From private practice; Clínica "EL Pinar"; INNOVARE; the Division of Internal Medicine, Jalisco Institute of Reconstructive Surgery "Dr. José Guerrerosanto"; and Clínica Colsanitas.
Plast Reconstr Surg. 2021 Feb 1;147(2):355-363. doi: 10.1097/PRS.0000000000007524.
Anemia is a frequent process of morbidity and mortality in body contouring procedures. In aesthetic surgery, there are no standardized processes to minimize bleeding during surgery. For this reason, a study was designed to implement patient blood management strategies to reduce bleeding and transfusions in patients undergoing body contouring operations.
From January of 2017 to May of 2018, a prospective cohort-type observational study was conducted, including two groups of patients undergoing single or combined body contouring procedures. The first group did not receive patient blood management strategies, whereas the second group did receive these strategies. These measures consisted of preoperative strategies to ensure the patient had optimal hemoglobin and hematocrit levels and supportive intraoperative measures to minimize blood loss. The results were validated with different statistical tests according to the variables studied.
A total of 409 patients were included in the study and were divided into two groups. The anthropometric and hemoglobin variables were similar in both groups. The 207 patients for whom patient blood management strategies were implemented lost an average of 1.2 g/dl less hemoglobin at 72 hours than the 202 patients for whom patient blood management strategies were not implemented (p ≤ 0.0001).
Patient blood management strategies, such as increasing hemoglobin before surgery, and strategies to minimize blood loss during surgery, proved to be effective at reducing bleeding in patients undergoing body contouring surgery, also decreasing the need to perform postoperative blood transfusions.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
贫血是身体塑形手术中发病率和死亡率的常见过程。在美容手术中,没有标准化的流程来最大限度地减少手术中的出血。出于这个原因,设计了一项研究来实施患者血液管理策略,以减少身体塑形手术患者的出血和输血。
从 2017 年 1 月至 2018 年 5 月,进行了一项前瞻性队列型观察研究,包括两组接受单一或联合身体塑形手术的患者。第一组未接受患者血液管理策略,而第二组则接受了这些策略。这些措施包括术前策略,以确保患者的血红蛋白和血细胞比容水平达到最佳状态,以及术中支持性措施,以最大限度地减少失血。根据研究的变量,使用不同的统计检验来验证结果。
共有 409 名患者纳入研究,并分为两组。两组的人体测量学和血红蛋白变量相似。实施患者血液管理策略的 207 名患者在 72 小时内平均失去 1.2 克/分升的血红蛋白,而未实施患者血液管理策略的 202 名患者平均失去 1.2 克/分升的血红蛋白(p≤0.0001)。
术前增加血红蛋白等患者血液管理策略,以及术中最大限度减少失血的策略,被证明可有效减少身体塑形手术患者的出血,也减少了术后输血的需求。
临床问题/证据水平:治疗,II。