scholarly journals Superomedial pedicle reduction mammaplasty with and without drains: a comparative analysis

2019 ◽  
Vol 2 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Derek G Liang ◽  
Varun Harish ◽  
Steven L Merten
Keyword(s):  
Breast Tissue ◽  
Reduction Mammaplasty ◽  
Breast Reduction Surgery ◽  
Delayed Wound Healing ◽  
Diabetic Status ◽  
Significant Difference ◽  
Postoperative Drainage ◽  
Breast Weight ◽  
Superomedial Pedicle ◽  
Tissue Reduction

Background: Postoperative suction drainage following reduction mammaplasty are purported to reduce complications such as haematoma, seroma, delayed wound healing and loss of nipple or areola. The aim of this study is to compare the complication profile of breast reduction surgery patients who received postoperative drains and those who did not. Methods: A retrospective analysis of 172 patients over the period January 2011 to June 2017 were identified. Statistical analysis with regression modelling was used to compare the complication profile between patients who had and had not received postoperative drainage. Results: Patients were divided between ‘drained’ (n=86) and ‘drainless’ (n=86) cohorts with no significant difference in age, smoking and diabetic status between the two groups (p>0.05). Mean body mass index (BMI) was significantly higher in the drained group (29.0) compared to 25.7 in the drainless cohort (p<0.05). Patients in the drained group also had a significantly higher breast weight reduction (660g compared to 536g, p<0.05). There was significantly more vertical skin resection patterns in the drained group (n=25 or 29.1%) compared to the drainless group (n=8 or 9.3%) (with p=0.001). Using multivariate logistic regression, drains resulted in a slightly lower risk for complications but this difference was not statistically significant (OR 0.84; 95% CI=0.39-1.81; p=0.66). However, BMI was strongly associated with complications (p=0.007). Conclusions: Our results support the contention that routine postoperative drain insertion in reduction mammaplasty does not significantly reduce complications irrespective of the patient’s BMI, breast tissue reduction weight, use of liposuction or skin resection pattern.

scholarly journals Predicting Breast Reduction Weight Using the Mass of Breast Ptosis

2008 ◽  
Vol 16 (1) ◽  
pp. 18-22 ◽  
Author(s):  
John D Murray ◽  
Eric T Elwood ◽  
Rebecca Barrick ◽  
Jack Feng
Keyword(s):  
Breast Reduction ◽  
Reduction Mammaplasty ◽  
Breast Mass ◽  
Breast Size ◽  
Clinical Method ◽  
Significant Difference ◽  
Ptotic Breast ◽  
Hypertrophic Breast ◽  
Breast Shape ◽  
Breast Weight

Background The preoperative prediction of therapeutic breast reduction weights, to achieve both relief of breast weight symptoms and yet achieve excellent breast shape, remains a challenge. Objectives To design a simple clinical method to preoperatively predict and quantify therapeutic breast reduction weights. Methods In 31 women who underwent therapeutic bilateral reduction mammaplasty, the mass of the hypertrophic breast hanging below the inframammary fold was preoperatively weighed and then compared with the mass of the reduction specimen. Thirty patients underwent breast reduction using a superomedial nipple-areolar pedicle. Postoperative breast weight-related symptoms and breast shape findings were then noted. Statistical analysis relied on mean, SD, sample size, Mann-Whitney test for medians, Levene's test for variances and regression analysis. Results The average clinical follow-up was 160 days, with all patients achieving satisfactory breast size and shape from both the patient and surgeon's perspectives. All patients reported improvement of back pain, shoulder pain and lower neck pain. Two breasts developed delayed healing of the lateral skin flap, necessitating debridement and reclosure, followed by uneventful ongoing healing. There was no significant difference in preoperative ptotic breast mass and resectional breast mass (all P>0.05). Conclusions Simple preoperative weighing of the ptotic portion of the hypertrophic breast can serve as a goal for the reduction weight, while creating pleasing breast proportions and improving breast weight-related symptoms. Preoperative quantification of the ptotic breast mass may guide the reduction technique and assist insurance precertification efforts.

Pengaruh Luka Iris Pada Tikus Dengan Paparan Hidrogen Peroxida 3% terhadap Epitelisasi dan Pembentukan Eksudat pada Permukaan Epitel Kulit.

