改进鼻整形术后管理:现有文献的综合综述。

IF 1.1 4区 医学 Q3 SURGERY
Pedro P Villarroel, Cristobal Langdon, Diego Arancibia-Tagle
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引用次数: 0

摘要

鼻中隔成形术解决了鼻畸形和功能问题。有效的术后护理对最佳恢复至关重要,因为肿胀、瘀伤和疼痛等并发症会对愈合和患者满意度产生不利影响。适当的术后护理强调综合管理策略的重要性。材料和方法利用PubMed和Cochrane数据库进行系统的文献综述,以确定2014年至2024年间发表的专门讨论鼻整形术后护理的文章。191篇文章中,22篇符合预先确定的纳入标准。我们根据牛津循证医学中心的证据水平评估证据的质量。结果对7项关键研究进行了分析,探讨了一系列术后护理干预措施,包括给药皮质类固醇、术中及术后抬高头部、采用替代治疗方法和应用冷却技术。鼻整形术后的恢复包括处理疼痛、肿胀、瘀伤以及其他并发症。教育患者预期的结果和治疗过程有助于减轻他们的焦虑和不确定性。皮质类固醇已被证明对控制肿胀和瘀伤有效。一般不建议使用抗生素。硅胶隔膜夹板提供支持,特别是当需要稳定受伤的粘膜或隔膜软骨时;但是,不建议使用鼻腔填塞。粘条可以帮助减少背部和尖端上区域的水肿。术中将患者置于20°反Trendelenburg位,术后保持头部抬高至90°角,可显著减少水肿和瘀斑。使用套管引流和冷却技术已被证明可以有效地降低术后发病率。结论鼻整形术是一种常见的面部整形手术,但对术后最佳护理尚无共识。关键策略包括硅胶夹板、骨膜下引流、鼻贴、冷却、皮质类固醇、术中及术后头部抬高。然而,需要进一步的系统试验来完善这些策略并改善患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improving Postsurgical Management of Rhinoplasty: A Comprehensive Review of Existing Literature.

Rhinoseptoplasty addresses both nasal deformities and functional issues. Effective postoperative care is essential for optimal recovery, as complications such as swelling, bruising, and pain can adversely affect healing and patient satisfaction. Proper postoperative care emphasizes the significance of comprehensive management strategies.A systematic literature review was performed utilizing the PubMed and Cochrane databases to identify articles published between 2014 and 2024 that specifically addressed postoperative care following rhinoplasty. Of 191 articles, 22 met the preestablished inclusion criteria. We assessed the quality of evidence according to the Oxford Centre for Evidence-Based Medicine's Levels of Evidence.Seven key studies were analyzed, exploring a range of postoperative care interventions, including administering corticosteroids, elevating the head during and after the procedure, using alternative therapeutic approaches, and applying cooling techniques.Postsurgical recovery after rhinoplasty involves managing pain, swelling, and bruising, among other complications. Educating patients about expected outcomes and the healing process helps alleviate their anxiety and uncertainty. Corticosteroids have proven effective in controlling swelling and bruising. Antibiotics are generally not recommended. Silicone septal splints provide support, particularly when stabilization of an injured mucous membrane or septal cartilage is required; however, nasal packing is not recommended. Adhesive strips can help reduce edema in the dorsal and supratip areas. Positioning patients in a 20° reverse Trendelenburg position during surgery, followed by maintaining the head elevated at a 90° angle postoperatively, has significantly reduced edema and ecchymosis. Using a cannula for drainage and cooling techniques has been shown to reduce postoperative morbidity effectively.Rhinoplasty is a common facial plastic surgery, yet there is no consensus on optimal postoperative care. Key strategies include silicone splints, subperiosteal drainage, nasal taping, cooling, corticosteroids, and intra- and postoperative head elevation. However, further systematic trials are necessary to refine these strategies and improve patient outcomes.

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来源期刊
Facial Plastic Surgery
Facial Plastic Surgery 医学-外科
CiteScore
1.80
自引率
10.00%
发文量
87
审稿时长
6-12 weeks
期刊介绍: Facial Plastic Surgery is a journal that publishes topic-specific issues covering areas of aesthetic and reconstructive plastic surgery as it relates to the head, neck, and face. The journal''s scope includes issues devoted to scar revision, periorbital and mid-face rejuvenation, facial trauma, facial implants, rhinoplasty, neck reconstruction, cleft palate, face lifts, as well as various other emerging minimally invasive procedures. Authors provide a global perspective on each topic, critically evaluate recent works in the field, and apply it to clinical practice.
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