Bien Erica M, Rich Matthew D, Zargari Pedram, Sorenson Thomas J, Barta Ruth J
Medical School, University of Minnesota, Minneapolis, MN, USA.
Division of Plastic Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
Plast Surg (Oakv). 2024 Aug;32(3):389-394. doi: 10.1177/22925503221128986. Epub 2022 Oct 17.
Reduction mammoplasty is becoming more commonly performed in the pediatric population yet the risk factors for complications have not been well-studied. The purpose of this study was to assess the relationship between preoperative patient characteristics and postoperative complications in a large population of pediatric patients undergoing reduction mammoplasty. Pediatric patients undergoing reduction mammoplasty were identified within the 2012 to 2019 National Surgical Quality Improvement Program database for cross-sectional study. The predictor variables were age, body mass index (BMI), diabetes, chronic steroid use, time under anesthesia, and operative time, and the primary outcome was a 30-day postoperative surgical site-related complication. Multivariate logistic regression was performed to identify a relationship between predictor variable and primary outcome. A total of 1216 pediatric patients were identified with a mean age of 16.6 years and mean BMI of 30.8 kg/m. The incidence of overall postoperative complications was 4.6%. Superficial surgical site infection (SSI) was the most common complication (29/1216; 2.4%). BMI was significantly associated with superficial SSI (odds ratio: 1.03, 95% confidence interval: 1.00-1.05, = .02) Sixteen patients (1.32%) underwent a second operation, most commonly to address hematoma/seroma (7/16; 43.8%). In a large series of patients, pediatric reduction mammoplasty is a safe procedure with a low complication rate. BMI was significantly associated with the incidence of superficial SSIs with the most common cause for reoperation being a hematoma/seroma. This study can help guide the discussion between physicians and patients regarding potential risks associated with pediatric reduction mammoplasty.
缩乳术在儿科人群中的开展越来越普遍，但并发症的危险因素尚未得到充分研究。本研究的目的是评估大量接受缩乳术的儿科患者术前特征与术后并发症之间的关系。在2012年至2019年国家外科质量改进计划数据库中识别接受缩乳术的儿科患者，进行横断面研究。预测变量包括年龄、体重指数（BMI）、糖尿病、长期使用类固醇、麻醉时间和手术时间，主要结局是术后30天与手术部位相关的并发症。进行多变量逻辑回归以确定预测变量与主要结局之间的关系。共识别出1216例儿科患者，平均年龄16.6岁，平均BMI为30.8kg/m²。术后总体并发症发生率为4.6%。浅表手术部位感染（SSI）是最常见的并发症（29/1216；2.4%）。BMI与浅表SSI显著相关（比值比：1.03，95%置信区间：1.00-1.05，P=0.02）。16例患者（1.32%）接受了二次手术，最常见的原因是处理血肿/血清肿（7/16；43.8%）。在大量患者中，儿科缩乳术是一种安全的手术，并发症发生率低。BMI与浅表SSI的发生率显著相关，再次手术的最常见原因是血肿/血清肿。本研究有助于指导医生与患者之间关于儿科缩乳术潜在风险的讨论。
