ABSTRACT
Objective:To explore the effect of decision-making assistance during the implantation selection of breast augmentation patients to provide a reference for improving decision-making aids.Methods:From June 2018 to June 2020, the decision-making assistance programs were used in the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People＇s Hospital for prosthesis selection in 51 breast augmentation female patients, aged 23 to 42 years, with an average of 31 years old. The BREAST-Q scale was applied to assess the postoperative results of augmentation patients. Postoperative breast satisfaction was also evaluated by the physicians.Results:With decision-making assistance, breast augmentation patients＇ satisfaction with breasts was (80.27±11.45) points, satisfaction with surgical results (83.41±12.29) points, social and psychological status scores (87.24±7.62) points, and sexual life status scores (85.49±7.90) points, physical condition score (73.94±8.98) points. There was no statistical difference in the scores of breast size between physicians and patients ( P>0.05). In the satisfaction score and total score of breast shape and feeling, physicians＇ scores were higher than patients＇ self-report scores, and the difference was statistically significant ( P<0.05). Conclusions:The patient self-reported postoperative outcomes are at a high level under the application of decision aid program. We can further improve the decision aid program for breast augmentation patients, adjust patient＇s surgical expectation, and realize shared decision making.
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Objective To investigate the clinical indication and effect of instant reconstruction of breast after removal of polyacrylamide hydrogel injection for breast augmentation.Methods Patients had breast ultrasound,MRI check before operation,to define the distribution and level of the injections and tissue infiltration.Depending on tissue degree,capsule integrity and breast degeneration situation,three different methods were chosen,including implantation of silicone gel underneath the breast,pectoralis major or dual-plane.Results 56 patients' incision healed well.Follow-up for 6 months to 3 years showed that breast shapes were good without scars,prosthetic herniapsular,capsular contracture and other complications.Conclusions Instant reconstruction of the breast after removal of polyacrylamide hydrogel injection can improve breast shape and get satisfied effects.
ABSTRACT
Tension pneumothorax is known as a rare complication of breast augmentation surgery, but can occur more than expected. This is a case of a 34-year-old woman who was to receive delay extended latissimus dorsi flap under general anesthesia. The patient was injected the tumescent solution by 25 gauge spinal needle preoperatively. In the course of operation, the peak inspiratory pressure was increased gradually. At the moment of changing the position from supine to sitting position, the blood pressure decreased to 75/45 mmHg. We took the chest radiography, which showed typical findings of tension pneumothorax of right side. Prompt needle aspiration and chest tube insertion relieved tension pneumothorax. The patient's vital signs got stabilized and there was no visible remained pneumothorax at following chest radiography taken. We should pay attention to the possible occurrence of devastating pneumothorax during breast augmentation surgery, especially local infiltration using long needle is performed.
Subject(s)
Adult , Female , Humans , Anesthesia, General , Blood Pressure , Breast , Chest Tubes , Needles , Pneumothorax , Thorax , Vital SignsABSTRACT
Objetivo. Determinar si la irrigación de anestésicos locales en la cavidad mamaria, en pacientes sometidas a mamoplastia de aumento, disminuye la necesidad de analgesia de rescate y la intensidad del dolor postoperatorio, medido con la escala visual análoga. Metodología. Estudio clínico cuasiexperimental controlado con placebo. En el grupo de intervención se irrigó la cavidad mamaria con una solución de lidocaína al 1% con epinefrina (7 mg/kg), bupivacaína al 0,5% (3 mg/kg) y solución salina. En el grupo control se irrigó la cavidad mamaria con solución salina. La técnica anestésica y la analgesia de transición fueron estandarizadas. Se registró el analgésico opiáceo (morfina, hidromorfona o meperidina) y la dosis total requerida como analgesia de rescate durante la estancia en la unidad de cuidados postanestésicos (UCPA). Se registró la intensidad del dolor postoperatorio al recuperar la conciencia, a los treinta minutos, a la primera hora, a las dos, a las cinco y a las veinticuatro horas del postoperatorio. Resultados. Se encontró diferencia en el número de pacientes que requirieron analgesia de rescate con morfina en la UCPA (p<0,01), 10% en él grupo de intervención versus 50% en el grupo control. También se encontró diferencia en la intensidad del dolor (p<0,01). Conclusiones. La irrigación de anestésicos locales en la cavidad mamaria en pacientes sometidas a mamoplastia de aumento disminuye la necesidad de analgesia de rescate con opiáceos y la intensidad del dolor postoperatorio.
Objective: To determine if the irrigation of the breast cavity with local anesthetics in patients who undergo breast augmentation surgery reduces rescue analgesic requirements and postoperatory pain intensity level, measured with the analogue visual scale. Methods: Placebo controlled non randomized clinicál triál. In the intervention group the breast cavity was irrigated with 1% lidocaine with epinephrine (7 mg/kg), 0,5% bupivacaine (3 mg/kg) and normal satine solution. In the second group the breast cavity was irrigated with satine solution. Anesthetic and transition analgesia techniques were standardized. Type (morphine, hydromorphone and meperidine) and total required dose of opioid rescue analgesic medication in the Post Anesthetic Core Unit were also registered. Postoperative pain intensity level was also registered at the moment of consciousness recovery, at thirty minutes, at the first hour, at two, five and twenty four hours of postoperative period. Results: There was a difference in the number of patients requiring opioid rescue analgesia with morphine at the Post Anesthetic Care Unit (p<0.01), 10% in the intervention group versus 50% in the control group. Likewise, there was difference in pain intensity level (p<0.01). Conclusions: Local anesthetic irrigation in patients who underwent breast augmentation surgery reduces opioid rescue analgesia requirements and postoperative pain intensity level.
Subject(s)
HumansABSTRACT
Objective:To observe and compare the wound healing effects,the time and costs of hospitalization of the two drainage ways in the breast polyacrylamide hydrogel removing operations by a prospective randomized controlled approach.Methods:From December 2004 to December 2009,a total of 54 breast-side of 40 patients,whose incision were not healing after breast polyacrylamide hydrogel removing operations,were divided into two groups.Both gorups'skin incision were on the areola or inframammary crease.In the case of removing the polyacrylamide hydrogel during the operation as much as possible,a new incision,approximately 1.5cm,was produced below the inframammary crease approximately 5cm,the negative drainage tube was inserted into the new incision in the A group(distal drainage way),While the negative drainage tube was inserted into the original incision in B group(In-situ drainage way).Results:The breast appearance was flat and thin,the texture was soft and there was no mass or sclerosis.There were significant differences between the two methods in primary healing,the time and costs of hospitalization.Conclusion:The clinical effect of the distal drainage way is better than the clinical effect of the In-situ drainage way,and it deserves to apply in clinical practice.