背景:使用同种异体和同种异体鼻植入物在鼻整形中广泛流行。然而,这些材料的使用伴随着感染和挤压的风险。传统上,这些并发症的管理是以双阶段的方式进行的.首先,移除植入物并控制感染,然后执行延迟重建。然而,瘢痕和软组织挛缩使延迟重建具有挑战性,和最佳的审美结果是很难实现的。这项研究旨在评估移除受感染的鼻植入物后立即进行鼻重建的结果。
方法:回顾性分析了所有感染鼻植入物并同时切除和立即用自体软骨重建鼻的患者(n=8)。收集的数据包括患者年龄,种族,术前演示,术中手术操作,以及术后结果和并发症。术后结果用于衡量单阶段方法的成功。
结果:随访时间为12至156个月,研究中评估的8名患者平均为84.4个月,没有任何需要翻修或重建的重大术后并发症.所有患者的鼻腔形态和功能均有明显改善。八名患者中有六名(75%)报告了出色的美学结果;两名(25%)出于美学考虑要求进行修正手术。
结论:在去除感染的鼻植入物后立即进行自体重建时,低并发症发生率和良好的美学效果是可能的。这是一种替代方法,可以避免传统延迟重建的固有问题。
方法:本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266..
BACKGROUND: The use of alloplastic and allogenic
nasal implants is widely popular in rhinoplasty. However, the use of these materials is accompanied by a risk of infection and extrusion. Traditionally, management of these complications is performed in a dual-staged fashion. First, the implant is removed and infection is controlled, then a delayed reconstruction is performed. However, scarring and soft tissue contracture make a delayed reconstruction challenging, and optimal aesthetic outcomes are difficult to achieve. This study was designed to evaluate the outcomes of immediate
nasal reconstruction following removal of an infected
nasal implant.
METHODS: A retrospective chart review was performed of all patients who had infected
nasal implants and underwent simultaneous removal and immediate nasal reconstruction with autologous cartilages (n = 8). Data collected included patient age, race, pre-operative presentation, intraoperative surgical maneuvers, and post-operative outcomes and complications. Post-operative results were used to measure success of the single-staged method.
RESULTS: Follow-up ranged from 12 to 156 months with mean 84.4 months of the eight patients who were evaluated in the study, none had any major post-operative complications that required revision or reconstruction. All of the patients had marked improvement in
nasal form and function. Six of the eight (75%) patients reported excellent aesthetic outcomes; two (25%) requested revisional surgeries for aesthetic concerns.
CONCLUSIONS: Low complication rates and excellent aesthetic outcomes are possible in immediate autologous reconstruction following removal of an infected
nasal implant. This is an alternative approach that obviates the inherent problems of a traditional delayed reconstruction.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ..