The Value Of Accurate Volumetric Deficiency Assessment Via Anesthetic Injection In The Treatment Of Groove Deformity By Adipose Transplantation

Objective: To explore the clinical application of accurate volumetric deficiency assessment via anesthetic injection in the treatment of patients with mild to moderate deformity of grooves by autologous adipose transplantation.Methods: A retrospective analysis was performed on 170 patients who received autologous adipose transplantation for groove deformity at the plastic surgery department from October 2015 to October 2019.The study group(n=88)were treated with autologous adipose transplantation with accurate adipose volume deficiency assessment.The control group(n=82)were treated with autologous adipose transplantation with adipose quantification based on the operator’s experience in assessing insufficient volume.Each group was further subdivided into 2 groups according to the method of adipose purification.So the study group was divided into,group A(the static separation method)and group B(the centrifugal method),and the control group was divided into group C(the static separation method)and group D(the centrifugal method).The study group was injected anesthetic solution with epinephrine in the treating area of groove deformity,which was filled until both doctor and the patient were satisfied with the local appearance,before undergoing autologous adipose transplantation,in order to accurately evaluate orbital adipose loss volume.Based on this data,the adipose injection volume was calculated in consideration of the adipose content and the adipose survival rate of different purification methods.For the control group,the amount of adipose loss in the suborbital area of the patients was estimated according to the previous experience of the operator.The Barton grading score before and after surgery was applied to evaluate the effect improvement extent and the postoperative satisfaction degree and complications were observed.Based on the different data types,Chi-square test,rank sum test were used accordingly for analysis and comparison.Results:(1)In four groups,the Barton grading score after surgery was significantly lower than that before surgery.The difference between preoperative and postoperative status was significant(P < 0.05).(2)For patients in group A and group C with the same Barton grading score before surgery,improvement in the group A is better than that in the group C(P < 0.05).For patients in group B and group D with the same Barton grading score before surgery,improvement in the group B is better than that in the group D(P < 0.05).No matter whether the method of adipose purification method was the static separation or the centrifugal,improvement in the study group was higher than that in the control group.(3)Satisfaction rate were increased in group A than that in group C(86.9% vs.67.5%,P < 0.05);group B showed a more promising satisfaction rate than that in group D(85.7% vs.57.1%,P < 0.05).The incidence of complications,including adipose transplantation,local tissue edema,swelling,local adipose nodules,bruises and so on,has no statistical significance between two groups(P < 0.05).Conclusion: The accurate volume loss evaluation method can guide adipose quantification in patients with mild or moderate groove malformation when undergoing autologous adipose transplantation in the area of groove deformity,and can improve the satisfaction rate without increasing postoperative complications.It’s easy to learn and practice for beginners,and is worthy of clinical promotion.