Modified Breast Band Improving the Postoperative Breast Augmentation and Reconstructive Experience

Superior displacement of implants is a common complication in the early postoperative period following breast augmentation surgery. Postoperative breast bands are used during the first 4 weeks to optimize breast implant position following breast augmentation and reconstructive procedures. Although currently available breast bands are effective in maintaining implants in an inferior position, they have been observed to irritate the armpit region. We hypothesized that a modified breast band geometry with cut outs to accommodate the armpit region would provide equal maintenance of desired implant position while providing improved postoperative comfort. Forty patients who underwent breast augmentation and/or reconstruction were randomly assigned to receive either the traditional breast band or the modified cut out designed breast band following surgery for 4 weeks. Patients rated their breast bands on a 1 to 10 scale regarding (1) comfort, (2) appearance, and (3) overall satisfaction at their routine postoperative visits at 1, 2, and 4 weeks following surgery. The modified breast band scored higher for all factors at 1, 2, and 4 weeks following surgery. The traditional band demonstrated decreasing scores for comfort and overall satisfaction when compared at 4 weeks versus 1 week. There was no change in the modified breast band scores for comfort, appearance, nor overall satisfaction over the same time period. This study of 40 patients found that the modified band provides equally effective maintenance of implants in a desired position without compromising comfort and appearance. Patients who used the modified band had a better experience with the band comfort, appearance, and overall satisfaction in comparison to the traditional band. The higher ratings for the cut out band for comfort, appearance, and overall satisfaction were consistent from week 1 to 4. In contrast, the traditional band not only scored lower in comfort, appearance, and overall satisfaction compared to the modified band but also demonstrated significant decrease in the patients’ ratings for comfort and overall satisfaction for the traditional band from week 1 to 4. This study supports the conclusion that a modified cut out breast band design provides an equally effective maintenance of implants in a desired position without compromising comfort, appearance, and overall satisfaction when compared to the traditional band.

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Comparison between different methods of breast implant volume choice and degree of postoperative satisfaction

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-6991e-20181345 ◽

2018 ◽

Vol 45 (1) ◽

Author(s):

RAFAEL DAIBERT DE SOUZA MOTTA ◽

ANA CLAUDIA WECK ROXO ◽

FABIO XERFAN NAHAS ◽

FERNANDO SERRA-GUIMARÃES

Keyword(s):

Postoperative Period ◽

Breast Augmentation ◽

Rio De Janeiro ◽

Statistical Significance ◽

Breast Implant ◽

Augmentation Mammaplasty ◽

University Hospital ◽

Surgical Scar ◽

Significant Difference ◽

Degree Of Satisfaction

ABSTRACT Objectives: to assess the degree of patient satisfaction after undergoing breast augmentation and compare three different, easy, inexpensive and universal methods of preoperative choice of breast implant volume. Methods: a prospective study was carried out at University Hospital Pedro Ernesto of State University of Rio de Janeiro, in 94 women from Rio de Janeiro, aged 18 to 49 years, submitted to breast augmentation mammaplasty with breast implant due to hypomastia. All implants were textured, with a round base and high projection and were introduced into the retroglandular space through an inframammary access. The patients were divided into three groups: Control, Silicone and MamaSize®, with 44, 25 and 25 patients, respectively. Satisfaction questionnaires were applied in the pre and postoperative periods by the same evaluator, through the visual analogue scale, in which ‘0’ meant very unsatisfied and ‘100’ very satisfied for the four variables: shape, size, symmetry and consistency. The degree of satisfaction with the surgical scar was also assessed in the postoperative period. Results: when the preoperative and postoperative satisfaction levels were compared, there was a difference in all variables for the three groups, with statistical significance. However, when the postoperative data were compared with each other, there was no significant difference. The degree of satisfaction with the surgical scar was high. Conclusion: the augmentation mammaplasty with breast implant had a high index of satisfaction among patients. However, there was no difference in the degree of satisfaction in the postoperative period between the three methodologies of breast volume measurement.

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The effect of admission to intensive care unit on outcomes and complication rates after head and neck reconstruction

Head and neck tumors (HNT) ◽

10.17650/2222-1468-2018-8-3-61-71 ◽

2018 ◽

Vol 8 (3) ◽

pp. 61-71

Author(s):

F. Carta ◽

A. Figus ◽

N. Chuchueva ◽

D. Quartu ◽

G. B. Sambiagio ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Head And Neck ◽

Postoperative Period ◽

Early Postoperative Period ◽

Head And Neck Reconstruction ◽

Complication Rates ◽

Study Objective ◽

Reconstructive Procedures ◽

Neck Reconstruction

The study objectiveis to evaluate the utilisation and effectiveness of intensive care unit (ICU) in the postoperative period as to its potential benefits to the head and neck reconstruction services.Materials and methods. This is a retrospective study on 143 consecutive patients who underwent 144 major head and neck microvascular reconstructive procedures performed by a single surgeon, that focused on perioperative management and on the relation between admission to ICU and complications/outcomes.Results.Thirty-four (23.6 %) patients were admitted to ICU during the early postoperative period. Admission to ICU was not associated with lower incidence of complications compared to direct admission to the Head and Neck ward: 29.4 % vs 27.3 % (p = 0.807709).Conclusion.Routinely early postoperative admission to ICU seems not to improve outcomes and/or reduce complications, and, as a consequence, ICU admission should be restricted to selected patients only.

