Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Hansjörg Wyss Department of Plastic Surgery, NYU Langone, New York, NY, USA.
Aesthetic Plast Surg. 2024 Aug;48(16):3137-3146. doi: 10.1007/s00266-024-04068-0. Epub 2024 May 20.
Fleur-de-lis panniculectomy (FDL), a contouring technique involving vertical and horizontal tissue resections, often involves longer operative times and potential complications. This study assessed operative time, postoperative outcomes, and patient-reported quality of life (PRO) with Insorb Absorbable Subcuticular Skin Stapler versus traditional sutures during FDL.
A retrospective review from 2015 to 2022 of FDL patients excluded those with complex concomitant procedures. Demographics, operative details, and surgical outcomes were compared between patients using the dermal stapler and those with suture-only closures.
Forty subjects were identified, with 25 (62.5%) in the dermal stapler cohort. The dermal stapler significantly reduced total procedure time (66.76 vs. 125.33 min, p < 0.05). There were no significant differences in surgical site occurrences, aesthetic outcomes, readmissions, or reoperations. Multivariate regression analysis further highlighted the choice of closure technique as an independent predictor of operative time, with traditional sutures indicating a significantly increased operative time compared to using the dermal stapler (AOR 76.53, CI 38.11-114.95, p < 0.001). Regarding PROs, both groups saw improvements across multiple BODY-Q domains, but the dermal stapler group reported greater enhancements (six out of nine domains vs. three for sutures).
The absorbable dermal stapler significantly reduces FDL operative time without increasing wound healing or aesthetic dissatisfaction incidents and maintains comparable quality-of-life improvements to standard suture closure.
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 https://link.springer.com/journal/00266 .
弗勒德利斯皮瓣切除术（FDL）是一种涉及垂直和水平组织切除的整形技术，通常涉及更长的手术时间和潜在的并发症。本研究评估了 Insorb 可吸收皮下皮肤吻合器与传统缝线在 FDL 中的手术时间、术后结果和患者报告的生活质量（PRO）。
回顾性分析 2015 年至 2022 年的 FDL 患者，排除了伴有复杂合并症的患者。比较了使用真皮吻合器和仅缝线闭合的患者的人口统计学、手术细节和手术结果。
确定了 40 名受试者，其中 25 名（62.5%）在真皮吻合器组。真皮吻合器显著缩短了总手术时间（66.76 分钟 vs. 125.33 分钟，p<0.05）。手术部位发生、美容效果、再入院或再次手术无显著差异。多变量回归分析进一步强调了闭合技术的选择是手术时间的独立预测因素，与使用真皮吻合器相比，传统缝线表明手术时间显著增加（优势比 76.53，95%置信区间 38.11-114.95，p<0.001）。关于 PRO，两组在多个 BODY-Q 领域都有改善，但真皮吻合器组报告的改善更大（九个领域中的六个 vs. 缝线中的三个）。
可吸收真皮吻合器显著缩短了 FDL 的手术时间，而不会增加伤口愈合或美容不满意的事件，并且保持与标准缝线闭合相当的生活质量改善。
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。有关这些循证医学评级的完整描述，请参考目录或在线作者指南 https://link.springer.com/journal/00266 。
