Rudolph Mona, Vogt Peter M, Müller Klaus, Mett Tobias R
Department of Plastic and Aesthetic Surgery, Asklepios Klinik Wandsbek, Hamburg, Germany.
Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Hannover, Germany.
Plast Reconstr Surg Glob Open. 2019 Mar 25;7(3):e2128. doi: 10.1097/GOX.0000000000002128. eCollection 2019 Mar.
Following liposuction, abdominoplasty is the most frequent body-contouring intervention in the world. The transection of small blood vessels in large areas and subsequent bleeding is a viable risk during this procedure. The resulting microvascular bleedings should be stopped thoroughly to reduce the probability of related complications. In this prospective, monocentric, randomized study, the efficacy of the polysaccharide-based hemostat 4DryField PH (4DF) (PlanTec Medical, Lueneburg, Germany) is examined in classic abdominoplasty and lower body lift after Lockwood.
For this prospective, monocentric, randomized study, 40 patients underwent surgery for both interventions. Twenty patients received an abdominoplasty, and 20 patients underwent a body lift. In each group, 10 patients have been treated with 4DF, whereas 10 have been served as the untreated control group.
4DF had neither a beneficial nor a negative effect on necessity of drainages, drainage volume and duration, length of hospital stay or frequency of postoperative seromas, wound healing disturbances, and infections, independent of surgical intervention. Patients in the 4DF group, however, had more individual risk factors, and required extended surgical interventions that might mask primary outcome results.
This is the first prospective, monocentric, randomized study on 4DF in body-contouring surgery. The use of 4DF did not lead to a better postoperative outcome regarding hemostasis and lymphostasis. Potential benefits need further evaluation in high-volume studies.
抽脂术后,腹壁成形术是全球最常见的身体塑形手术。该手术过程中大面积小血管横断及随后的出血是一个切实存在的风险。应彻底止住由此产生的微血管出血,以降低相关并发症的发生概率。在这项前瞻性、单中心、随机研究中,对基于多糖的止血剂4DryField PH(4DF,德国吕讷堡PlanTec Medical公司生产)在经典腹壁成形术和Lockwood式下半身提升术中的疗效进行了研究。
在这项前瞻性、单中心、随机研究中,40例患者接受了这两种手术。20例患者接受了腹壁成形术,20例患者接受了身体提升术。每组中,10例患者接受4DF治疗,而10例作为未治疗的对照组。
无论手术干预方式如何,4DF对引流的必要性、引流量和持续时间、住院时间或术后血清肿、伤口愈合障碍及感染的发生率均无有益或不良影响。然而,4DF组的患者有更多个体危险因素,且需要延长手术干预时间,这可能掩盖了主要结局结果。
这是第一项关于4DF在身体塑形手术中的前瞻性、单中心、随机研究。4DF的使用在止血和淋巴淤滞方面并未带来更好的术后结局。潜在益处需要在大规模研究中进一步评估。