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Vojnosanitetski pregled
2018, vol. 75, br. 4, str. 352-358
jezik rada: engleski
vrsta rada: izvorni naučni članak
objavljeno: 09/08/2018
doi: 10.2298/VSP160701239V
Creative Commons License 4.0
Rinoplastika bez tamponade nosa i bez udlage
aKlinički centar Kragujevac, Centar za plastičnu hirurgiju + Univerzitet u Kragujevcu, Medicinski fakultet
bVojnomedicinska akademija, Klinika za plastičnu hirurgiju i opekotine, Beograd + Univerzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd
cUniverzitet u Kragujevcu, Medicinski fakultet + Klinički centar Kragujevac, Klinika za oftalmologiju

e-adresa: dejanavu@eunet.rs

Sažetak

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.

Ključne reči

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