Answer:
Dry: no infiltrate
Wet: 200-300 ml/area
Superwet: 1 ml infiltrate: 1 ml aspirate
Tumescent: infiltrate to skin turgor (2-3 ml infiltrate: 1 ml aspirate)
Klein:
50 ml 1% lidocaine
1 ml epinephrine (1:1000)
12.5 ml 8.4% sodium bicarb
1000 ml saline
Hunstad:
50 ml 1% lidocaine
1 ml epinephrine (1:1000)
1000 ml LR (38-40 degrees)
Fodor:
No lidocaine
1 ml epinephrine (1:500 to 1:1500, depending on aspirate amount)
1000 ml LR
Southwestern:
30 ml 1% lidocaine
1 ml epinephrine (1:1000)
1000 ml LR (38 degrees)
The first person to use any fluid infiltration was Illouz.. He used hypotonic saline to induce swelling and lysis of fat cells. Although there is no evidence that this occurs, the idea of using saline infiltration caught on. By the early 80’s, many surgeons used the wet technique, where 200-300 cc per area to be suctioned was infiltrated, and this fluid often contained additives of lidocaine, epinephrine, or bicarbonate, depending on the surgeon’s preference. In 1986, Fodor introduced the superwet technique, injecting saline with epinephrine and sometimes lidocaine in an amount equal to the expected aspirate. Shortly thereafter, in 1987, Klein (a dermatologist) introduced the tumescent technique. This involves the infiltration of large volumes of saline containing dilute epinephrine and lidocaine until the tissue has turgor.