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[乳房缩小术后外科医生是否应继续进行引流?]

[Should surgeons keep performing drainage after breast reduction?].

作者信息

Vidali N, Chevet-Noel A, Ringenbach P, Andreoletti J B

机构信息

Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier de Mulhouse, 20, avenue du Dr-René-Laennec, 68100 Mulhouse, France.

Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier de Belfort, 14, rue de Mulhouse, 90000 Belfort, France.

出版信息

Ann Chir Plast Esthet. 2019 Feb;64(1):54-60. doi: 10.1016/j.anplas.2018.03.006. Epub 2018 Apr 9.

Abstract

OBJECTIVE

Despite the absence of "evidence-based medicine", the use of closed suction drainage in breast surgery is currently the standard practice. Its goal is to minimize the amount of fluid at the operation site, the dead space that can involve postoperative complications. The purpose of this study is to demonstrate that with or without drainage the complication rate is unchanged.

METHODS

We conducted a retrospective and comparative study of two groups of breast reduction with and without drainage. Every complication has been recorded and statistically analyzed: seroma and hematoma, infections, wound breakdown, skin flap or nipple-areola complex necrosis, fat necrosis and reoperation.

RESULTS

A total of 138 breast reductions were performed (37 drained patients and 32 non-drained). Data collection of complications was done on average 10months after the operation (1-15). There was no statistical difference between the two groups regarding the complication rate. Our results confirm the ones found in the literature.

CONCLUSION

Except for specific cases (e.g. gigantomasty), this study demonstrates that after breast reduction, drainage is not appropriate. Drains do not reduce postoperative complications and can increase hospitalization length of stay (inducing higher costs). Furthermore, it is often source of pain, anxiety and discomfort for patients.

摘要

目的

尽管缺乏“循证医学”依据,但在乳腺手术中使用闭式吸引引流目前仍是标准做法。其目的是尽量减少手术部位的液体量以及可能引发术后并发症的死腔。本研究的目的是证明无论有无引流,并发症发生率均无变化。

方法

我们对两组行缩乳术的患者进行了回顾性对比研究,一组有引流,一组无引流。记录并对每种并发症进行了统计分析:血清肿和血肿、感染、伤口裂开、皮瓣或乳头乳晕复合体坏死、脂肪坏死及再次手术。

结果

共进行了138例缩乳术(37例有引流患者和32例无引流患者)。并发症数据收集平均在术后10个月(1 - 15个月)进行。两组在并发症发生率方面无统计学差异。我们的结果证实了文献中的发现。

结论

除特殊情况(如巨乳症)外,本研究表明缩乳术后引流并不适宜。引流并不能降低术后并发症发生率,还可能增加住院时间(导致更高费用)。此外,引流常常是患者疼痛、焦虑和不适的根源。

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