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DOZ047.48: Postoperative anastomotic stricture after the operation for esophageal atresia

Diseases of the Esophagus ◽

10.1093/dote/doz047.48 ◽

2019 ◽

Vol 32 (Supplement_1) ◽

Author(s):

M Wolski ◽

A Jasińska ◽

A Kamiński

Keyword(s):

Gastroesophageal Reflux ◽

Esophageal Atresia ◽

Satisfactory Result ◽

Postoperative Period ◽

Stent Placement ◽

Anastomotic Stricture ◽

Early Postoperative Period ◽

Anastomotic Site ◽

Common Complication ◽

Single Calibration

Abstract Introduction Anastomotic stricture is the most common complication after the treatment of esophageal atresia. It occurs in 20–80% of operated patients. Predisposing factors are the leakage of the anastomosis, undertension anastomosis, elongation, and gastroesophageal reflux. A few dilation techniques are being utilized. Material and Methods Between 2006 and 2018, 79 patients with esophageal atresia were treated in the clinic. Primary or delayed anastomosis was possible in 69 patients. Five patients died in the early postoperative period. Clinical data of the remaining 64 patient were analyzed retrospectively. Results All anastomoses were calibrated with either bougie or balloon dilators. The anticipated diameter of the anastomosis was acquired during calibration in 24 patients (seven of these with bougie and 17 with balloon dilations). The total number of bougie dilations was 29 and balloon dilations 35. The stricture was present in 40 patients. In this group under—tension anastomoses were present in 25 patients, anastomotic leakage in 13 (81% of all leaks), gastroesophageal reflux in 14 (66% of all refluxes). The stricture was dilated with the balloon in 22 cases, bougie in 18 cases, stent placement in 3 cases. The number of required dilations was most often 2 or 3. In 4 patients multiple dilations were necessary. Dilating procedures were finished with a satisfactory result before the age of 6 months in 26 patients, 12 months in 13 and 24 months in 5 patients. Rupture of the anastomotic site during dilation occurred in 4 patients. Conclusions Anastomotic stricture occurred in 63% of patients. The majority of the undertension and leaking anastomoses were complicated with stricture. A single calibration with balloon was successful in 49% of cases compared to 24% bougie calibrations. In 59% of dilated patients, the procedure was finished before the age of 6 months, which enabled physiological feeding pattern.

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The Effect of Cimetidine and Ranitidine on Cognitive Function in Postoperative Cardiac Surgical Patients

The International Journal of Psychiatry in Medicine ◽

10.2190/cbua-rl4v-5un8-mwj3 ◽

1996 ◽

Vol 26 (3) ◽

pp. 295-307 ◽

Cited By ~ 12

Author(s):

Kelly Y. Kim ◽

James R. McCartney ◽

William Kaye ◽

Robert J. Boland ◽

Ray Niaura

Keyword(s):

Hospital Discharge ◽

Postoperative Period ◽

Mmse Score ◽

Laboratory Data ◽

Early Postoperative Period ◽

Surgical Patients ◽

Surgical Patient ◽

Cardiac Surgical Patient ◽

Significant Difference ◽

To Receive

Objective: To compare the incidence of delirium in postoperative cardiac surgical patients treated with either cimetidine or ranitidine. Method: Cardiac surgery patients were randomized to receive either cimetidine or ranitidine postoperatively. Each patient underwent three Mini-Mental Status Examinations (MMSE) and the medical record was reviewed for pertinent past medical history, laboratory data, and evidence of delirium on three occasions: one day preoperatively (before H-2 blocker was given), in the early postoperative period (while receiving the H-2 blocker); usually two days postoperatively on the day of hospital discharge (several days after the H-2 blocker had been discontinued). Results: Overall, both groups in the early postoperative period showed a significant decrease in the MMSE score (27.11 ± 4.44 to 25.38 ± 2.87, mean ± SD; t = 5.16, p < .0005), which resolved by the time of hospital discharge. There was no significant difference between cimetidine and ranitidine. Both age and preoperative MMSE score were strongly associated with the development of delirium. Conclusions: We found no significant difference between cimetidine's versus ranitidine's effect upon cognitive functioning in the postoperative cardiac surgical patient. This was true even when controlling for age and length of stay.

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