Implementation of the Improved Postsurgical Recovery Protocol in Abdominal Liposuction
Keywords:
liposuction, postsurgical recovery, protocol, improved postsurgical recovery.Abstract
Introduction: The enhanced postsurgical recovery protocol has the main purpose of attaining a complete, effective and early recovery by means of interaction with the patient as one of its main pillars, in addition to decreasing hospital stay, in-hospital expenses and complications, as well as achieving patient satisfaction. Plastic surgery has been recently using this protocol.
Objective: To apply and evaluate the outcomes of the enhanced postoperative recovery protocol in abdominal liposuction.
Methods: A descriptive, longitudinal and prospective study was conducted of patients operated on with abdominal liposuction, in which the parameters of the protocol of improved postoperative recovery were applied in the reconstructive surgery and caumatology service at Hospital Clínico Quirúrgico Hermanos Ameijeiras.
Results: The female sex predominated, accounting for 85.7 % of the studied cases; while the age range was between 30 and 39 years old, followed by patients between 19 and 29 years old. Mestizo skin represented 50 % of the sample. There was a preeminence of overweight patients (57 %). Endovenous fluids were withdrawn from 100 % of the patients before 12 hours. The liquid diet was tolerated by 78.6 % before 4 hours, and 92.9 % tolerated the soft diet. 78.6 % were able to ambulate before 12 hours. 64.3 % were discharged from the hospital before 24 hours. No patient required reintegration and mortality was 0 %.
Conclusions: During the study, the safety of the enhanced postoperative recovery protocol was demonstrated to be beneficial to the service.
Downloads
References
Kehlet H, Wilmore D. Estrategias multimodales para mejorar el resultado quirúrgico. Soy J Surg. 2002;183(6):630-41. DOI: https://doi.org/10.1016/s0002-9610(02)00866-8
Ljungqvist O, Scott M, Fearon K. Enhanced Recovery After Surgery: A Review. JAMA Surg. 2017;152(3):292-8. DOI: https://doi.org/10.1001/jamasurg.2016.4952
Pirrera B, Lucchi A, Gabbianelli C, Alagna V, Martorelli G, Berti P, et al. E.R.A.S. pathway in colorectal surgery in elderly: Our experience: a retrospective cohort study. Int J Surg. 2017;43:101-6. DOI: https://doi.org/10.1016/j.ijsu.2017.05.013
Feo C, Portinari M, Tsolaki E, Romagnoni G, Verri M, Camerani S, et al. The effect of an enhanced recovery program in elective retroperitoneal abdominal aortic aneurysm repair. J Vasc Surg. 2016;63(4):888-94. DOI: https://doi.org/10.1016/j.jvs.2015.09.060
Yang R, Tao W, Chen Y, Zhang B, Tang J, Zhong S, et al. Enhanced recovery after surgery programs versus traditional perioperative care in laparoscopic hepatectomy: a meta-analysis. Int J Surg. 2016;36:274-82. DOI: https://doi.org/10.1016/j.ijsu.2016.11.017
Schatz C. Enhanced recovery in a minimally invasive thoracic surgery program. AORN J. 2015;102(5):482-92. DOI: https://doi.org/10.1016/j.aorn.2015.09.006
Tyson M, Chang S. Enhanced recovery pathways versus standard care after cystectomy: a meta-analysis of the effect on perioperative outcomes. Eur Urol. 2016;70(6):995-1003. DOI: https://doi.org/10.1016/j.eururo.2016.05.031
