Staged dissection reduces blood loss in surgery for metopic synostosis.

IF 1 4区 医学 Q3 ORTHOPEDICS
Anna Sundelin, Madiha Bhatti-Søfteland, Ingrid Stubelius, Tobias Hallén, Robert Olsson, Giovanni Maltese, Peter Tarnow, Karin Säljö, Lars Kölby
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引用次数: 0

Abstract

Introduction: Fronto-orbital remodelling for metopic synostosis is an extensive operation with substantial blood loss, particularly from emissary veins in the glabellar region. One possibility to reduce blood loss may be to stage dissection and cauterise anomalous emissary veins before dissecting in the subperiostal plane.  OBJECTIVE: The aim of the present study was to compare perioperative bleeding using a staged dissection in the glabellar region with the traditional subperiostal dissection technique during surgery for metopic synostosis.

Methods: All consecutive patients operated for metopic synostosis with the new staged dissection technique (T2) were included. For comparison, the most recent equal number of cases operated with the traditional dissection technique (T1) were included. Age, sex, weight, surgical technique (spring or bone graft), perioperative blood loss, perioperative blood pressure, per- and postoperative blood transfusion, operation time and length of hospital stay were registered.  RESULTS: A total of 80 patients were included; 40 T1 and 40 T2, respectively. Perioperative blood loss was significantly reduced with the new staged dissection technique. Blood loss in absolute numbers was reduced from 160.0 (120-240) (median and (interquartile range)) ml to 150 (102.5-170.0) ml, p=0.028. Blood loss in relation to patient weight was reduced from 24.2 ml/kg (15.3-33.3) to 18.7 (16.6-23.1) ml/kg, p=0.024. As percentage of total blood volume, blood loss was reduced from 32.3 (20.3-32.3) % to 29.9 (18.4-30.8) %, p=0.024. No other variables differed significantly between the techniques.  CONCLUSION: In summary, staged dissection technique in the glabellar region, allowing control of the emissary veins, reduces perioperative blood loss during surgery for metopic synostosis.

分阶段剥离可减少偏头合骨术的失血量。
简介前眶重塑术治疗偏侧合眼症是一项大范围的手术,会造成大量失血,尤其是来自睑板区的吻合静脉的失血。减少失血量的一种方法是在骨膜下平面进行解剖前,分期解剖并烧灼异常的突眼静脉。 目的:本研究的目的是比较在角弓反张手术中采用分期解剖睑板区和传统肋骨下解剖技术的围手术期出血量:方法:纳入所有采用新的分阶段剥离技术(T2)进行偏侧合眼症手术的连续患者。为了进行比较,还纳入了最近采用传统剥离技术(T1)进行手术的同等数量的病例。对年龄、性别、体重、手术方法(弹簧或植骨)、围手术期失血量、围手术期血压、围手术期和术后输血量、手术时间和住院时间进行了登记。 结果:共纳入 80 名患者,其中 T1 和 T2 患者分别为 40 人和 40 人。采用新的分期解剖技术后,围手术期失血量明显减少。绝对失血量从 160.0(120-240)毫升(中位数和(四分位间距))减少到 150(102.5-170.0)毫升,P=0.028。失血量与患者体重的关系从 24.2 毫升/千克(15.3-33.3)降至 18.7(16.6-23.1)毫升/千克,P=0.024。失血量占总血量的百分比从 32.3% (20.3-32.3) 降至 29.9% (18.4-30.8),p=0.024。两种技术的其他变量无明显差异。 结论:总之,在睑板区域采用分期解剖技术可以控制突静脉,从而减少偏侧合眼症手术的围手术期失血量。
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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
108
审稿时长
6-12 weeks
期刊介绍: The purpose of the Journal of Plastic Surgery and Hand Surgery is to serve as an international forum for plastic surgery, hand surgery and related research. Interest is focused on original articles on basic research and clinical evaluation. The scope of the journal comprises: • Articles concerning operative methods and follow-up studies • Research articles on subjects related to plastic and hand surgery • Articles on cranio-maxillofacial surgery, including cleft lip and palate surgery. Extended issues are published occasionally, dealing with special topics such as microvascular surgery, craniofacial surgery, or burns. Supplements, usually doctoral theses, may also be published. The journal is published for the Acta Chirurgica Scandinavica society and sponsored by the Key Foundation, Sweden. The journal was previously published as Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery.
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