Journal für Ästhetische Chirurgie

, Volume 2, Issue 3, pp 137–140 | Cite as

Wunddrainage in der plastischen Chirurgie

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Zusammenfassung

Halstedt konstatierte: „Je weniger vollkommen die Technik des Chirurgen, desto größer die Notwendigkeit für eine Drainage. Gar keine Drainage ist besser als deren unkundige Anwendung.“ Die Verwendung von Drainagen in der plastischen Chirurgie ist nicht unumstritten. Während Drainagen routinemäßig nach Facelift-Operationen, Mammareduktionsplastiken, Abdominoplastiken oder auch freien Lappentransferoperationen angewendet werden, ist die rationale Basis für die Anwendung oftmals brüchig. Vielmehr konnten randomisiert-kontrollierte Studien für die Mammareduktionsplastik eine erhöhte Komplikationsrate bei Verwendung von Drainagen nachweisen. Bei Facelift-Operationen ist die Drainageentfernung nach 24 Stunden nicht mit veränderten Komplikationsraten gegenüber keiner Drainage verbunden. Möglicherweise kann die Seromhäufigkeit an der Hebestelle des M. latissimus dorsi durch Fibrinkleber, Triamcinolon-Injektion und bestimmte Nahttechniken reduziert werden. Insgesamt ist der routinemäßige Einsatz von Drainagen in der plastischen Chirurgie nicht durch randomisiert-kontrollierte Studien abgesichert. Die Anlage einer Drainage sollte daher auch nicht routinemäßig durchgeführt, sondern bei jeder Operation als Einzelfall entschieden werden.

Schlüsselwörter

Drainage Sogdrainage Serom Komplikation Plastische Chirurgie 

Wound drainage in plastic surgery

Abstract

As Halstedt stated:“The more imperfect the technique of the surgeon, the greater the necessity for drainage. No drainage at all is better than the ignorant employment of it”. Drainage is a matter of debate in plastic surgery and is not undisputed. While drainage is applied in face-lifting procedures, mammoplasty, abdominoplasty and free flap transfers on a routine basis, the rationale for usage is often weak. Randomised controlled trials could show a significantly higher complication rate using drainage in breast reduction surgery. Performing reduction mammoplasty without the use of closed suction drainage is safe and is preferred by the patients. Postoperative drainage after face lifting procedures does not influence the incidence of postoperative complications but does reduce the degree of postoperative bruising. The likelihood of seromas at the donor site of the latissimus dorsi muscle can be reduced by fibrin glue, triamcinolone injections and/or progressive tension sutures. The routine use of drainage in plastic surgery is not supported by evidence-based recommendations. Therefore, drainage should not be automatically employed in plastic surgery, but as an operative decision for each individual patient.

Keywords

Drainage Suction drainage Seroma Complication Plastic surgery 
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Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer Medizin Verlag 2009

Authors and Affiliations

  1. 1.Plastische, Hand- und WiederherstellungschirurgieMedizinische Hochschule HannoverHannoverDeutschland

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