Faculty of Life Sciences and Medicine, King's College London, Guy's Campus, Great Maze Pond, London, SE1 1UL, UK.
Lister Hospital, East and North Hertfordshire NHS Trust, Stevenage, UK.
Aesthetic Plast Surg. 2023 Jun;47(3):1144-1154. doi: 10.1007/s00266-022-03100-5. Epub 2022 Sep 26.
Piezosurgery use has become increasingly prevalent in osteotomies. Piezoelectric ultrasound waves can cut bone effectively, and some studies have shown reduced post-operative morbidities compared to conventional osteotomies. Oedema and ecchymosis are common complications of rhinoplasty and can impact patient satisfaction, wound healing, and recovery. We aim to provide an up-to-date comparison of post-operative oedema and ecchymosis in piezosurgery and conventional osteotomies. A literature search was conducted using the following online libraries; Pubmed, Cochrane, Science Direct, and ISRCTN (International Standard Randomised Controlled Trial Number). English publications between 2015 and 2020 were included. A systematic review was completed, and a comparison of oedema and ecchymosis in piezosurgery and conventional osteotomies was examined alongside other outcomes such as pain, mucosal injury, and surgery time. Eight randomised controlled trials (RCTs) met our criteria with a combined total of 440 patients: 191 male and 249 female. Piezosurgery had statistically significant (p < 0.05) reduction in short-term oedema compared to conventional osteotomies in 75% of the papers included, and in 50% this persisted across the whole follow-up period. Similarly, ecchymosis scoring was initially statistically lower (p < 0.05) in piezosurgery in 87.5% of the RCTs, and in 75% this persisted across the whole follow-up period. A reduction in pain (p < 0.05) and mucosal injury (p < 0.05) was also seen in piezoelectric osteotomies. The length of surgery time varied. Piezoelectric osteotomies reduce oedema and ecchymosis compared to conventional osteotomies, in addition to improving pain and mucosal injury. However, disadvantages such as length of surgery time and cost have been reported. LEVEL OF EVIDENCE III: 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 .
超声骨刀在截骨术中的应用越来越普遍。压电超声能有效切割骨组织，一些研究表明与传统截骨术相比，术后并发症减少。肿胀和瘀斑是鼻整形术的常见并发症，会影响患者满意度、伤口愈合和恢复。我们旨在提供超声骨刀与传统截骨术术后肿胀和瘀斑的最新比较。使用以下在线文库进行文献检索; Pubmed、Cochrane、Science Direct 和 ISRCTN（国际标准随机对照试验编号）。纳入 2015 年至 2020 年期间发表的英文文献。完成系统评价，并对超声骨刀与传统截骨术在肿胀和瘀斑方面的比较，以及疼痛、粘膜损伤和手术时间等其他结果进行了检查。有 8 项随机对照试验（RCT）符合我们的标准，共有 440 例患者：191 名男性和 249 名女性。在纳入的 75%的论文中，超声骨刀在短期肿胀方面与传统截骨术相比有统计学意义（p<0.05），在 50%的论文中，这种情况在整个随访期间持续存在。同样，在纳入的 87.5%的 RCT 中，瘀斑评分最初在超声骨刀中具有统计学意义（p<0.05），在 75%的 RCT 中，这种情况在整个随访期间持续存在。在压电骨切割术中还观察到疼痛（p<0.05）和粘膜损伤（p<0.05）减少。手术时间长短不一。与传统截骨术相比，超声骨刀可减少肿胀和瘀斑，同时改善疼痛和粘膜损伤。然而，也有报道称其存在手术时间长和成本高等缺点。证据等级 III：本杂志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完整描述，请参考目录或在线作者指南 www.springer.com/00266 。
