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肉毒杆菌毒素注射对乳房手术结果的影响:系统评价和荟萃分析。

The Impact of Botulinum Toxin Injection on the Outcomes of Breast Surgeries: A Systematic Review and Meta-Analysis.

机构信息

Department of Plastic and Reconstructive Surgery, Faculty of Medicine (Boys), Al-Azhar University, Al Mokhaym Al Daem, Gameat Al Azhar, Nasr City, Cairo, Egypt.

Department of Plastic and Reconstructive Surgery, El-Sahel Teaching Hospital, Cairo, Egypt.

出版信息

Aesthetic Plast Surg. 2023 Oct;47(5):1771-1784. doi: 10.1007/s00266-023-03466-0. Epub 2023 Jul 18.

Abstract

BACKGROUND

Breast surgeries aim to restore the natural appearance of the breasts with acceptable functional and cosmetic outcomes. However, these surgical procedures may be associated with considerable adverse events. The present systematic review and meta-analysis was designed to reveal the functional and aesthetic outcomes of botulinum toxins (BTX) injection in patients subjected to breast surgeries.

METHODS

A literature review was performed up to 21 September 2022. All clinical studies included patients older than 18 years old and treated with BTX injection for breast surgeries were included.

RESULTS

The present study included 12 articles, encompassing 496 patients. The average dosage of BTX injection ranged from 20 to 100 units. Injecting BTX significantly reduced the mean post-operative opioid analgesics usage (SMD -1.577; 95% -2.087, -1.067; P < 0.001) and the risk of severe animation deformity (RR 12.37; 95% 1.76, 86.66; P = 0.01). There was a statistically significant higher mean expansion volume per visit in the BTX injection group (SMD 1.166; 95% 0.313, 2.018; P = 0.007). There was no statistically significant impact of BTX injection on the risk of surgical site infection (RR 0.59; 95% 0.15, 2.34; P = 0.45) and seroma (RR 0.51; 95% 0.03, 10.15; P = 0.66).

CONCLUSIONS

The present study revealed the potential benefits of BTX injection in breast surgeries. This included reduced post-operative analgesics, as well as the risk of severe animation deformity. This was accomplished with increased expansion volume per visit and a similar risk of BTX injection-related complications.

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 .

摘要

背景

乳房手术旨在通过可接受的功能和美容效果来恢复乳房的自然外观。然而,这些手术可能会导致相当多的不良事件。本系统评价和荟萃分析旨在揭示在接受乳房手术的患者中使用肉毒毒素 (BTX) 注射的功能和美学效果。

方法

文献检索截至 2022 年 9 月 21 日。所有纳入的研究均为年龄大于 18 岁并接受 BTX 注射治疗乳房手术的患者。

结果

本研究共纳入 12 篇文章,共纳入 496 例患者。BTX 注射的平均剂量范围为 20-100 单位。注射 BTX 可显著减少术后阿片类镇痛药的平均用量(SMD-1.577;95%CI-2.087,-1.067;P<0.001)和严重运动畸形的风险(RR 12.37;95%CI1.76,86.66;P=0.01)。BTX 注射组每次就诊的平均扩张量更高(SMD 1.166;95%CI0.313,2.018;P=0.007)。BTX 注射对手术部位感染(RR 0.59;95%CI0.15,2.34;P=0.45)和血清肿(RR 0.51;95%CI0.03,10.15;P=0.66)的风险无统计学意义。

结论

本研究揭示了 BTX 注射在乳房手术中的潜在益处。这包括减少术后镇痛药物的使用,以及严重运动畸形的风险。这是通过每次就诊时增加扩张量和类似的 BTX 注射相关并发症风险来实现的。

证据水平 III:本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述,请参考目录或在线作者指南 www.springer.com/00266

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e9b/10582146/66896b6a560a/266_2023_3466_Fig1_HTML.jpg

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