Tumescence solution can be applied either manually with an injection syringe or mechanically with a pump. In the manual technique the injection syringe is connected to the tumescence solution via a one-way cock. The manual technique requires a lot of time and effort and has the same results as the mechanical injection of solution via a pump. In this technique the pump is connected with the system via a three-way or six-way cock so that the tumescence solution can be applied evenly and homogeneously via three or six cannulas, also saving time.
For liposuction in the abdominal/hip area about 61 of tumescence solution is needed. Manual application of the solution takes 90 min; application using the pump takes 45 min.
After applying all the tumescence solution, it should be given at least 30 min to take effect. During this time disinfection and sterile draping of the patient are carried out. Mang's tumescence solution (0.9% NaCl 3,000 ml, 1 % Prilocaine 1,500 mg = 150 ml, epinephrine 3 mg, Na HCO3 8.4% 30 mEq, triamcinolone acetonide 30 mg) should still be limited to 6 l for patients weighing up to 80 kg. If the patient weighs more than this and is in good general condition, the amount of tumescence can be increased to 71.
The best temperature for the solution is 30 °C (warm cabinet).
The prepared tumescence solution should be injected within 1 h of preparation. The solution must only be prepared (sterile preparation) by a qualified person supervised by a doctor.
The surgeon must apply the tumescence himself/herself, as in so doing he/she can see exactly how much tumescence solution flows into each fat deposit. He/she can therefore already begin to estimate during tumescence from which regions the most fat cells will need to be removed. Tumescence solution that has been opened must not be reused under any circumstances.
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