Journal of Plastic Surgery and Hand Surgery最新文献

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Staged dissection reduces blood loss in surgery for metopic synostosis. 分阶段剥离可减少偏头合骨术的失血量。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-11-12 DOI: 10.2340/jphs.v59.42160

Anna Sundelin, Madiha Bhatti-Søfteland, Ingrid Stubelius, Tobias Hallén, Robert Olsson, Giovanni Maltese, Peter Tarnow, Karin Säljö, Lars Kölby

{"title":"Staged dissection reduces blood loss in surgery for metopic synostosis.","authors":"Anna Sundelin, Madiha Bhatti-Søfteland, Ingrid Stubelius, Tobias Hallén, Robert Olsson, Giovanni Maltese, Peter Tarnow, Karin Säljö, Lars Kölby","doi":"10.2340/jphs.v59.42160","DOIUrl":"https://doi.org/10.2340/jphs.v59.42160","url":null,"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.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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