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锚线式腹壁整形术联合保留 Scarpa 筋膜在减重术后患者中的应用:一项对照随机研究。

Anchor-Line Abdominoplasty with Scarpa Fascia Preservation in Postbariatric Patients: A Comparative Randomized Study.

机构信息

Plastic Surgeon, Postgraduate Program in Translational Surgery, University Federal of São Paulo (UNIFESP), São Paulo, Brazil.

University Federal of São Paulo (UNIFESP), Avenida Ana Costa 493, cj 21, Santos, SP, CEP 11060-911, Brazil.

出版信息

Aesthetic Plast Surg. 2020 Apr;44(2):445-452. doi: 10.1007/s00266-019-01547-7. Epub 2019 Nov 27.

Abstract

BACKGROUND

The number of bariatric surgeries for the treatment of morbid obesity has increased, and there is growing demand for postbariatric abdominoplasty. The aim of this study was to evaluate the impacts of Scarpa's fascia preservation on total drainage volume, time to drain removal, and seroma formation in anchor-line abdominoplasty.

METHODS

A total of 42 postbariatric patients were randomly assigned to two groups and underwent anchor-line abdominoplasty. Scarpa's fascia was not preserved during abdominoplasty in one group (n = 21) but was preserved in the other group (n = 21). A suction drain was left in place until the drainage volume was less than 30 ml/24 h. Seroma formation was assessed by abdominal ultrasound on the twentieth postoperative day; only fluid collections greater than 30 ml were considered seromas.

RESULTS

The time to drain removal was shorter, and the total drainage volume was lower in the fascial preservation group than in the fascial dissection group. However, no difference in the seroma formation rate was observed between the groups.

CONCLUSION

Scarpa's fascia preservation decreased the drainage volume and the time to drain removal but not the rate of seroma formation.

LEVEL OF EVIDENCE II

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

治疗病态肥胖的减重手术数量不断增加,对减重后腹部整形术的需求也在不断增加。本研究旨在评估保留 Scarpa 筋膜对锚定式腹部整形术总引流量、引流管拔除时间和血清肿形成的影响。

方法

将 42 例接受减重手术的患者随机分为两组,行锚定式腹部整形术。一组(n=21)术中不保留 Scarpa 筋膜,另一组(n=21)保留 Scarpa 筋膜。当引流量小于 30ml/24h 时,留置引流管。术后第 20 天行腹部超声评估血清肿形成情况;仅将大于 30ml 的积液视为血清肿。

结果

筋膜保留组的引流管拔除时间更短,总引流量也低于筋膜切开组。但两组的血清肿形成率无差异。

结论

保留 Scarpa 筋膜可减少引流量和引流管拔除时间,但不影响血清肿形成率。

证据等级 II:本期刊要求作者为每篇文章分配一个证据等级。有关这些循证医学等级的更详细描述,请参考目录或在线作者指南 www.springer.com/00266。

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