Demir Canser Yilmaz, Sultanoglu Yılmaz, Kocak Omer Faruk, Ersoz Muhammet Eren
Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Yuzuncu Yıl University, Van, Turkey.
Aesthetic Plast Surg. 2017 Oct;41(5):1024-1030. doi: 10.1007/s00266-017-0895-y. Epub 2017 May 23.
To compare the perioperative findings of inferior pedicle reduction mammoplasty (IPRM) performed with or without a tourniquet.
This study was carried out in the plastic and reconstructive surgery department at a tertiary care center on a total of 42 consecutive women scheduled for IPRM. Patients in Group I (n = 21) underwent surgery using a tourniquet, whereas patients in Group II (n = 21) were operated on without a tourniquet. Levels of hemoglobin (Hb), hematocrit (Hct), Hct/Hb ratio, and platelet counts were noted preoperatively and on postoperative 24th and 48th h. Numbers of surgical pads and gauze sponges completely used and dripping with blood were recorded. Duration of operation, the amount of breast tissue excised on both sides, and fluid collected in hemovac drains on 48th h after operation were documented.
In Group I, the operative time was significantly shorter (p < 0.001), and numbers of gauze sponges and surgical pads were fewer (p < 0.001 for both). Hemoglobin levels were significantly higher in Group I on postoperative 24th (p = 0.002) and 48th h (p = 0.007). Similarly, hematocrit levels in Group I were higher than those of Group II on postoperative 24th (p = 0.004) and 48th h (p = 0.009).
We determined that use of a tourniquet significantly reduced the operative time and blood loss during IPRM. Therefore, our preliminary results support that tourniquet usage is practical and safe, and it may also improve the cost-effectiveness of the procedure.
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比较使用或不使用止血带进行下蒂缩乳术（IPRM）的围手术期结果。
本研究在一家三级医疗中心的整形与重建外科进行，共有42例连续安排接受IPRM的女性患者。第一组（n = 21）患者使用止血带进行手术，而第二组（n = 21）患者不使用止血带进行手术。术前以及术后第24小时和第48小时记录血红蛋白（Hb）、血细胞比容（Hct）、Hct/Hb比值和血小板计数。记录完全使用且沾满血液的手术垫和纱布海绵的数量。记录手术时间、双侧切除的乳腺组织量以及术后第48小时在负压引流管中收集的液体量。
在第一组中，手术时间明显更短（p < 0.001），纱布海绵和手术垫的数量更少（两者均p < 0.001）。第一组术后第24小时（p = 0.002）和第48小时（p = 0.007）的血红蛋白水平明显更高。同样，第一组术后第24小时（p = 0.004）和第48小时（p = 0.009）的血细胞比容水平高于第二组。
我们确定在IPRM中使用止血带可显著减少手术时间和出血量。因此，我们的初步结果支持使用止血带是实用且安全的，并且它还可能提高该手术的成本效益。
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