Nelson G, Kalogera E, Dowdy S. Enhanced recovery pathways in gynecologic oncology. Gynecol Oncol. 2014;135(3):586-94. DOI: https://doi.org/10.1016/j.ygyno.2014.10.006
Fayezizadeh M, Petro C, Rosen M, Novitsky Y. Enhanced recovery after surgery pathway for abdominal wall reconstruction: pilot study and preliminary outcomes. Plast Reconstr Surg. 2014;134(4):S151-9. DOI: https://doi.org/10.1097/PRS.0000000000000674
Offodile A, Gu C, Boukovalas S, Coroneos C, Chatterjee A, Largo R, et al. Enhanced recovery after surgery (ERAS) pathways in breast reconstruction: systematic review and meta-analysis of the literature. Breast Cancer Res Treat. 2019;173(1):65-77. DOI: https://doi.org/10.1007/s10549-018-4991-8
Bartlett E, Zavlin D, Friedman J, Abdollahi A, Rappaport N. Enhanced Recovery After Surgery: The Plastic Surgery Paradigm Shift. Aesthetic Surgery Journal. 2018;38(6):676-85. DOI: https://doi.org/10.1093/asj/sjx217
American Society of Plastic Surgeons. 2017 Cosmetic plastic surgery statistics. Arlington Heights, IL: The Society; 2017 [acceso 12/04/2022]. Disponible en: https://www.plasticsurgery.org/documents/News/Statistics/2017/plastic-surgery-statistics-report-2017.pdf
Soteropulos C, Tang S, Poore S. Enhanced recovery after surgery in breast reconstruction: a systematic review. J Reconstr Microsurg. 2019;35(9):695-704. DOI: https://doi.org/10.1055/s-0039-1693699
Wu S, Coombs D, Gurunian R. Liposuction: Concepts, safety, and techniques in body-contouring surgery. Cleve Clin J Med. 2020;87(6):367-75. DOI: https://doi.org/10.3949/ccjm.87a.19097
Stein M, Matarasso A. High-Definition Liposuction in Men. Clin Plast Surg. 2022;49(2):307-12. DOI: https://doi.org/10.1016/j.cps.2022.01.003
Flynn T, Coleman W, Field L, Klein J, Hanke C. History of liposuction. Dermatol Surg. 2000;26(6):515-20. DOI: https://doi.org/10.1046/j.1524-4725.2000.00066.x
Halk A, Habbema L, Genders R, Hanke C. Safety studies in the field of liposuction: a systematic review. Dermatol Surg. 2019;45(2):171-82. DOI: https://doi.org/10.1097/DSS.0000000000001707
Al Dujaili Z, Karcher C, Henry M, Sadick N. Fat reduction: complications and management. J Am Acad Dermatol. 2018;79(2):197-205. DOI: https://doi.org/10.1016/j.jaad.2017.07.026
Escobar H, Bezares I, Lugo J, Expósito A, León Y. Variaciones séricas de las fracciones lipídicas en la liposucción. Rev Acta Médica. 2014 [acceso 15/04/2022];15(2):1-11. Disponible en: https://www.medigraphic.com/pdfs/actamedica/acm-2014/acm142d.pdf
Beidas O, Gusenoff J. Update on Liposuction: What All Plastic Surgeons Should Know. Plast Reconstr Surg. 2021;147(4):658e-68e. DOI: https://doi.org/10.1097/PRS.0000000000007419
Mentz J, Mentz H, Nemir S. Pneumothorax as a Complication of Liposuction. Aesthet Surg J. 2020;40(7):753-8. DOI: https://doi.org/10.1093/asj/sjaa029
Uttamani R, Venkataram A, Venkataram J, Mysore V. Tumescent Anesthesia for Dermatosurgical Procedures Other Than Liposuction. J Cutan Aesthet Surg. 2020;13(4):275-82. DOI: https://doi.org/10.4103/JCAS.JCAS_192_19
World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4. DOI: https://doi.org/10.1001/jama.2013.281053
ISAPS (International Society of Aesthetic Plastic surgery) 2020 [acceso 12/04/2022]. Disponible en: https://www.isaps.org/
