Tumescent anesthesia combined with skin and soft tissue expansion for the repair of 41 cases of congenital giant melanocytic nevi / 中华皮肤科杂志

Objective:To investigate the efficacy of tumescent anesthesia combined with skin and soft tissue expansion for the repair of congenital giant melanocytic nevi.Methods:From July 2015 to December 2019, 41 patients with congenital giant melanocytic nevi, including 24 males and 17 females aged 7 - 45 years, were collected from the Department of Dermatology, Xijing Hospital, the Fourth Military Medical University. Skin lesions ranged from 5 cm × 12 cm to 12 cm × 18 cm in size, and were located on the scalp in 13 cases, on the face in 18 cases, as well as on the trunk in 10 cases. Before surgery, the composition of tumescent solution was adjusted according to the body weight, operation duration, skin lesion area, etc., and the total dose and peak plasma concentration of lidocaine should be below 35 mg/kg and 4 mg/L respectively. All the patients received tissue expander placement and second-stage flap transfer under tumescent anesthesia.Results:During surgery, satisfactory effect of tumescent anesthesia was achieved in all the 41 patients, the pain score assessed by a numerical rating scale was 1.82 ± 0.54. In addition, the surgical field and dissection levels were clear with little bleeding and no related complications. Follow-up of 3 - 36 months showed that the skin flaps matched the surrounding skin tissues well, with relatively concealed incision lines and soft flat scars.Conclusion:For the treatment of congenital giant melanocytic nevi, tumescent anesthesia is effective and safe, which combined with skin and soft tissue expansion can effectively reduce the incidence of postoperative complications, and this strategy is worthy of clinical promotion.

A Novel Comparative Study of Phlebectomy with Invagination Stripping of the GSV Done Under Tumescent and Spinal Anaesthesia: A Prospective Cohort From Tertiary Centre In South India

Background: Varicose veins are commonly encountered vascular disease with wide variety of surgical and minimally invasive /interventional modes of treatment .we put forth a novel economical and efficient technique of performing high ligation, long saphenous vein stripping and Muller's hook phlebectomy in tumescent local anaesthesia compared with spinal anaesthesia. AIM &OBJECTIVE: The purpose of the study was to compare a novel technique of performing phlebectomy and invagination stripping of the GSV using tumescent anesthesia and spinal anesthesia in terms of post operative pain, complications. Methods: A total of 200 patients (100 patients in each arm of spinal anaesthesia group, and tumescent anaesthesia group) diagnosed cases of varicose vein lower limb being operated with phlebectomy and invagination stripping of the GSV at Surgery Department of Government Medical College and Hospital, Kozhikode, Kerala were considered in this study. Consecutive sampling was done. Results: Of these patients, 120 (60%) were female and 40 were male (40%) with a mean age of 35.4 ± 8 and 47.4 ± 14 years, respectively No statistically significant difference with respect to the wound infection, local discomfort, postoperative recurrence rates of varicosity and patients satisfaction score was observed (P > 0.05. Conclusion: Tumescent local anesthesia is a novel, economical and efficient technique of performing high ligation, long saphenous vein stripping and Muller's hook phlebectomy when compared to doing under spinal anaesthesia with similar results.

Research Progress of Tumescent Anesthesia / 中国微创外科杂志

[Summary] Tumescent anesthesia is mainly used in liposuction operation and has produced an exemplary safety record for this technique to date .Now surgical applications for the technique widely vary ranging across vascular surgery , breast surgery , plastic surgery and so on .It can be used in both hospital-and day-case environments .In this review we summarized the research progress of tumescent anesthesia in respect with indications , selection and maximum dose of local anesthetics , additives use , and safety .

Ambulatory Phlebectomy Using the Tumescent Anesthesia / 대한피부과학회지

BACKGROUND: Ambulatory phlebectomy is a cosmetically elegant outpatient procedure for the removal of varicose veins. One of the keys to its success is the ability to perform the procedure under local anesthesia. Tumescent anesthesia is applied in dermatologic surgery and now being expanded for use in phlebectomy. OBJECTIVE: To evaluate the efficacy and safety as well as advantages of 0.1% tumescent anesthesia with epinephrine in ambulatory phlebectomy. METHODS: Twenty-two patients(twenty-seven legs) without reflux at the SFJ were treated with ambulatory phlebectomy using the tumescent(0.1%) technique. In all patients, we monitored blood pressure, heart rate, and O2 saturation before, during, and after procedure. All patients were asked to rate the pain, both intraoperatively and postoperatively. They visited in hospital to record complications at one day, one week, and various monthly intervals (1, 3, 6, 12 months) following the initial treatment. RESULTS: The volume of anesthetic fluid ranged from 90 to 650ml, with an average of 320.7ml of fluid. Blood pressure, heart rate, and O2 saturation measured did not significantly change before, during, or after procedure. The average reported intraoperative pain for all interviewees was from 0 to 2. For postoperative pain, patients reported pain rate less than one. During operation, significant surgical blood loss is eliminated. There were minimal hematoma, purpura, and hyperpigmentation after operation. CONCLUSION: 0.1% Tumescent anesthesia provides a very safe, comfortable technique of anesthetizing patients for ambulatory phlebectomy and may decrease the incidence of complications.

Ambulatory Phlebectomy Using the Tumescent Anesthesia / 대한피부과학회지

BACKGROUND: Ambulatory phlebectomy is a cosmetically elegant outpatient procedure for the removal of varicose veins. One of the keys to its success is the ability to perform the procedure under local anesthesia. Tumescent anesthesia is applied in dermatologic surgery and now being expanded for use in phlebectomy. OBJECTIVE: To evaluate the efficacy and safety as well as advantages of 0.1% tumescent anesthesia with epinephrine in ambulatory phlebectomy. METHODS: Twenty-two patients(twenty-seven legs) without reflux at the SFJ were treated with ambulatory phlebectomy using the tumescent(0.1%) technique. In all patients, we monitored blood pressure, heart rate, and O2 saturation before, during, and after procedure. All patients were asked to rate the pain, both intraoperatively and postoperatively. They visited in hospital to record complications at one day, one week, and various monthly intervals (1, 3, 6, 12 months) following the initial treatment. RESULTS: The volume of anesthetic fluid ranged from 90 to 650ml, with an average of 320.7ml of fluid. Blood pressure, heart rate, and O2 saturation measured did not significantly change before, during, or after procedure. The average reported intraoperative pain for all interviewees was from 0 to 2. For postoperative pain, patients reported pain rate less than one. During operation, significant surgical blood loss is eliminated. There were minimal hematoma, purpura, and hyperpigmentation after operation. CONCLUSION: 0.1% Tumescent anesthesia provides a very safe, comfortable technique of anesthetizing patients for ambulatory phlebectomy and may decrease the incidence of complications.