Rinoplastika bez tamponade nosa i bez udlage

Dejan Vulović; Jefta V Kozarski; Uroš Radivojčević; Nenad Stepić; Saša Milićević; Nenad T Petrović

doi:10.2298/VSP160701239V

Dejan Vulović Clinical Center “Kragujevac”, Center for Plastic Surgery, Clinic for Ophtalmology, Kragujevac, Serbia
Jefta V Kozarski Military Medical Academy, Clinic for Plastic Surgery and Burns, Belgrade, Serbia
Uroš Radivojčević Center for Plastic Surgery, Clinical Center” Kragujevac”, Kragujevac, SerbiaFaculty od Medical Sciences, University of Kragujevac, Kragujevac, Serbia
Nenad Stepić Military Medical Academy, Clinic for Plastic Surgery and Burns, Belgrade, Serbia
Saša Milićević Military Medical Academy, Clinic for Plastic Surgery and Burns, Belgrade, Serbia
Nenad T Petrović Center for Plastic Surgery, Clinical Center” Kragujevac”, Kragujevac, SerbiaFaculty od Medical Sciences, University of Kragujevac, Kragujevac, Serbia

DOI: https://doi.org/10.2298/VSP160701239V

Keywords: rinoplastika;, hirurgija, operativne procedure;, postoperativni period;, postoperativne komplikacije;, bolesnik, zadovoljstvo.

Abstract

Uvod/Cilj. Većina hirurga, na kraju korektivne rinoplastike, koristi endonazalnu tamponadu i spoljašnju udlagu prvenstveno radi hemostaze i imobilizacije. Moguće komplikacije ove operacije su različite i najčešće su bol, otok nosa, i otok sa krvnim podlivima očnih kapaka. Cilj naše studije bio je da se proceni učestalost neestetskih komplikacija i efikasnost korektivne rinoplastike bez tamponade i spoljašnje udlage. Metode. Sprovedena je analiza sto pedeset i jednog bolesnika u Kliničkom centru “Kragujevac” u Kragujevcu, Srbija, u periodu od 1999. godine do maja 2016. godine, koje je operisao isti hirurg i uradio primarnu korektivnu rinoplastiku bez endonazalne tamponade i bez spoljašnje udlage. Umesto splinta, korišćene su adhezivne sterilne kožne trake. Prospektivnom studijom, tipa uzastopne serije slučajeva, analizirali smo moguće komplikacije i subjektivne procene bolesnika kod kojih je urađena primarna korektivna rinoplastika na opisani način. Za procenu postoperativnog bola korišćena je vizuelna analogna skala (VAS). Dobijeni rezultati rangirani su od 1 do 5. Za procenu otoka i krvnih podliva očnih kapaka 24 sata posle operacije, primenjena je skala hirurškog periorbitalnog rejtinga otoka i ekhimoza (SPREE). Rezultati su rangirani od 0 do 5. Stepen restrikcije disanja kroz nos evaluiran je u skali od 1 do 4. Opšti komfor u postoperativnom periodu operisani su ocenili kao: dobar, neodređen, loš. Zadovoljstvo bolesnika estetskim rezultatom je analizirano sedmog i tridesetog dana od operacije, na skali od 1 (veoma zadovoljan) do 5 (veoma nezadovoljan). Rezultati. Analiziran je sto pedeset i jedan bolesnik, starosti od 18 do 47 godina, a najviše je bilo mlađih bolesnika (prosečno 23,19 godina). Zastupljenost ženskog pola (72,18%) je bila veća, Umeren bol imalo je 47,02% bolesnika. Nijedan od njih nije imao jake ili najteže moguće bolove, a 32,45% bolesnika nije uopšte imalo bolove. Otok očnih kapaka i periorbitalne zone bili su umereni kod svih bolesnika (100%). Ostale komplikacije nisu postojale, osim unilateralne epistakse kod jednog (0,66%) bolesnika, desetog postoperativnog dana. Najveći broj operisanih (52,97%) je odmah posle operacije mogao normalno da diše kroz nos. Bolesnici su opšti komfor nakon operacije uglavnom opisivali najvećom ocenom (74,17%). Većina bolesnika bila je zadovoljna estetskim rezultatom posle sedam dana (58,28%) kao i posle mesec dana (52,32%). Bilo je veoma zadovoljnih bolesnika, sedmog dana - 27,15% i tridesetog dana – 39,73%. Zaključak. Smatramo da je rinoplastika bez tamponade i imobilizacije bezbedna, ugodna i ekonomična. Intenzitet bola, otoka i ekhimoza je nizak, kao i učestalost drugih komplikacija.

Author Biography

Jefta V Kozarski, Military Medical Academy, Clinic for Plastic Surgery and Burns, Belgrade, Serbia

Specijalista za plastičnu, rekonstruktivnu i estetsku hirurgiju

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