Tamayo A, Gaitán C, Muñoz U, Rodríguez R, Cuastumal D. Cirugía Plástica y Reconstructiva en cifras: Hospital Clínico Quirúrgico “Hermanos Ameijeiras”. Acta Médica. 2020 [acceso 10/04/2022];21(42):e103. Disponible en: http://www.revactamedica.sld.cu/index.php/act/article/view/103/pdf
Skorochod R, Fteiha B, Gronovich Y. Perforation of Abdominal Viscera Following Liposuction: A Systemic Literature Review. Aesthetic Plast Surg. 2022;46(2):774-85. DOI: https://doi.org/10.1007/s00266-021-02532-9
Sociedad Española de Cirugía plástica, reparadora y estética. Infosalud. 2020 [acceso 09/04/2022]. Disponible en: https://www.infosalus.com/
Frank K, Hamade H, Casabona G, Gotkin R, Kaye K, Tiryaki T, et al. Influences of Age, Gender, and Body Mass Index on the Thickness of the Abdominal Fatty Layers and its Relevance for Abdominal Liposuction and Abdominoplasty. Aesthet Surg J. 2019;39(10):1085-93. DOI: https://doi.org/10.1093/asj/sjz131
Shin H, Rodríguez A, Abraham J, Cargile J, Brown C, Altman A, et al. Does ERAS benefit higher BMI patients? A single institutional review. J Plast Reconstr Aesthet Surg. 2021;74(3):475-9. DOI: https://doi.org/10.1016/j.bjps.2020.08.098
Smith T, Wang X, Singer M, Godellas C, Vaince F. Enhanced recovery after surgery: a clinical review of implementation across multiple surgical subspecialties. Am J Surg. 2020;219(3):530-4. DOI: https://doi.org/10.1016/j.amjsurg.2019.11.009
Kennedy G, Hill C, Huang Y, So A, Fosnot J, Wu L, et al. Enhanced recovery after surgery (ERAS) protocol reduces perioperative narcotic requirement and length of stay in patients undergoing mastectomy with implant-based reconstruction. Am J Surg. 2020;220(1):147-52. DOI: https://doi.org/10.1016/j.amjsurg.2019.10.007
Kiong K, Vu C, Yao C, Kruse B, Zheng G, Yu P, et al. Enhanced recovery after surgery (ERAS) in head and neck oncologic surgery: a case-matched analysis of perioperative and pain outcomes. Ann Surg Oncol. 2021;28(2):867-76. DOI: https://doi.org/10.1245/s10434-020-09174-2
Straughan D, Lindsey J, McCarthy M, Legendre D, Lindsey J. Enhanced recovery after surgery protocol with ultrasound-guided regional blocks in outpatient plastic surgery patients leads to decreased opioid prescriptions and consumption. Aesthet Surg J. 2021;41(8):1105-14. DOI: https://doi.org/10.1093/asj/sjab137
Faulkner H, Coopey S, Sisodia R, Kelly B, Maurer L, Ellis D. Does an ERAS protocol reduce postoperative opiate prescribing in plastic surgery? JPRAS Open. 2021;31:22-8. DOI: https://doi.org/10.1016/j.jpra.2021.10.006
Haddock N, Garza R, Boyle C, Teotia S. Observations from Implementation of the ERAS Protocol after DIEP Flap Breast Reconstruction. J Reconstr Microsurg. 2022;38(6):506-10. DOI: https://doi.org/10.1055/s-0041-1740125
Kohnenkampf R, Maldonado F. Protocolos de recuperación acelerada después de cirugía ¿tienen espacio en nuestra práctica diaria actual? Rev Chil Anest. 2019 [acceso 12/04/2022];48:20-7. Disponible en: https://revistachilenadeanestesia.cl/PII/revchilanestv48n01.05.pdf
Jogerst K, Thomas O, Kosiorek H, Gray R, Cronin P, Rebecca A, et al. Same-day discharge after mastectomy: breast cancer surgery in the Era of ERAS®. Ann Surg Oncol. 2020;27(9):3436-45. DOI: https://doi.org/10.1245/s10434-020-08386-w
Downloads
Published
How to Cite
Issue
Section
License
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
