Strategies for Reducing Fatal Complications in Liposuction

Abstract

Background:Liposuction has become one of the most common cosmetic surgical procedures, and severe complications secondary to this procedure have also increased significantly. That is why we carry out a research work to know the most frequent severe complications reported in the scientific literature to indicate criteria for prevention.Methods:English-language scientific publications about liposuction and its complications were analyzed using the PubMed.gov, from the beginning of PubMed's history through June 10, 2017. Five terms were used to define liposuction and its complications: "liposuction," "liposuction AND complications," liposuction AND major complications," "liposuction AND complications AND death," and "liposuction AND death." The quantities of results for the 5 phrases were analyzed, along with their contents.Results:One thousand sixty-three results were obtained from 1973 through June 10, 2017 for the phrase "Liposuction and Complications" in humans; for "Liposuction and Major Complications," 153 articles were found; for "Liposuction and Deaths," 89 articles were found; and 42 articles were obtained with the terms "Liposuction and Major Complications and Deaths." After final depuration, all those that were not specific to severe liposuction complications were eliminated, leaving a total of 39 articles that were included in our study. Five problems proved to be the most serious complications when performing liposuction: Thromboembolic disease, fat embolism, pulmonary edema, lidocaine intoxication, and intraabdominal visceral lesion.Conclusions:The 5 most important complications that can cause death in liposuction are easily preventable using simple measures and proper safety protocols that are described in this work.

Perforación visceral en liposucción. Medicina basada en evidencia

“…Los factores involucrados son pacientes con costillas prominentes y flacidez importante de la pared abdominal, introducir las cánulas para aspirar en un plano oblicuo al eje de la piel, así como el tipo de cánula, mientras más delgada mayor factor de flexión, lo que puede cambiar la dirección de la punta. [4][5][6][7]10,11 Recomendaciones: [4][5][6][7]8,[10][11][12][13][14] 1. En pacientes con abdomen globoso, pared abdominal con marcada flacidez y costillas prominentes se debe tener cuidado especial al realizar la aspiración en los cuadrantes superiores del abdomen.…”

“…El manejo inicial es con una punción en el segundo espacio intercostal a nivel de la línea medio clavicular y el tratamiento definitivo será la colocación de un tubo torácico conectado a un equipo de sello de agua. [4][5][6][7] Recomendaciones: [4][5][6][7][12][13][14] 1. Recordar que los pacientes con costillas prominentes, abdomen globoso y flacidez de la pared abdominal tienen riesgo de perforación de hígado, bazo y pleura.…”

“…En los casos en los que el diagnóstico y tratamiento se realicen después del tercer día, se recomienda realizar una estoma, desbridamiento del tejido necrótico, dejar las heridas abiertas y mantener a los pacientes en una Unidad de Terapia Intensiva para dar soporte de vida. [4][5][6][7][8][9][15][16][17][18][19][20][21][22][23][24][25] Recomendaciones: [4][5][6][7][12][13][14]26 1. En todos los pacientes a los que se realizará una liposucción del abdomen, se deberán buscar factores de riesgo: obesidad, abdomen globoso, flacidez de la pared abdominal, diastasis de rectos, hernias umbilicales, cicatrices por cirugías, adherencias e irregularidades por liposucciones previas.…”

Anesthesia Management for Large-Volume Liposuction

“…It is quite important to consider the necessary care during changes in position (ventral decubitus to prone decubitus) to minimize hemodynamic changes when patients are turned around and protect certain areas to avoid pressure injuries, corneal injuries, neural damage, and even blindness after anesthesia surgery. A recent report [24] mentioned the five more frequent serious complications of liposuction: thromboembolic disease, fat embolism, pulmonary edema, lidocaine intoxication, and intraabdominal visceral lesion. These events are easily preventable by simple measurements and safety protocols.…”

Operative Behandlung des Lipödems

“…Im Rahmen des vom Autor propagierten Konzepts wird die Infiltration mit einer Lösung bestehend aus 1 ml Adrenalin 1:1.000 auf 1.000 ml NaCl empfohlen. In Anlehnung an die Empfehlungen von Cárdenas-Camarena sollte die Gesamtdosis des mit der Infiltrations-Lösung applizierten Adrenalins 10 mg nicht übersteigen [37].…”