Ormseth Benjamin H, Livermore Nina R, Schoenbrunner Anna R, Janis Jeffrey E
From the Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Division of Plastic & Reconstructive Surgery, Spectrum Health/Michigan State University College of Human Medicine, Grand Rapids, Mich.
Plast Reconstr Surg Glob Open. 2023 Sep 25;11(9):e5293. doi: 10.1097/GOX.0000000000005293. eCollection 2023 Sep.
This practical review critically evaluates the evidence behind the widespread use of postoperative compression therapy intended to improve surgical outcomes, such as reduced edema, ecchymosis, pain, and seroma formation. A literature search of PubMed was conducted to identify relevant studies concerning the use of compression garments after aesthetic surgery, including rhinoplasty, facelift, neck lift, mammoplasty, abdominoplasty, limb contouring, and others. Additionally, reconstructive and therapeutic procedures closely related in anatomy or technique to these cosmetic operations, such as breast reconstruction, mastectomy, and hernia repair, were also considered to provide further perspective. After study extraction, the volume, quality, and agreement of the evidence found was highly heterogenous depending on the context of specific operations and outcomes evaluated. The most well-supported indications for the use of postoperative compression garments are to mitigate edema and ecchymosis after rhinoplasty and to reduce postoperative pain after breast and abdominal procedures, although no effect on seroma rate was demonstrated. Any potential benefit must be balanced against the associated costs and possible complications of compression, including patient discomfort, increased venous stasis, and skin defects. Thus, we encourage surgeons to critically reassess their use of compression garments. In many settings, such as brachioplasty, there is limited high-quality evidence to inform best practice, and we urge the community to continue researching this important topic so that more definitive and comprehensive guidelines may be established.
本实用性综述批判性地评估了旨在改善手术效果(如减轻水肿、瘀斑、疼痛和减少血清肿形成)的术后加压疗法广泛应用背后的证据。通过对PubMed进行文献检索,以确定有关美容手术后使用加压服装的相关研究,包括隆鼻术、面部提升术、颈部提升术、乳房成形术、腹壁成形术、肢体塑形术等。此外,与这些美容手术在解剖学或技术上密切相关的重建和治疗程序,如乳房重建、乳房切除术和疝修补术,也被纳入考虑以提供更多视角。在研究提取后,根据所评估的特定手术和结果的背景,所发现证据的数量、质量和一致性存在高度异质性。术后使用加压服装最有力的指征是减轻隆鼻术后的水肿和瘀斑,以及减轻乳房和腹部手术后的术后疼痛,尽管未证明对血清肿发生率有影响。任何潜在益处都必须与加压的相关成本和可能的并发症相权衡,包括患者不适、静脉淤滞增加和皮肤缺陷。因此,我们鼓励外科医生批判性地重新评估他们对加压服装的使用。在许多情况下,如上臂成形术,高质量证据有限,无法为最佳实践提供依据,我们敦促学界继续研究这一重要课题,以便制定更明确、更全面的指南。
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