Altmann Jens, Burns A Jay, Kilmer Suzanne L, Lee Christopher, Lim Tingsong, Metelitsa Andrei, Stevens W Grant, Taub Amy, Welsh Kathleen, Kazem Farid
Aesthet Surg J Open Forum. 2022 Feb 1;4:ojac008. doi: 10.1093/asjof/ojac008. eCollection 2022.
Cryolipolysis is an increasingly popular nonsurgical fat-reduction procedure. Published treatment guidance and adverse event (AE) management protocols are limited.
A modified Delphi study aimed to establish global expert consensus on the use of CoolSculpting (Allergan Aesthetics, an AbbVie Company, Irvine, CA), a noninvasive cryolipolysis treatment system.
A literature search informed survey topics for an 11-expert Delphi panel. Panelists completed an online 39-question survey. An interim panel discussion, with open-ended questions and yes/no voting, informed a second survey containing 61 statements, for which panelists rated agreement using a 5-point Likert scale. Topics included treatment outcome and responder definitions, patient evaluation and selection, treatment protocols, patient satisfaction, and AEs.
Panelists achieved consensus on 38 final guidelines and recommendations. They reached moderate to complete consensus on 4 statements on defining responders (ie, patients with a range of visible improvement) and 6 statements on patient factors contributing to treatment outcomes (eg, how well the applicator conforms to patient body region). Panelists defined minimum numbers of treatment cycles to achieve visible clinical outcomes for 12 body regions, with moderate to complete consensus on 31 statements. They achieved a strong to complete consensus on 7 statements about patient satisfaction (eg, importance of patient expectations, visible improvement, and before-and-after photographs). Panelists defined management strategies for AEs, with moderate to complete consensus on 15 statements.
A modified Delphi process yielded multiple guideline recommendations for cryolipolysis, providing a needed resource for the broad range of clinicians who perform this noninvasive fat-reduction procedure.
冷冻溶脂术是一种越来越受欢迎的非手术减脂方法。已发表的治疗指南和不良事件（AE）管理方案有限。
一项改良的德尔菲研究旨在就无创冷冻溶脂治疗系统酷塑（艾尔建美学公司，艾伯维公司旗下，加利福尼亚州欧文市）的使用达成全球专家共识。
文献检索为一个由11名专家组成的德尔菲小组提供了调查主题。小组成员完成了一项包含39个问题的在线调查。一次中期小组讨论，包括开放式问题和是/否投票，为第二项调查提供了信息，该调查包含61条陈述，小组成员使用5点李克特量表对同意程度进行评分。主题包括治疗结果和反应者定义、患者评估和选择、治疗方案、患者满意度和不良事件。
小组成员就38项最终指南和建议达成了共识。他们在关于定义反应者（即有一系列明显改善的患者）的4条陈述和关于影响治疗结果的患者因素（如 applicator 与患者身体部位的贴合程度）的6条陈述上达成了中度至完全共识。小组成员确定了12个身体部位实现明显临床效果所需的最少治疗周期数，在31条陈述上达成了中度至完全共识。他们在关于患者满意度的7条陈述（如患者期望、明显改善和前后照片的重要性）上达成了强烈至完全共识。小组成员确定了不良事件的管理策略，在15条陈述上达成了中度至完全共识。
改良的德尔菲法产生了多项冷冻溶脂术指南建议，为广泛开展这种无创减脂手术的临床医生提供了必要的资源。
