ABSTRACT
The tumescent technique of liposuction is a modification of the wet technique. A large volume of very dilute epinephrine is infiltrated into a targeted fat compartment prior to liposuction, producing a swelling and firmness. This tumescence of fat permits an increased accuracy in liposuction and minimizes postsurgical irregularities or rippling of the skin. Epinephrine- induced vasoconstriction minimizes blood loss, bruising, and postoperative soreness. Safe, rapid infiltration of large volumes of solution is achieved using a closed sterile system featuring a newly designed blunt-tipped, 30-cm-long, 4.7-mm-diameter needle having a hollow handle that accommodates a 60-cc syringe. Attached to a liter bottle of anesthetic solution by an intravenous line, the needle is inserted via the same incision and deposits the solution along the same path as that intended for the liposuction cannula. Thus, the solution is infiltrated exactly where it is needed for hemostasis or local anesthesia. Used in conjunction with general anesthesia, the tumescent technique saves time in achieving maximal vasoconstriction of the targeted fat compartment. If dilute lidocaine (0.1%) is added to the solution, the technique permits liposuction of more than 2 liters of fat totally by local anesthesia. Twenty-six patients, having received a mean lidocaine dose of 1250 mg (18.4 mg/kg or 8.5 mg/kg/hr) infiltrated into subcutaneous fat, had a mean serum lidocaine level of less than 0.36 ųg/ml 1 hour after completion of the infiltration.
ABSTRACT
The use of tumescent technique, which contains epinephrine, in penile surgery has not been reported previously. Two patients with hypospadias had reconstructive operation using tumescent technique with a ”One-per-Mil” tumescent solution containing epinephrine intra-operatively. The results was a clear operation field, almost bloodless during dissection, and no complication on the penis after epinephrine injection with minimal edema. Apparently, the “One-per-Mil” tumescent solution acts as a natural hydro-dissector creating avascular anatomic tissue planes for easier and more rapid dissection in surgery for hypospadias. We suggest that epinephrine is safe to be injected in penis as a future area of clinical practice.
Subject(s)
Hypospadias , EpinephrineABSTRACT
Objective To explore the application and formulas of the tumescent technique in the ultrosonic liposuction for better and more predictable reseults. Methods The tumescent technique formulas were present and analysed through 318 cases of ultrosonic liposuction. Results The following regimen was recommended as a result of the above studies: Lactated Ringer's solution or nosmal sodium was the fluid of choice; Lidocaine (500 mg/l) was a reference anesthetic. The maximal safe dose recommended for liposuction was 35 mg/kg body weight and total dose of epinephrine was 2～3 mg/l. But its concentation should be lower than 1:1 000 000. Concentration of sodium bicarbonate was 500 mg/l, and higer doses were of no value but harmless. Conclusions Safer formulas are provided for the tumescent technique administration in the ultrosonic liposuction. The tumescent technique may reduce potential complications related to ultrosonic liposuction
ABSTRACT
Objective To observe the feasibility and effects of tumescent anesthesia on out-patients base in large-volume liposuction. Methods A total of 184 times of large volume liposuction in 154 patients were performed under tumescent technique with 0.05 % lidocaine and 1∶500,000 epinephrine. The whole abdomen, hypochondrium and waist areas or the posterior, lateral, medial aspects of the legs and the subgluteal regions were covered in one operation. The total injected tumescent liquid is from 2 200 ml to 5250 ml, the average was 2 730 ml. The dose of lidocaine was less than 40 mg/kg body weight or less than 2.4g in total. Results Some patients felt little discomfort during tumescent liquid injection, but all patients tolerated the procedure well under lower-concentration lidocaine without assistance of any analgesics or sedatives, the suctioned volume was 1 900～4 200 ml (the average 2 568 ml) and the supernatant of the suctioned volume was 1 200～3 400 (the average 2 036 ml). Conclusions It is practicable to perform large-volume liposuction using lower-concentration lidocaine tumescent technique with good persistent results.
ABSTRACT
Objective To discuss the benefits of the external ultrasonic liposuction through comparing the different effects of external ultrasonic tumescent liposuction and simple negative pressure liposuction. Methods The clinical effects of ten patients were compared, in which one side of abdomen was treated with external ultrasonic tumescent liposuction, and the other side with tumescent liposuction and the aspirates were analyzed. Results The percentage of supernatant fat in the whole aspirated volume on the ultrasonic treated sides was higher than that of non ultrasonic treated sides ( P
ABSTRACT
The purpose of our study is to evaluate utilization and application of the tumescent infusion technique as an adjunct to reconstructive protocols for non-liposuction surgery. Tumescent infusion techniques have improved anesthesia, hemostasis, fluid resuscitation, and safety for cosmetic and reconstructive lipoplasty patients. Clinically, utilization of these techniques has expanded to over 77 non-liposuction cosmetic and reconstructive procedures in the past 28 months. Procedures include : tissue expander insertion(3), major flap reconstruction (10), treatment of pressure sore(4), excision of benign tumor(5), escharectomy of burn wound(5), donor site of the skin graft(27), recipient bed of skin graft(9), full thickness skin graft(3), treatment of gynecomastia(3), other procedures(8). Their age range is from 8 to 66 years and total body surface area of tumescent injection ranged from 1 to 18%. The utilized tumescent fluid was Klein formula and the Hunstad modification of the Klein formula (1 liter N/S, 50-100cc 0.5-1% lidocaine, 1:1000-2000 1-2cc epinephrine, 38degrees C sodium bicarbonate 10mEq(10ml of 8.4% NaHCO3), Triamcinolone 10mg), and the infusion performed by 50cc syringe. Intraoperative blood loss for all tumescent technique was unnoticed in all patients. Post-operative pain was also notably reduced. The tumescent infusion technique can be a useful adjunct for non-liposuction procedures. This retrospective review highlights improved anesthesia, hemostasis, easy excision of skin, easy dissection, fluid resuscitation, and safety, while maintaining satisfactory post-operative healing.