背景:美容乳房手术在中国的普及导致对评估并发症和死亡率的危险因素的更大需求。
目的:确定中国乳房美容手术后并发症的发生率和独立危险因素。
方法:对2012年至2021年期间4973例乳房美容手术患者进行了回顾性队列研究。术后并发症包括轻微并发症(切口愈合受损,血肿,或脂肪液化)和手术部位感染(SSI),术后30天内记录。随访时间仅在假体植入手术后延长至1年。潜在的危险因素,包括年龄,体重,住院时间,操作时间,体积切除,切口位置,和其他临床资料进行了评估.
结果:在4973例接受乳房美容手术的患者中,轻微并发症发生率为0.54%,SSI为0.68%。假体植入的增强有最高的SSI率(4.23%),与年龄增长(相对危险度[RR]1.12;P<0.01)和乳晕周围切口(RR5.87,P<0.01)显著相关。自体脂肪移植后,术后抗生素使用(RR6.65,P<0.01)是SSI的独立危险因素。调整重量后,体积切除量超过1500g(RR14.7,P<0.01)是减少乳房固定术SSI的独立危险因素。乳房缩小术(1.01%)和乳房矫正术(0.75%)的并发症发生率较低,并且在乳房固定术中没有并发症的记录(n=161)。
结论:乳房美容手术后并发症的发生率较低。并发症的危险因素主要包括年龄增长,围手术期抗生素使用,乳晕周围切口,和广泛的体积切除。在临床实践中,应更多地关注高危患者,以减少乳腺癌感染。
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The popularity of aesthetic breast surgery in China results in greater demand for assessing risk factors for complications and mortality.
To determine the incidence and independent risk factors for postoperative complications following aesthetic breast surgery in China.
A retrospective cohort study on 4973 patients who had aesthetic breast surgery between 2012 and 2021 was performed. Postoperative complications include minor complications (incision healing impaired, hematoma, or fat liquefaction) and surgical site infection (SSI), which were recorded within 30 days after surgery. The follow-up time was expanded to 1 year only after prosthesis implantation procedures. Potential risk factors including age, weight, length of hospital stay, operation time, volume resection, incision location, and other clinical profile information were evaluated.
Among 4973 patients who underwent aesthetic breast surgery, the minor complication rate was 0.54%, and SSI was 0.68%. Augmentation with prosthesis implantation had the highest SSI rate (4.23%), which was significantly associated with increasing age (relative risk [RR] 1.12; P < 0.01) and periareolar incision (RR 5.87, P < 0.01). After augmentation with autologous fat transplantation, postoperative antibiotic use (RR 6.65, P < 0.01) was an independent risk factor for SSI. After adjusting for weight, volume resection over 1500 g (RR 14.7, P < 0.01) was an independent risk factor for SSI of reduction-mastopexy surgery. The complication rate of reduction mammaplasty (1.01%) and gynecomastia correction was lower (0.75%), and there was no record of complication in mastopexy procedures (n = 161).
The incidence of postoperative complications following aesthetic breast surgery is low. Risk factors for complications mainly include increasing age, perioperative antibiotic use, periareolar incision, and extensive volume resection. Much more attention should be focused on those high-risk patients in clinical practice to decrease breast infection.
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