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整形外科医生主导的超声检查。

Plastic Surgeon-Led Ultrasound.

机构信息

Chelmsford, United Kingdom.

From the St. Andrews Centre for Plastic Surgery and Burns, Broomfield Hospital.

出版信息

Plast Reconstr Surg. 2018 Feb;141(2):300e-309e. doi: 10.1097/PRS.0000000000004071.

Abstract

BACKGROUND

Portable high-frequency ultrasound is a useful adjunct to a plastic surgeon's practice. With a short learning curve, this patient-friendly imaging modality has a variety of uses that aid patient management/treatment plans. The authors describe clinical cases and review the literature regarding ultrasound performed by the surgeon.

METHODS

The Sonosite S-Nerve machine with the L25X transducer was used (depth, 4.3 cm). Clinical cases that ordinarily would have been referred to the radiology department were taken from the day-to-day practice of the senior author (M.G.). The clinical scenarios ranged from acute presentations to planned elective settings.

RESULTS

Ultrasound was a useful adjunct in a variety of applications, ranging from acute hand trauma visualizing neurovascular bundles and tendons, to elements of reconstructive breast surgery such as fat grafting over an implant and scar release. The ultrasound machine was also used for determination of the depth and size of collections such as seromas to facilitate drainage, for identification of lymph nodes before transfer, and for acute presentations of conditions ranging from undiagnosed swelling to foreign body localization.

CONCLUSIONS

The portable ultrasound machine has become an invaluable tool in the senior author's practice. In a short time and with a short learning curve, the authors' unit identified numerous applications for its use. From a patient perspective, it is noninvasive/nonpainful and has no deleterious radiation effects, and treatment plans can be enacted without delay. It is highly recommended that surgeons become familiar with this imaging modality and assimilate it into their daily practice.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

摘要

背景

便携式高频超声是整形外科医生实践的有用辅助手段。这种患者友好型成像方式具有多种用途,可以辅助患者管理/治疗计划,学习曲线短。作者描述了临床病例,并回顾了关于外科医生进行的超声检查的文献。

方法

使用 Sonosite S-Nerve 机器和 L25X 换能器(深度为 4.3 厘米)。从高级作者(M.G.)的日常实践中选取了原本会转介给放射科的临床病例。临床情况从急性表现到计划中的选择性设置不等。

结果

超声在各种应用中是一种有用的辅助手段,范围从急性手部创伤可视化神经血管束和肌腱,到重建乳房手术的元素,如在植入物上进行脂肪移植和疤痕松解。超声机还用于确定积液(如血清肿)的深度和大小,以促进引流,在转移前识别淋巴结,以及处理从未确诊的肿胀到异物定位等急性病症。

结论

便携式超声机已成为高级作者实践中不可或缺的工具。在短时间内,通过短时间的学习曲线,作者所在单位确定了其多种用途。从患者的角度来看,它是非侵入性/无痛的,没有有害的辐射影响,并且可以立即制定治疗计划。强烈建议外科医生熟悉这种成像方式,并将其纳入日常实践中。

临床问题/证据水平:治疗,V。

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