Pneumothorax as a Complication of Liposuction
| Autor: | James A Mentz, Henry A. Mentz, Stephanie Nemir |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment 030230 surgery 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Postoperative Complications Lipectomy medicine Humans In patient Postoperative Period Positive end-expiratory pressure Retrospective Studies Asj/4 AcademicSubjects/MED00987 business.industry Pneumothorax Retrospective cohort study General Medicine Original Articles medicine.disease Body Contouring Cannula Surgery Axilla medicine.anatomical_structure surgical procedures operative Liposuction Female Complication business |
| Zdroj: | Aesthetic Surgery Journal |
| ISSN: | 1527-330X |
| Popis: | Background Pneumothorax is a rare complication of liposuction resulting from injury to the lung parenchyma. Objectives This study aimed to determine the incidence of pneumothorax complicating liposuction, describe an archetypal presentation, identify risk factors, and propose options for risk reduction. Methods In a retrospective chart review, liposuction procedures performed over a 16-year period by 8 surgeons in 1 practice were screened for pneumothorax. Cases featuring pneumothorax were analyzed to ascertain risk factors, presentation, and pathogenesis. Results Among the 16,215 liposuction procedures performed during the study period, 7 pneumothoraxes were identified (0.0432%). Six (85.7%) were female. Three (42.9%) had previous liposuction. Six cases (85.7%) included liposuction of the axillary region. All cases featured depression of intra/postoperative oxygen saturations as the initial sign. Three (42.9%) were identified intraoperatively. All patients were transferred to a hospital for imaging. Five (71.4%) underwent chest tube placement. Two (28.6%) were treated with observation alone. Pneumothoraxes were left-sided in 4 cases (57.1%), and right-sided in 3 cases (42.9%). In early cases, 1.5-mm infiltration cannulas were used; in 2016 cannula size was changed to 3-4 mm for infiltration and 4-5 mm for liposuction. Conclusions Possible risk factors for pneumothorax include liposuction of the axilla, use of flexible infiltration cannulas, and scarring from previous liposuction. We recommend including pneumothorax as a potential complication during informed consent, performing infiltration with a stiff >3.5-mm cannula, minimizing positive-pressure ventilation, emphasized awareness of cannula tip location in all patients but particularly in patients with previous liposuction or scar tissue, and increased caution when operating in the axillary area. Level of Evidence: 4 |
| Databáze: | OpenAIRE |
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