种技术之间的并发症发生率无显著差异。
术后伤口裂开是小阴唇缩小手术的主要并发症。我们13%的总体并发症发生率与当前文献相符。可以看出一种趋势，楔形切除术比边缘切除术更易发生伤口裂开。
