Daniel Y Kwon, Peter Shamamiam, Esther Kim, Simeret Genet, Abena Gyasi, Zachary Gallate, Nargiz Seyidova, Olachi Oleru, Peter W Henderson
{"title":"脉冲冲洗降低乳房缩小术后血肿率。","authors":"Daniel Y Kwon, Peter Shamamiam, Esther Kim, Simeret Genet, Abena Gyasi, Zachary Gallate, Nargiz Seyidova, Olachi Oleru, Peter W Henderson","doi":"10.1007/s00266-025-04682-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Breast reduction (BR) involves a large surface area of manipulated tissue, increasing the risk of postoperative hematoma. Pulse irrigation (PI) uses a device to deliver intermittent pressurized irrigant intraoperatively. This study aims to evaluate whether the use of PI is associated with reduced incidence of postoperative hematoma after BR.</p><p><strong>Methods: </strong>An IRB-approved, retrospective cohort study was performed on all female patients >18 years old who underwent BR at a single academic medical center from 2019 to 2023. Patients operated on by surgeons who performed BR exclusively with or exclusively without PI were excluded. Demographics, surgical details, and postoperative complications were compared using T-tests for independent samples and Pearson chi-square tests of significance (statistical significance set at p<0.05).</p><p><strong>Results: </strong>A total of 418 patients met inclusion and exclusion criteria: 196 PI patients (46.9%) and 222 (53.1%) non-PI patients. PI patients had differences in race, type of insurance and higher usage of liposuction (all p<0.001). There was a statistically significantly lower hematoma rate in PI patients compared to non-PI patients (0.0% vs. 2.7%, p=0.020). Although not statistically significant, PI patients had lower rates of seroma (1.0% vs. 3.6%, p=0.085) and superficial incisional SSI (1.5% vs. 2.7%, p=0.410) than non-PI patients.</p><p><strong>Conclusion: </strong>Intraoperative use of PI reduces the rate of postoperative hematoma in patients undergoing BR. This finding is hypothesized to be due to provocative disruption of unstable clots which thereby helps to identify sites of tenuous hemostasis so that they can be better cauterized prior to completion of the procedure.</p><p><strong>Level of evidence iii: </strong>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 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pulse Irrigation Reduces Rate of Postoperative Hematoma Following Breast Reduction.\",\"authors\":\"Daniel Y Kwon, Peter Shamamiam, Esther Kim, Simeret Genet, Abena Gyasi, Zachary Gallate, Nargiz Seyidova, Olachi Oleru, Peter W Henderson\",\"doi\":\"10.1007/s00266-025-04682-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Breast reduction (BR) involves a large surface area of manipulated tissue, increasing the risk of postoperative hematoma. Pulse irrigation (PI) uses a device to deliver intermittent pressurized irrigant intraoperatively. This study aims to evaluate whether the use of PI is associated with reduced incidence of postoperative hematoma after BR.</p><p><strong>Methods: </strong>An IRB-approved, retrospective cohort study was performed on all female patients >18 years old who underwent BR at a single academic medical center from 2019 to 2023. Patients operated on by surgeons who performed BR exclusively with or exclusively without PI were excluded. Demographics, surgical details, and postoperative complications were compared using T-tests for independent samples and Pearson chi-square tests of significance (statistical significance set at p<0.05).</p><p><strong>Results: </strong>A total of 418 patients met inclusion and exclusion criteria: 196 PI patients (46.9%) and 222 (53.1%) non-PI patients. PI patients had differences in race, type of insurance and higher usage of liposuction (all p<0.001). There was a statistically significantly lower hematoma rate in PI patients compared to non-PI patients (0.0% vs. 2.7%, p=0.020). Although not statistically significant, PI patients had lower rates of seroma (1.0% vs. 3.6%, p=0.085) and superficial incisional SSI (1.5% vs. 2.7%, p=0.410) than non-PI patients.</p><p><strong>Conclusion: </strong>Intraoperative use of PI reduces the rate of postoperative hematoma in patients undergoing BR. This finding is hypothesized to be due to provocative disruption of unstable clots which thereby helps to identify sites of tenuous hemostasis so that they can be better cauterized prior to completion of the procedure.</p><p><strong>Level of evidence iii: </strong>This journal requires that authors assign a level of evidence to each article. 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Pulse Irrigation Reduces Rate of Postoperative Hematoma Following Breast Reduction.
Purpose: Breast reduction (BR) involves a large surface area of manipulated tissue, increasing the risk of postoperative hematoma. Pulse irrigation (PI) uses a device to deliver intermittent pressurized irrigant intraoperatively. This study aims to evaluate whether the use of PI is associated with reduced incidence of postoperative hematoma after BR.
Methods: An IRB-approved, retrospective cohort study was performed on all female patients >18 years old who underwent BR at a single academic medical center from 2019 to 2023. Patients operated on by surgeons who performed BR exclusively with or exclusively without PI were excluded. Demographics, surgical details, and postoperative complications were compared using T-tests for independent samples and Pearson chi-square tests of significance (statistical significance set at p<0.05).
Results: A total of 418 patients met inclusion and exclusion criteria: 196 PI patients (46.9%) and 222 (53.1%) non-PI patients. PI patients had differences in race, type of insurance and higher usage of liposuction (all p<0.001). There was a statistically significantly lower hematoma rate in PI patients compared to non-PI patients (0.0% vs. 2.7%, p=0.020). Although not statistically significant, PI patients had lower rates of seroma (1.0% vs. 3.6%, p=0.085) and superficial incisional SSI (1.5% vs. 2.7%, p=0.410) than non-PI patients.
Conclusion: Intraoperative use of PI reduces the rate of postoperative hematoma in patients undergoing BR. This finding is hypothesized to be due to provocative disruption of unstable clots which thereby helps to identify sites of tenuous hemostasis so that they can be better cauterized prior to completion of the procedure.
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 .
期刊介绍：
Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP).
Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships.
Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.
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