2020 ◽  
Vol 17 (2) ◽  
pp. 172
Author(s):  
HARMAN AGUSAPUTRA ◽  
MARIA SUGENG ◽  
AYLY SOEKAMTO ◽  
ATIK WULANDARI
Keyword(s):  
Hydrogen Peroxide ◽  
Wound Healing ◽  
The Other ◽  
Delayed Wound Healing ◽  
Peroxide Group ◽  
Hemostatic Effect ◽  
Significant Difference ◽  
Negative Effect ◽  
Wound Healing Effect ◽  
Epithelial Growth

<p><strong>Abstract</strong></p><p><strong>Background:</strong> Hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>) as antiseptic has been used frequently to clean woundsin in hospitals and clinics. Hydrogen peroxide has the effectof strong oxidative that can kill pathogens. It can clean up debris and necrotic tissuesin wounds. Hydrogen peroxidealso has hemostatic effect that can help to stop bleeding. Besides antiseptic effects, hydrogen peroxide i s suspected of having negative effect in wound healing. Hydrogen peroxide presumably could cause delayed wound healing by exudate formation and delayed epithelial growth.</p><p><strong>Method</strong>: This study was conducted in the laboratory using 48 white mice that were divided into 2 groups. All the mice were purposely wounded. Afterwards in one group the wounds were clean up using hydrogen peroxide, while in the other group without hydrogen peroxide as control. The wounds of both groups were observed on day 1, day 3 and day 7. On day 1 and day 3, both groups did not show significant difference.</p><p><strong>R</strong><strong>esult</strong> : on day 7 showed that the wound healing in hydrogen peroxide group were delayed. Fifty percent of them had the formation of exudate and 62.5% of them showed delayed epithelial growth.</p><p><strong>Conclusion </strong>: This study could show hydrogen peroxide as wound antiseptic has delayed wound healing effect.</p><p><strong>Keyword</strong>: hydrogen peroxide, wound healing</p>

Copper Concentrations in Breast Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 27 (37) ◽  
pp. 6373-6383 ◽  
Author(s):  
Leila Jouybari ◽  
Faezeh Kiani ◽  
Farhad Islami ◽  
Akram Sanagoo ◽  
Fatemeh Sayehmiri ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Breast Tissue ◽  
Reference Lists ◽  
Meta Analysis ◽  
Cancer Risks ◽  
Hair Samples ◽  
Significant Difference ◽  
Mean Differences ◽  
Very High

: Breast cancer is the most common neoplasm, comprising 16% of all women's cancers worldwide. Research of Copper (Cu) concentrations in various body specimens have suggested an association between Cu levels and breast cancer risks. This systematic review and meta-analysis summarize the results of published studies and examine this association. We searched the databases PubMed, Scopus, Web of Science, and Google Scholar and the reference lists of relevant publications. The Standardized Mean Differences (SMDs) between Cu levels in cancer cases and controls and corresponding Confidence Intervals (CIs), as well as I2 statistics, were calculated to examine heterogeneity. Following the specimens used in the original studies, the Cu concentrations were examined in three subgroups: serum or plasma, breast tissue, and scalp hair. We identified 1711 relevant studies published from 1984 to 2017. There was no statistically significant difference between breast cancer cases and controls for Cu levels assayed in any studied specimen; the SMD (95% CI) was -0.01 (-1.06 - 1.03; P = 0.98) for blood or serum, 0.51 (-0.70 - 1.73; P = 0.41) for breast tissue, and -0.88 (-3.42 - 1.65; P = 0.50) for hair samples. However, the heterogeneity between studies was very high (P < 0.001) in all subgroups. We did not find evidence for publication bias (P = 0.91). The results of this meta-analysis do not support an association between Cu levels and breast cancer. However, due to high heterogeneity in the results of original studies, this conclusion needs to be confirmed by well-designed prospective studies.

Increse of newly - detected in situ cancers in non-palpable breast lesions

2006 ◽  
Vol 53 (1) ◽  
pp. 73-75
Author(s):  
N. Miletic ◽  
D. Stojiljkovic ◽  
M. Inic ◽  
M. Prekajski ◽  
A. Celebic ◽  
...  
Keyword(s):  
Breast Tissue ◽  
Malignant Disease ◽  
Clinical Stage ◽  
Diagnostic Procedures ◽  
Basal Membrane ◽  
Needle Aspiration ◽  
Screening Mammography ◽  
Significant Difference ◽  
Malignant Lesions

