| 摘要 |
FIELD: medicine, plastic surgery. ^ SUBSTANCE: the present innovation deals with carrying out cosmetological surgical interferences for removing local fatty depositions that deform body contours. One should perform presurgical survey of a patient followed by roentgenograms, roentgenography of thoracic area or fluorography, electrocardiography and inspecting the function of external respiration. Application of contours and borders of surgical field at patient's standing position along with detecting the thickness of subcutaneous-fatty fiber and areas with cellulites, at analysis of the already protruded cavities and, also, the sites of desired incisions. Moreover, the protruding areas of liposuctioning should be marked with a "+" symbol, as for the areas of cavities and defects of a patient's body contours - with a "-" sign. The desired volume of anesthesiological manual should be fulfilled depending upon the number of operated areas, their localization and the volume of the removed subcutaneous-fatty fiber. Transcutaneously one should make incisions along the edge of liposuctioning of about 5-8 mm length to introduce through them an infiltration cannula of 2 mm diameter with foramens located at its end. Under manual control it is necessary to perform steady infiltration of subcutaneous-fatty fiber due to introducing an infiltration cannula through these foramens under the pressure being 0.4-0.6 Bar at the rate of 80-100 ml/min of tumescent solution being heated up to 37-38°C. Reciprocatingly it is necessary to replace the infiltration cannula in the volume of fatty fiber in every individually formed tunnel of fan-shaped net of closely connected infiltration tunnels and saturating it with tumescent solution to create local intra-cellular hyperhydration of lipocytes. About 10-15 min after the onset of infiltration one should widen the site of puncture or incision with the help of a blunt dilator. Trocar with a protective silicon interlayer should be applied to introduce through it a titanium hollow probe of ultrasound apparatus. Then comes ultrasound destruction of fatty cells at a probe's uninterrupted linear movement in the layer of fatty fiber along with a probe's reciprocating movement at the rate of 40-50 movements/min in each developed tunnel and at simultaneous suction of the developed fatty detritus of emulsified adipocytes out of liposuctioning area through the foramens of the canal of ultrasound probe of about 3-4 mm diameter at using negative pressure of 0.2-0.3 Bar. Ultrasound impact upon subcutaneous-fatty fiber should start in every developed tunnel first, from inferior layers of subcutaneous-fatty acids and subsequent transition after the suction of the developed fatty detritus onto above-lying layers of subcutaneous-fatty fiber. On finishing the operation one should apply aseptic bandages and compression linen. Wounds should be bandaged in post-surgical period due to applying antiseptic solutions and water-soluble ointments along with the intake of non-narcotic analgetics, sedative preparations and antibacterial therapy with antibiotics for 4-7 d after the operation. The method decreases the risk of undesired skin traumatism and damage of surrounding vessels and nerves and, also, exclude the damage in surrounding structures and obtain maximal effect of "skin lifting" and accelerate the process of rehabilitation. ^ EFFECT: higher efficiency. ^ 11 cl, 3 ex |
