Vera Cucchiaro Javier, Lostia Horacio, Velazquez Patricia, Liska Elizabeth
Clinic Aesthetic Surgery Salta Argentina, Salta Argentina.
Plast Reconstr Surg Glob Open. 2017 Jun 29;5(6):e1338. doi: 10.1097/GOX.0000000000001338. eCollection 2017 Jun.
Proactively preserving Scarpa's fascia and thus its intrinsic lymphatic drainage and tensile strength for suture placement can eliminate the need for drains after lipoabdominoplasty and therefore reduce the rate of seroma development. In this article, we describe the effectiveness of a modified progressive traction suture (PTS) technique, which enables us to lessen the most common complications and avoid hospital readmission; these sutures take 3-5 minutes of additional surgery time.
Two hundred seventy-six patients (mean age, 38 years; range, 19-67 years), with a mean body mass index of 25 were included in this study. All patients underwent complete lipoabdominoplasty with ultrasound-assisted liposuction (VASER) throughout the abdomen and flanks. Abdominal rectus plication was performed in 100% of cases. All patients were operated on under spinal anesthesia and stayed overnight in hospital.
Of the 276 patients, 1.8% developed postoperative seromas. No patients developed hematomas. New wound closure was needed in 1.4% of patients, performed within 7-10 days of surgery, scar revision in 4.7%, residual liposuction under local anesthesia in 9.7%, and liposuction under sedation in 1%; deep vein thrombosis without thromboembolic phenomenon developed in 1%, none resulting in death. In addition, the use of a PTS technique is a time-saving procedure because it takes the surgeons between 3-5 minutes of operative time, unlike that of adhesion and/or separate traction, which takes between 30 and 45 minutes.
The use of PTSs helped diminish complications such as seroma and hematoma and prevent additional cost involving hospital readmission and/or further surgery. Furthermore, use of these sutures required only 3-5 minutes of additional operative time.
在腹壁成形术中，主动保留斯卡帕筋膜及其固有的淋巴引流和拉伸强度以进行缝合，可避免术后放置引流管，从而降低血清肿的发生率。在本文中，我们描述了改良的渐进性牵引缝合（PTS）技术的有效性，该技术使我们能够减少最常见的并发症并避免再次入院；这些缝合需要额外3 - 5分钟的手术时间。
本研究纳入了276例患者（平均年龄38岁；范围19 - 67岁），平均体重指数为25。所有患者均接受了全腹及双侧腰部的超声辅助吸脂（VASER）腹壁成形术。100%的病例进行了腹直肌折叠术。所有患者均在脊髓麻醉下手术，并在医院过夜。
276例患者中，1.8%出现术后血清肿。无患者出现血肿。1.4%的患者需要在术后7 - 10天内进行新的伤口缝合，4.7%需要进行瘢痕修复，9.7%需要在局部麻醉下进行残留吸脂，1%需要在镇静下进行吸脂；1%的患者发生了无血栓栓塞现象的深静脉血栓形成，无一例导致死亡。此外，使用PTS技术是一种节省时间的手术，因为它仅需外科医生3 - 5分钟的手术时间，而粘连和/或单独牵引则需要30至45分钟。
使用PTS有助于减少血清肿和血肿等并发症，并避免再次入院和/或进一步手术带来的额外费用。此外，使用这些缝合仅需额外3 - 5分钟的手术时间。
