Rede hemostática: uma alternativa para a prevenção de hematoma em ritidoplastia

Abstract

Auersvald A et al. Hemostatic net: an alternative for the prevention of hematoma in rhytidoplasty Rede hemostática: uma alternativa para a prevenção de hematoma em ritidoplastia ABSTRACT Background: Hematoma is the most common postoperative complication of rhytidoplasty. Its occurrence increases morbidity and impairs recovery. Internal sutures to close detached areas are used in abdominoplasty to prevent seromas. Taking this into account and in order to reduce the number of patients with hematomas post rhytidoplasty, we have developed a similar surgical procedure in which a hemostatic net is made of continuous nylon 4-0 transfixing stitches to include the skin and the superficial musculoaponeurotic system-platysma. Methods: A total of 366 patients who underwent rhytidoplasty of at least the middle third of the face between July 2009 and September 2011 were included in the study. Group A was identified as the control group; it included the first 120 patients assessed retrospectively. The remaining 246 patients, who underwent the surgical procedure here proposed and who were evaluated prospectively formed group B. We observed the incidence of hematoma, ischemia, and necrosis in the first 72 postoperative hours. Results: In group A, 17 (14.2%) patients developed hematomas, whereas none occurred in group B. The surgical procedure did not significantly increase the occurrence of ischemia: 11 (9.2%) patients in group A and 16 (6.5%) in group B had this complication (P < 0.3964). There was also no significant increase in the incidence of necrosis, which was observed in 3 (2.5%) patients in group A and 4 (1.6%) in group B (P < 0.4298). Conclusions: The hemostatic net is an efficient method for the prevention of early hematomas following rhytidoplasty. This surgical procedure did not result in a significant increase in the incidence of ischemia and necrosis.

Atenolol prevents the formation of expansive hematoma after rhytidoplasty

“…Several authors use general anesthesia in their services 3,4,8,10 . The anesthesia performed in this study was sedation associated with local infiltrative anesthesia with lidocaine, also used by other authors 2,11 . Endotracheal intubation and reflexes triggered by general anesthesia can cause arrhythmias, reflex hypertension and bleeding, with hematoma formation.…”

“…Many surgical approaches have been suggested for the prevention of this complication, most only of local action, such as external stitches 2 , use of suction drains 4 , tumescent infiltration 4 , tissue glues 5 , dissection with ultrasonic instruments 6 and internal adhesion stitches 7 .…”

Necrose extensa em face pós-ritidoplastia: relato de caso

“…Dentre todas, a complicação mais frequente continua sendo o hematoma que, em algumas situações, pode comprometer a vascularização do retalho levando a necrose tecidual e exigir reabordagem cirúrgica [3][4][5][6][7][8][9][10][11][12] .…”

Novel Use for Hemostatic Net in Split-thickness Skin Grafts

“… 4 In 2012 based on the concept of mechanical closure, Auersvald et al described a surgical procedure of transcutaneous continuous and transfixing sutures of skin flaps in rhytidoplasty, creating a hemostatic net that leads to almost total occlusion of the treated area. 5 They found that this technique was an efficient method for the prevention of early hematomas, without an increase in ischemia or necrosis of flaps. 4 In 2018, the same authors described the use of this method in facelift surgery, with the conclusion that hemostatic net is a safe and effective method to reduce hematoma in the early postoperative period by not altering the perfusion of the flaps.…”

“… 4 This is achieved because the suture performed provides an almost total occlusion of the surgical area and avoids fluid accumulation. 5 However, the use of this procedure has not been described in split-thickness skin grafts in burn patients.…”