Послеоперационные осложнения при редукционной маммопластики

Abstract

An analysis of the literature indicates that reduction mammoplasty continues to be a widely popular procedure in the treatment of macromastia. At the same time, there is inconsistency in reporting risk factors predisposing to postoperative complications. According to various studies, the frequency of postoperative complications during reduction mammoplasty ranges from 4.3- 8.2% to 14.0-23.0%. The most common complications were minor hematomas (8.1%), bleeding (4.0%), skin and nipple necrosis or suture dehiscence (8.9–41.7%), and delayed healing due to superficial infection (7.3-26.0%), which resulted in hypertrophic scars (13.0-20.0%), deep infection (1.1-8.0%) and seroma formation (1.2-14,0%) and change sensitivity of the nipple (8.4%) or breast (7.8%). Reoperation rates were 6.7% for scars, 1.4% for fat necrosis, and 1.0% for wounds. The incidence of complications in patients with and without concomitant diseases was 10.2% and 4.6%, respectively, i.e. 2.2 times more. Fat necrosis and infection were more common in obese patients. Smokers had a 2.03 times higher risk of infection and a 2.34 times higher risk of dehiscence. These studies can serve as the basis for preoperative patient education, choice of surgical method for reduction mammoplasty, and determination of the amount of postoperative care. In most cases, patients who have undergone reduction mammoplasty note an improvement in their quality of life, a decrease in pain and an increase in self-esteem. At the same time, the proportion of older patients wishing to improve their quality of life and physical function is increasing.