Yaedú Renato Yassutaka Faria, Mello Marina de Almeida Barbosa, Tucunduva Rosana Adami, da Silveira Juliana Specian Zabotini, Takahashi Marina Prado Monson Santana, Valente Ana Carolina Bonetti
*Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo †Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo ‡Department of Physiotherapy, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo §Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
J Craniofac Surg. 2017 Oct;28(7):1816-1820. doi: 10.1097/SCS.0000000000003850.
To evaluate the effects of manual lymphatic drainage (MLD) on facial edema and pain in patients who underwent orthognathic surgery from patient and professional perspectives and clinical measures.
It is a randomized double-blind clinical trial, where 30 patients who underwent bimaxillary orthognathic surgery were divided into 2 groups (treatment and placebo). One group (treatment) received MLD from 2nd postoperative day, besides cryotherapy and postoperative medications. The other group (placebo) received cryotherapy, medications, and manual superficial sliding movements as placebo. For edema evaluation, facial measurements with tape and photographs were used. To evaluate patients' perception, visual analog scale for pain and edema was used. In statistical analysis, quantitative data were analyzed using Student t test for normally distributed variables and Mann-Whitney test for non-normal to find differences between groups; 5% significance level was adopted.
No difference was found between groups in the amount of maximum developed edema (P = 0.290) nor on what day the edema peak occurred (P = 0.091). However, it was found that treatment group showed faster and greater regression of swelling compared with placebo (P < 0.001). Manual lymphatic drainage was not effective in relieving pain in these patients and nor in edema perception (P = 0.784 and P = 0.946, respectively).
Manual lymphatic drainage was effective in reducing facial measurements in orthognathic surgery postoperatory. When considering patient's pain and swelling perception, no difference was found between groups.
从患者和专业角度以及临床测量方面评估手法淋巴引流(MLD)对正颌手术患者面部水肿和疼痛的影响。
这是一项随机双盲临床试验,30例行双颌正颌手术的患者被分为2组(治疗组和安慰剂组)。一组(治疗组)从术后第2天开始接受MLD,此外还接受冷冻疗法和术后药物治疗。另一组(安慰剂组)接受冷冻疗法、药物治疗以及作为安慰剂的手动浅表滑动动作。对于水肿评估,使用卷尺进行面部测量并拍照。为评估患者的感知,使用疼痛和水肿视觉模拟量表。在统计分析中,定量数据对于正态分布变量使用学生t检验,对于非正态分布变量使用曼-惠特尼检验以找出组间差异;采用5%的显著性水平。
两组在最大水肿量方面(P = 0.290)以及水肿峰值出现的日期方面(P = 0.091)均未发现差异。然而,发现治疗组与安慰剂组相比肿胀消退更快且更明显(P < 0.001)。手法淋巴引流在缓解这些患者的疼痛以及水肿感知方面均无效(分别为P = 0.784和P = 0.946)。
手法淋巴引流在正颌手术后减少面部测量方面有效。在考虑患者的疼痛和肿胀感知时,两组之间未发现差异。