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Komplikationen und Blutverlust von vertikaler und horizontaler Mamma-Reduktionsplastik im Vergleich 
Übersetzter Titel:
comparison of complications and blood loss between the Wise pattern and vertical reduction mammaplasty 
Fakultät für Medizin 
Ninkovic, Milomir (apl. Prof.Dr.) 
Schmalfeldt, Barbara (Univ.-Prof.Dr.); Ninkovic, Milomir (apl. Prof.Dr.) 
MED Medizin 
Übersetzte Stichworte:
reduction mammaplasty 
Die Technik der Mamma-Reduktionsplastik mit vertikaler Narbe erfreut sich großer Popularität bei Patientinnen und Chirurgen gleichermaßen. Sie hat die konventionelle Methode mit horizontal-vertikaler Narbe weitgehend verdrängt und ist Methode der ersten Wahl im Bereich moderater bis mittlerer Resektionsgewichte. Ziel der Studie war die Analyse der Komplikationen und des Blutverlustes sowie der Eigenblutspende nach Mamma-Reduktionsplastik mit vertikaler und horizontal-vertikaler Narbe im Vergleic...    »
Übersetzte Kurzfassung:
The vertical reduction mammaplasty, due to its smaller scar, has become very popular for patients as well as for surgeons. This technique has mainly replaced the classical Wise pattern with inferior pedicle and is for small and moderate hypertrophy of the breast the method of choice. Aim of the study is a comparison of the vertical reduction mammaplasty with the Wise pattern reduction with respect to complication, blood loss and autologous blood predonation. Patients and Methods: This study comprises 157 patients between 2002 and 2003 who had either a Wise or vertical mammaplasty operation at the clinic of Munich Bogenhausen in the Division of plastic surgery. 53 patients (106 breasts) had a vertical reduction (Lejour group) versus 104 patients (207 breasts) who had a Wise pattern method with a superior pedicle (Höhler group). A retrospective chart analysis of the 157 patients’ medical records was made. Data on body mass index, age, resection weight, haemoglobin values, history of smoking, as well as early and late complications were collected. The statistical analysis was done by 2-way analysis of variance with t-tests by Mann-Whitney, Chi-Square-Test (Pearson) and Fishers exact t-test. Values of p<0.05 were considered statistically significant. Results: The results of the two groups show no statistically significant difference regarding age (34.1 vs. 37.9 years), body mass index (24.6 vs. 26.2 kg/m2) and average resection weight (377.37 vs. 678.55 g). Early complications during hospital stay were considered haematoma, infections, fat necroses, wound dehiscence, and areola necroses. As late complications or imperfections were considered hypertrophic scars and dog-ears. Our vertical reduction had 28.1% of early complications and 8.8% of late complications or imperfections. The Wise pattern reduction had 19.4% of early complications and 11.1% of imperfections. These differences were not statistically significant. Blood loss was not statistically significant for the two groups, but patients who did have an autologous blood predonation had a statistically significant lower haemoglobin level at the beginning of the operation than those who did no predonation. Conclusion: In our clinic the vertical reduction mammaplasty has no statistically significant higher rate of complications or imperfections compared to the classical Wise pattern reduction. Liposuction was not done in the vertical reduction due to a known increase of complications after such procedures. Patients have to be informed that both techniques have a high risk of developing complications after reduction mammaplasty. Autologous blood donation is no longer justified on a routine basis, due to an interoperatively decreased blood loss. 
Universitätsbibliothek der Technischen Universität München 
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