Great importance in detecting cancer in the phase of in situ lays in the fact that the epithelial layer is deprived of blood and lymph vessels, so metastases may develop only when basal membrane has been broken. This paper includes 46 operated women in whom it preoperatively had been verified suspect non-palpable lesion. The preoperative diagnostics included use of high- resolution mammography, aimed mammography, palpatory examination, as well as fine-needle aspiration (FNA), biopsy and cytologic analysis of the sample. The methodology of this work implies the use of stereotaxic marking, specimen mammography and ex-tempore pathohistology analysis. Out of 46 investigated patients in clinical stage T0N0M0, in whom there were no signs of malignant disease, and according to suspect lesion of initial screening mammography, malignant lesions of breast tissue were diagnosed in 19 patients (41%) intraoperatively. Three of these lesions (15,8%) were histopathologically verified as in situ. Comparing our results with data of the Institute of oncology and radiology of Serbia hospital registry (IORS) for the year 2001, from 1173 patients registered with malignant lesions, only 16 ones (1,4%) had in situ cancer, operated on the basis of the suspect mammography of clinical stage T0N0M0. Statistically significant difference was found related to the number of detected cancers in this early phase of the breast malignant disease. This limits surgical intervention to tumorectomy, with preservation of the remaining breast tissue, what brings to healing, justifying in that way, screening examinations and routine application of the most contemporary diagnostic procedures.

Vertical Reduction Mammaplasty Combined With a Superomedial Pedicle in Gigantomastia

2010 ◽  
Vol 64 (3) ◽  
pp. 279-285 ◽  
Author(s):  
Peymaneh Amini ◽  
Tilman Stasch ◽  
Panagiotis Theodorou ◽  
Ahmed Ali Altintas ◽  
Vu Phan ◽  
...  
Keyword(s):  
Reduction Mammaplasty ◽  
Superomedial Pedicle

POSTOPERATIVE DRAINAGE IN REDUCTION MAMMAPLASTY

1999 ◽  
Vol 104 (3) ◽  
pp. 885-886
Author(s):  
Anton H. Schwabegger ◽  
Christian Rainer ◽  
Milomir M. Ninkovic
Keyword(s):  
Reduction Mammaplasty ◽  
Postoperative Drainage

Wound healing after craniotomy: a randomized trial comparing scalp clips to artery forceps for scalp hemostasis

2009 ◽  
Vol 111 (6) ◽  
pp. 1175-1178 ◽  
Author(s):  
Peter Langford ◽  
Rory Wolfe ◽  
R. Andrew Danks
Keyword(s):  
Clinical Trial ◽  
Wound Healing ◽  
Randomized Trial ◽  
Tissue Damage ◽  
The Self ◽  
Delayed Wound Healing ◽  
Prospective Randomized Clinical Trial ◽  
Skin Edge ◽  
Significant Difference ◽  
Artery Forceps

Object In this prospective randomized clinical trial, investigators looked at wound healing after craniotomy. The hypothesis was that the self-closing plastic scalp clips used for hemostasis on the skin edge might lead to localized microscopic tissue damage and subsequent delayed wound healing. Methods The trial consisted of 2 arms in which different methods were used to secure scalp hemostasis: 1) the routinely used plastic clips (Scalpfix, Aesculap); and 2) the older method of artery forceps placed on the galea. Participants were restricted to those > 16 years of age undergoing craniotomies expected to last > 2 hours. Repeat operations were not included. One hundred fifty patients were enrolled. They were visited at 3 and 6 weeks postoperatively by an observer blinded to the method used, and the wounds were assessed for macroscopic epithelial closure, signs of infection, and hair regrowth by using a predefined assessment scale. Results The results showed no significant difference in wound healing between the 2 groups at either 3 weeks (OR 0.55, 95% CI 0.27–1.11; p = 0.09) or 6 weeks (OR 0.79, 95% CI 0.39–1.58; p = 0.50). The length of operation was found to be a significant factor affecting wound healing at 6 weeks (OR/hour 0.68, 95% CI 0.51–0.92; p = 0.01). Conclusions The use of Aesculap Scalpfix self-retaining plastic scalp clips on the skin edge during craniotomy surgery does not appear to affect wound healing significantly to the postoperative 6-week mark.

scholarly journals Effect of Intraoperative Valsalva Maneuver Application on Bleeding Point Detection and Postoperative Drainage After Thyroidectomy Surgeries

2015 ◽  
Vol 100 (6) ◽  
pp. 994-998 ◽  
Author(s):  
Mehmet Tokaç ◽  
Ersin Gürkan Dumlu ◽  
Birkan Bozkurt ◽  
Haydar Öcal ◽  
Cevdet Aydın ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Hospital Stay ◽  
Multinodular Goiter ◽  
Valsalva Maneuver ◽  
Study Groups ◽  
Hemorrhagic Complication ◽  
Minor Bleeding ◽  
Significant Difference ◽  
Postoperative Drainage ◽  
Age Range

