The Use of Tumescent Technique in Mastectomy and Related Complications: A Meta-Analysis
| Autor: | Michele A. Manahan, David M. Euhus, Charalampos Siotos, Stella M. Seal, Gedge D. Rosson, Jeffrey W. Aston |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Mammaplasty MEDLINE Context (language use) Breast Neoplasms 030230 surgery Risk Assessment 03 medical and health sciences Necrosis 0302 clinical medicine Hematoma Postoperative Complications medicine Humans Mastectomy Skin business.industry Dissection medicine.disease Prognosis Surgery Treatment Outcome 030220 oncology & carcinogenesis Meta-analysis Female Risk assessment Complication Breast reconstruction business |
| Zdroj: | Plastic and reconstructive surgery. 143(1) |
| ISSN: | 1529-4242 |
| Popis: | BACKGROUND Postoperative skin necrosis in surgical patients is costly to hospitals and health care providers. Tumescent dissection technique is commonly used in mastectomy and immediate breast reconstruction, as it helps reduce blood loss; however, it may increase the risk of mastectomy skin flap necrosis. In this context, the authors have conducted a systematic review of the literature to perform a meta-analysis of the relationship between tumescent technique in mastectomy with or without breast reconstruction and complication rates. METHODS The authors screened the PubMed (1966 to 2016), Scopus (2004 to 2016), Embase (1966 to 2016), and Web of Science (1964 to 2016) databases for relevant articles through March 30, 2017. The authors included studies on the use of tumescent technique in the context of mastectomy with or without immediate breast reconstruction. The primary outcome the authors evaluated was the rate of skin flap necrosis; the secondary outcomes were the rates of breast hematomas and infections. Because of the heterogeneity of the studies, the authors performed a meta-analysis using the random effects model. RESULTS After screening, the authors evaluated five studies including 3982 mastectomies. Mastectomies performed under the preoperative application of tumescent solution had statistically higher rates of skin flap necrosis overall (p = 0.03) and major (p < 0.01) and minor skin necrosis (p = 0.03). However, the rates of hematoma and infection were not correlated with the use of tumescent technique. CONCLUSIONS The authors' systematic review of the literature provides a better understanding of the consequences of the application of tumescent technique in mastectomy. The authors' findings suggest that tumescent technique may increase the risk of skin necrosis in mastectomy with or without breast reconstruction. |
| Databáze: | OpenAIRE |
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