标准化操作可减少隆胸并发症：290 例连续病例与非标准化对照结果比较。

Standardized Practice Reduces Complications in Breast Augmentation: Results with the First 290 Consecutive Cases Versus Non-standardized Comparators.

机构信息

Plastic Surgery, Health Park, Via Michelangelo Schipa 40, 80122, Naples, Italy.

Plastic Surgery, Clinica Grimaldi, San Giorgio a Cremano, Naples, Italy.

出版信息

Aesthetic Plast Surg. 2019 Apr;43(2):336-347. doi: 10.1007/s00266-018-1291-y. Epub 2018 Dec 12.

DOI:10.1007/s00266-018-1291-y

PMID:30542977

Abstract

BACKGROUND

Several systematic methods for breast augmentation have been published, providing key principles and technical steps for minimizing complications and optimizing patient satisfaction. The aim of this study was to compare complication rates in patients receiving a breast augmentation performed using a structured, standardized approach versus comparator patients operated on without a standardized approach.

METHODS

This was a single-center, retrospective review of 290 consecutive breast augmentations performed between October 2016 and September 2017 based on a standardized technique (Randquist's "five P's" combined with Adams' 14-point plan), and 235 comparators who underwent breast augmentations prior to standardization between April 2014 and September 2016. All study subjects were females aged ≥ 18 years, undergoing bilateral breast augmentation, either alone or in the context of augmentation mastopexy or implant replacement. Various implant ranges were used before standardization; most (94.8%) of the standardized procedures used Natrelle devices. Follow-up lasted for ≥ 12 months.

RESULTS

Significantly fewer patients in the standardized surgery group experienced complications (14.5%, n = 42) compared with the non-standardized group [29.4%, n = 69; Chi square = 6.57; degrees of freedom (df) = 1; p = 0.01041]. Complication rates were also significantly lower in the standardized surgery group for each of the three types of breast augmentation surgery assessed separately. Reoperation rates with standardized and non-standardized surgery were 4.1% (n = 12) and 11.9% (n = 28), respectively (Chi square = 6.4; df = 1; p = 0.01145). Patient satisfaction was increased post-surgery in both groups.

CONCLUSIONS

The use of a structured, standardized approach to breast augmentation reduced the risk of postoperative complications.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景

已经发表了几种系统的隆胸方法，为最小化并发症和优化患者满意度提供了关键原则和技术步骤。本研究旨在比较采用结构化、标准化方法进行隆胸的患者与未采用标准化方法进行手术的对照患者的并发症发生率。

方法

这是一项回顾性单中心研究，纳入了 2016 年 10 月至 2017 年 9 月期间基于标准化技术（Randquist 的“五个 P”与 Adams 的 14 点计划相结合）进行的 290 例连续隆胸手术，以及 2014 年 4 月至 2016 年 9 月期间在标准化前进行隆胸手术的 235 例对照者。所有研究对象均为年龄≥18 岁的女性，行双侧隆胸术，单独或在隆胸乳房上提术或假体置换术中进行。在标准化之前使用了各种不同的植入物范围；大多数（94.8%）标准化手术使用了 Natrelle 装置。随访持续≥12 个月。

结果

标准化手术组患者的并发症发生率明显低于非标准化组（14.5%，n=42）[29.4%，n=69；卡方=6.57；自由度（df）=1；p=0.01041]。在评估的三种隆胸手术类型中，标准化手术组的并发症发生率也显著降低。标准化手术和非标准化手术的再次手术率分别为 4.1%（n=12）和 11.9%（n=28）（卡方=6.4；df=1；p=0.01145）。两组患者术后满意度均提高。