The purpose of this paper was to analyze the effect of Valsalva maneuver application before finalizing thyroidectomy operations on the identification of bleeding points and postoperational drainage. One hundred patients (age range, 24–76 years) with multinodular goiter, recurrent multinodular goiter, toxic diffuse multinodular goiter, or papillary thyroid cancer were included in the study and were divided into 2 groups of 50 randomly. Both groups underwent thyroidectomy operation, only 1 group received intraoperative Valsalva maneuver application (twice, 30 seconds of 30-cm PEEP). The size of the thyroid gland, the duration of operation, hospital stay, and drain usage were reported. Postoperational occurrences of drainage, hematoma, reoperation, and additional complications were compared between the groups. Valsalva maneuver application helped to identify minor bleeding points in 32% of the cases. There was no significant difference between the study groups regarding the thyroid gland size, operation duration, hospital stay, and the duration of drain usage (P &gt; 0.05 for all). The amount of drainage as well as the frequencies of hematoma, reoperation, and further complications was not significantly different between the study groups (P &gt; 0.05 for all). Intraoperative application of Valsalva maneuver is only useful to detect minor bleeding points in some patients during thyroidectomy operations, but it had no effect on the duration of postoperative drain usage, the amount of drainage, and risk of hematoma. Therefore, intraoperative application of Valsalva maneuver has no beneficial effect on postoperative hemorrhagic complication after thyroidectomy operations.

scholarly journals Vertical Reduction Mammaplasty Utilizing the Superomedial Pedicle: Is It Really for Everyone?

2012 ◽  
Vol 32 (6) ◽  
pp. 718-725 ◽  
Author(s):  
Keith C. Neaman ◽  
Shannon D. Armstrong ◽  
Shawn J. Mendonca ◽  
Marguerite A. Aitken ◽  
Douglas L. VanderWoude ◽  
...  
Keyword(s):  
Reduction Mammaplasty ◽  
Superomedial Pedicle

scholarly journals Effects of intravenous infusion of lidocaine and dexmedetomidine on inhibiting cough during the tracheal extubation period after thyroid surgery

2019 ◽  
Author(s):  
Shenghong Hu Shenghong Hu ◽  
Yuanhai Li ◽  
Shengbin Wang ◽  
Siqi Xu ◽  
Xia Ju ◽  
...  
Keyword(s):  
Thyroid Surgery ◽  
Tracheal Extubation ◽  
Intravenous Lidocaine ◽  
Clinical Trial Registry ◽  
Treatment Groups ◽  
Hemodynamic Variables ◽  
Arterial Blood ◽  
Significant Difference ◽  
Postoperative Drainage ◽  
Equal Effectiveness

Abstract Background: Intravenous lidocaine and dexmedetomidine treatments have been proposed as methods for inhibiting cough. We compared the efficacy of intravenous lidocaine and dexmedetomidine treatments on inhibiting cough during the tracheal extubation period after thyroid surgery. Methods: One hundred eighty patients undergoing thyroid surgeries were randomly allocated to the LIDO group (received lidocaine 1.5 mg/kg loading, 1.5 mg/kg/h infusion), the DEX group (received dexmedetomidine 0.5 µg/kg loading, 0.4 µg/kg/h infusion) and the CON group (received saline), with 60 cases in each group. The incidences and severities of cough were recorded within 2 minutes after the extubations. Hemodynamic variables were measured at T0 (before the induction of anesthesia), T1 (immediately after the extubation) and T2 (5 minutes after extubation). The volume of drainage was recorded within 24 hours after the surgeries. Results: The incidences of cough were significantly lower in the LIDO group (28.3%) and the DEX group (31.7%) than in the CON group (66.7%) (P=0.000). Additionally, both moderate and severe cough were significantly lower in the LIDO group (13.3%) and the DEX group (13.4%) than in the CON group (43.4%) (P<0.05). Compared with the two treatment groups, both mean arterial blood pressure and heart rate were significantly increased in the CON group at T1 and T2 (P<0.05). Compared with the CON group, the volume of drainage was significantly reduced in the two treatment groups within 24 hours after surgery (P<0.05). Conclusion: Both intravenous infusions of lidocaine and dexmedetomidine had equal effectiveness in attenuating cough, hypertension, and tachycardia during the tracheal extubation period in patients undergoing thyroid surgery. Additionally, there was no significant difference in the reduction of postoperative drainage between the two treatments. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800017482 (date of registration August 2018). Keywords: Lidocaine, Dexmedetomidine, Cough, Thyroid surgery.

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