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2019, Number 1

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Cir Plast 2019; 29 (1)

Visceral perforation in liposuction. Evidence based medicine

Contreras-Bulnes, Livia; Cuenca-Pardo, Jesús; Quintana-Vilchis, César; Vélez-Benítez, Estela

Language: Spanish
References: 28
Page: 88-107
PDF size: 362.51 Kb.


ABSTRACT

Visceral perforations are a severe complication of liposuction; the incidence and risk factors are not precisely known. We carried out a systematic review in order to find the risk factors and issue safety recommendations. We found few publications on the subject and with IV and V level of evidence. Visceral perforations are the second cause of death from lipoaspiration. The factors attributed to this complication are the surgeon’s lack of experience and factors related to patients, such as obesity, globose abdomen, presence of hernias, scars and adhesions. The perforations are of two types: the first group, of extreme urgency, manifest during surgery or in the first postoperative hours. This group includes tension pneumothorax and hemorrhage due to injury to organs or large vessels. These conditions require immediate treatment to avoid the death of the patient. The second group is bowel injuries. They occur in an insidious way, several days after surgery, the cardinal manifestation being atypical pain, which may be accompanied by intestinal obstruction, fever and general deterioration. Delaying the treatment leads to poor evolution and high mortality. The exploratory laparotomy is a lifesaving diagnostic procedure that must be performed urgently, even if radiographic studies are not available. In most cases the main problem is not the incident of the injury, but the failure to recognize it.


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