Tebbetts J B
Plast Reconstr Surg. 1998 Oct;102(5):1690-7. doi: 10.1097/00006534-199810000-00058.
Numerous complications and increased operating times were reported with ultrasonically assisted lipoplasty in the first several months after introduction of the technology in the United States. The purpose of this study was to review early reported complications and management regimens, evaluate possible causes of problems, and apply indications and techniques to attempt to minimize complications during an initial experience with this technique beginning in January of 1997. Seven specific indications and modifications of existing techniques were developed and applied to an initial clinical series of 70 consecutive patients who underwent ultrasound-assisted suction lipoplasty between January 10, 1997, and August 1, 1997. Follow-up ranged from 1 to 7 months. No perioperative or postoperative complication occurred in any patient in this series. In this series of ultrasound-assisted lipoplasty cases, application of the following criteria resulted in a series of 70 patients with 1 to 7-month follow-up without complications: (1) selecting patients with well localized fat deposits who were no more than 20 percent above their ideal body weight; (2) infusing a solution of Ringer's Lactate containing 1 cc of 1:1000 epinephrine per 1000 cc into the area of fat removal, stopping infusion when the tissues first become firm, not infusing to marked tissue turgor or skin induration; (3) restricting the level of energy application to a minimum of 1 cm from the undersurface of the dermis; (4) limiting ultrasonic energy application in each area to approximately 1 minute per estimated 100 cc of total aspirate in a wet to superwet environment; (5) not performing ultrasound-assisted lipoplasty in the same area as another procedure that could potentially compromise tissue vascularity; (6) using a Lysonix 2000 generator and 5-mm golf tee tip probe at a power setting of 8 to apply ultrasonic energy to the area of fat removal, ceasing energy application when tissue resistance to the passage of the probe decreases and moving the cannula as rapidly as tissue resistance allows; and (7) using a standard elastic garment without adherent foam or other materials for 2 weeks postoperatively, encouraging all normal activity immediately, and restricting aerobic activities for 2 weeks.
在美国引进超声辅助脂肪抽吸术的最初几个月里，有报道称该技术存在诸多并发症且手术时间延长。本研究的目的是回顾早期报道的并发症及处理方案，评估问题的可能原因，并应用相应的适应证和技术，以便在1997年1月开始初次使用该技术时尽量减少并发症。我们制定了7条特定的适应证和对现有技术的改进措施，并将其应用于1997年1月10日至1997年8月1日期间连续接受超声辅助吸脂术的70例患者的初始临床系列中。随访时间为1至7个月。该系列患者中无一例发生围手术期或术后并发症。在这一系列超声辅助脂肪抽吸术病例中，应用以下标准使得70例患者在1至7个月的随访期内均未出现并发症：（1）选择脂肪堆积部位明确且体重不超过理想体重20%的患者；（2）在脂肪抽吸区域注入每1000毫升含1毫升1:1000肾上腺素的乳酸林格液，当组织首次变硬时停止注入，不要注入至明显的组织肿胀或皮肤硬结；（3）将能量应用水平限制在距真皮底面至少1厘米处；（4）在湿至超湿环境下，每个区域的超声能量应用时间限制为每估计100毫升总吸出量约1分钟；（5）不在可能影响组织血管供应的同一区域同时进行其他可能影响组织血管供应的手术；（6）使用Lysonix 2000发生器和5毫米高尔夫球杆头探头，功率设置为8，对脂肪抽吸区域施加超声能量，当组织对探头通过的阻力降低时停止能量应用，并在组织阻力允许的情况下尽快移动套管；（7）术后使用无粘性泡沫或其他材料的标准弹性服装2周，鼓励立即进行所有正常活动，并限制有氧运动2周。
