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Purpose <p>Breast reduction (BR) involves a large surface area of manipulated tissue, increasing the risk of postoperative hematoma. Pulse irrigation (PI) uses a device to deliver intermittent pressurized irrigant intraoperatively. This study aims to evaluate whether the use of PI is associated with reduced incidence of postoperative hematoma after BR.</p> Methods <p>An IRB-approved, retrospective cohort study was performed on all female patients &gt;18 years old who underwent BR at a single academic medical center from 2019 to 2023. Patients operated on by surgeons who performed BR exclusively with or exclusively without PI were excluded. Demographics, surgical details, and postoperative complications were compared using T-tests for independent samples and Pearson chi-square tests of significance (statistical significance set at <i>p</i>&lt;0.05).</p> Results <p>A total of 418 patients met inclusion and exclusion criteria: 196 PI patients (46.9%) and 222 (53.1%) non-PI patients. PI patients had differences in race, type of insurance and higher usage of liposuction (all <i>p</i>&lt;0.001). There was a statistically significantly lower hematoma rate in PI patients compared to non-PI patients (0.0% vs. 2.7%, <i>p</i>=0.020). Although not statistically significant, PI patients had lower rates of seroma (1.0% vs. 3.6%, <i>p</i>=0.085) and superficial incisional SSI (1.5% vs. 2.7%, <i>p</i>=0.410) than non-PI patients.</p> Conclusion <p>Intraoperative use of PI reduces the rate of postoperative hematoma in patients undergoing BR. This finding is hypothesized to be due to provocative disruption of unstable clots which thereby helps to identify sites of tenuous hemostasis so that they can be better cauterized prior to completion of the procedure.</p> Level of Evidence III <p>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 <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>

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Pulse Irrigation Reduces Rate of Postoperative Hematoma Following Breast Reduction

  • 期刊论文

  • 发表日期：

    2025年1月21日

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  • Daniel Y. Kwon,
  • Peter Shamamiam,
  • Esther Kim,
  • Simeret Genet,
  • Abena Gyasi,
  • Zachary Gallate,
  • Nargiz Seyidova,
  • Olachi Oleru,
  • Peter W. Henderson

摘要

Purpose

Breast reduction (BR) involves a large surface area of manipulated tissue, increasing the risk of postoperative hematoma. Pulse irrigation (PI) uses a device to deliver intermittent pressurized irrigant intraoperatively. This study aims to evaluate whether the use of PI is associated with reduced incidence of postoperative hematoma after BR.

Methods

An IRB-approved, retrospective cohort study was performed on all female patients >18 years old who underwent BR at a single academic medical center from 2019 to 2023. Patients operated on by surgeons who performed BR exclusively with or exclusively without PI were excluded. Demographics, surgical details, and postoperative complications were compared using T-tests for independent samples and Pearson chi-square tests of significance (statistical significance set at p<0.05).

Results

A total of 418 patients met inclusion and exclusion criteria: 196 PI patients (46.9%) and 222 (53.1%) non-PI patients. PI patients had differences in race, type of insurance and higher usage of liposuction (all p<0.001). There was a statistically significantly lower hematoma rate in PI patients compared to non-PI patients (0.0% vs. 2.7%, p=0.020). Although not statistically significant, PI patients had lower rates of seroma (1.0% vs. 3.6%, p=0.085) and superficial incisional SSI (1.5% vs. 2.7%, p=0.410) than non-PI patients.

Conclusion

Intraoperative use of PI reduces the rate of postoperative hematoma in patients undergoing BR. This finding is hypothesized to be due to provocative disruption of unstable clots which thereby helps to identify sites of tenuous hemostasis so that they can be better cauterized prior to completion of the procedure.

Level of Evidence III

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.