Date Published: March 5, 2018
Publisher: Springer US
Author(s): Francesco D’Andrea, Luca D’Andrea, Ercole Manzi.
Post-operative oedema and ecchymosis represent early post-operative complications, impacting negatively on the final aesthetic outcome of each surgical procedure. In particular, such complications are very frustrating for patients and—sometimes—are difficult to be managed by surgeons. Several strategies are available for managing oedema, although some side effects have been reported. A new promising compound for the management of oedema is Venoplant, and this study aims to assess its effectiveness in decreasing post-operative oedema.
Patients were randomly allocated for receiving three different treatments: (1) Venoplant tablets and Venoplant gel; (2) only Venoplant tablets; and (3) not treated with Venoplant. The aesthetical outcome has been evaluated using the Global Aesthetic Improvement Scale (GAIS), compiled by both patient and clinician. The GAIS scale was administered several times: the day following the surgical procedure (T0) after 3 days (T1), after 7 days (T2), after 15 days (T3) and after 1 month (T4).
Forty-three patients participated in the study. According to patient’s evaluations, at T0 in Group 1 and in Group 2 a significant statistical difference was found compared to the control group (p < 0.001 and p < 0.05, respectively). Over time, a significant reduction in swelling and ecchymosis was reported by patients treated with Venoplant (tablets alone or in combination with gel) compared to the control group. According to the physician’s assessment, during the different time points of evaluation, a significant reduction in post-operative oedema in Group 1 and in Group 2 compared to the control group was found. Venoplant represents a valid therapeutic strategy for the management of post-operative oedema, guaranteeing a good level of patient satisfaction, in the absence of common side effects which are often associated with other therapies. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.
Post-operative oedema and ecchymosis represent early post-operative complications, impacting negatively on the final aesthetic outcome of each surgical procedure. In particular, these complications are associated with delayed post-surgical recovery and achievement of the definitive aesthetic result, with high levels of dissatisfaction reported by patients . Among these complications, oedema represents the most annoying and disabling effect, delaying the patient’s return to routine activities.
From September 2015 to December 2017, all patients aged between 18–65 years old, able to express their informed consent referred for an intervention of aesthetic plastic surgery (additive mastoplasty, blepharoplasty, rhinoplasty, facelift) were recruited. Exclusion criteria from the study were: 1) patients suffering from disorders of coagulation, treated with antiplatelet and/or anticoagulant oral medications; patients who have suspended treatments with antiplatelet and/or anticoagulant oral drugs for less than one month. According to a randomized procedure, patients were allocated into three groups: 1. patients receiving Venoplant tablets and Venoplant gel; 2. patients receiving only Venoplant tablets; 3. patients not treated with Venoplant (considered as the control group). Assessment procedures were implemented by a blinded researcher, who did not join the randomization. Patients allocated in Group 1 and Group 2 received 2 tablets per day, from two days prior to the surgery until eight days after the surgery. Patients allocated in Group 1 started the treatment with Venoplant gel from the day following the surgical procedure 2 times/day, until the ecchymosis was resolved. All patients had to wear compression garments at the same time (if allowed according to the type of surgical procedure), and to use ice bags during the 3 hours following the surgical operation.
Fifty-eight patients were invited to take part to the experimental study. Fifteen patients refused to participate with a final sample of 43 patients. They were mainly female (83.7%, n = 36), aged between 18 and 65 years old (M: 36.2; s.d.: 14.3). As regards the surgical procedures received by patients, the majority underwent an additive mastoplasty procedure (34.9%, n = 15); 16.3% (n = 7) received a rhinoplasty procedure; 14% (n = 6) underwent a mastopexy procedure with breast implants; and 11.6% (n = 5) of patients were treated with a mini-facial lift. In the remaining cases, five procedures of replacement of breast implants (11.6%) and five blepharoplasty (11.6%) procedures were implemented.
Management of post-operative oedema is a significant problem after any kind of surgical procedure. This complication has a central role in aesthetic surgical procedures, because patients want to return to their daily routine soon after the intervention. Moreover, post-operative oedema reduction allows a faster achievement of the final aesthetic result. This study represents the first in the field of aesthetic surgery aiming to manage post-operative oedema using food supplements (Figs. 3, 4, 5, 6, 7, 8, 9). In previous studies in orthognathic surgery, Tozzi at al.  highlighted that using food supplements with antiedemigenic properties (such as Venoplants) guarantees a reduction in the prescription of corticosteroids.Fig. 3a Patient from Group 1, seven days after additive mastoplasty. b Patient from Group 1, 15 days after additive mastoplastyFig. 4a Patient from Group 1, before additive mastoplasty. b Patient from Group 1, 15 days after additive mastoplasty. c Patient from Group 1, one month after additive mastoplastyFig. 5a Patient from Group 1, before III mid-facelift procedure. b Patient from Group 1, 15 days after III mid-facelift procedure. c Patient from Group 1, one month after III mid-facelift procedureFig. 6a Patient from Group 2, before additive mastoplasty. b Patient from Group 2, 15 days after additive mastoplasty. c Patient from Group 2, one month after additive mastoplastyFig. 7a Patient from Group 2 before blepharoplasty. b Patient from Group 2, three days after blepharoplastyFig. 8a Patient from the Control Group, before blepharoplasty. b Patient from the Control Group, 3 days after blepharoplasty. c Patient from the Control Group, 15 days after blepharoplasty. d Patient from the Control Group, one month after blepharoplastyFig. 9a Patient from the Control Group before additive mastoplasty. b Patient from the Control Group, seven days after the additive mastoplasty