Breast reduction with the posterosuperior pedicle: a series of 200 consecutive patients

Folia Medica ◽  
2011 ◽  
Vol 53 (4) ◽  
pp. 34-41 ◽  
Author(s):  
Hristo Shipkov ◽  
Ali Mojallal ◽  
Fabienne Braye
Keyword(s):  
Breast Reduction ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Vascular Supply ◽  
Average Weight ◽  
Superior Pedicle ◽  
Areola Complex ◽  
Junction Site ◽  
Duration Of Surgery ◽  
The Mean

ABSTRACT AIM: To present and evaluate the outcomes of the posterosuperior pedicle breast reduction technique. PATIENTS AND METHODS: 200 patients were included in the present retrospective study. They were operated on between January 2006 and January 2009. The mean age was 35.9 years (range 22 to 58 years). The average notch-to-nipple distance was 35.8 cm (range, 29 to 42 cm). The mean body mass index was 27 (range, 22 to 35 cm). Results were assessed by means of self-evaluation and by an independent 5-member jury. Fifty two patients (26%) had had bariatric surgery and 48 (24%) had had abdominoplasty. None of the patients had any previous breast surgery. All patients reported dorsal and cervical pain. RESULTS: The mean follow-up period was 16 months (range, 13 to 23 months). The average weight resected was 981 g (range from 370 g to 1800 g). The average duration of surgery was 2h (range, 1.50 to 2.30 hours) and average length of hospital stay was 2.3 days (range, 2 to 4 days). The duration of the outpatient postoperative care until complete wound healing was 15.2 days (range, 13 to 20 days). There were 4 major complications (2%) (1 bilateral and 3 unilateral infections) treated by drainage and intravenous antibiotics. Twenty-two minor complications were recorded (11%) including one desquamation of the nipple-areola complex without necrosis (0.5%) delayed healing at the junction site of the inverted T incision in 21 cases (10.5%). One hundred and forty eight patients evaluated their results as “very good” (74%), 36 as “good” (18%), and 16 as “acceptable” (8%). There were no results assessed as “poor.” Fifty-eight percent of the patients found that back pain had totally resolved versus 42% who had signifi cant improvement though not complete resolution. CONCLUSIONS: The postero-superior pedicle for breast reduction is a reproducible and versatile technique. The preservation of the anterior intercostal artery perforators enhances the reliability of the vascular supply to the superior pedicle.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

Supero-Septum Pedicle Mammaplasty: A New Modification for Reduction Mammaplasty

2019 ◽  
Vol 40 (10) ◽  
pp. 1080-1095 ◽  
Author(s):  
Mohammadhossein Hesamirostami ◽  
Leila Sarparast ◽  
Hamed Bateni ◽  
Abbas Kazemi Ashtiani
Keyword(s):  
Reduction Mammaplasty ◽  
Wound Dehiscence ◽  
Modified Technique ◽  
Level Of Evidence ◽  
Superior Pedicle ◽  
Aesthetic Result ◽  
Areola Complex ◽  
The Mean ◽  
The Aesthetic ◽  
A Prospective Study

Abstract Background Many techniques have been introduced for reduction mammaplasty and are utilized in diverse frequencies by different surgeons according to patient needs. Each technique is evaluated based on the aesthetic result, longevity, complication rate, and preservation of the nipple-areola complex (NAC) sensation. Objectives The authors sought to introduce the new modified technique of supero-septum pedicle mammaplasty (SSPM) that utilizes both the septum and superior pedicle and is suitable for macromastia and gigantomastia cases. Methods Between 2015 and 2018, 60 women who underwent SSPM were evaluated in a prospective study after undergoing superior pedicle deepithelialization and resection of the inferior, lateral, and medial segments. In the lateral pillar, a tongue of tissue was preserved for fixation to the medial pectoral fascia through a window created in the superior pedicle at the third intercostal space. Finally, septum pedicle was sutured to the fascia and muscle at the upper border of the sixth rib somewhat medially. Patients were followed up for a minimum of 13 months. Results The mean nipple-to-sternal notch (N-SN) distance was 33.05 cm, and the mean NAC elevation was 10.92 cm. Breast reductions varied from 270 to 2800 g per breast. Complications included wound dehiscence (5%), wound infection (2.5%), and partial NAC necrosis (2.5%). At 6 months postoperation, the NAC sensation was significantly better compared with preoperative values (P < 0.005). Conclusions SSPM is a relatively safe method of reduction mammaplasty, even for very large breasts, that leads to good aesthetic form along with preserving circulation and sensation of the NAC. Level of Evidence: 4

Comparison of the Efficacy of Transurethral Enucleation and Resection of the Prostate with Transurethral Resection of the Prostate for Medium Prostate Sizes

2020 ◽  
Vol 103 (11) ◽  
pp. 1208-1213
Keyword(s):  
Transurethral Resection ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Average Weight ◽  
Intraoperative Bleeding ◽  
Tissue Removal ◽  
Prospective Randomized Controlled Trial ◽  
The Mean ◽  
Baseline Characteristics ◽  
One Year

Objective: To compare the efficacy of the transurethral enucleation of the prostate (TUERP) to transurethral resection of the prostate (TURP) through a prospective randomized controlled trial. Materials and Methods: Between January 2016 and December 2019, 46 patients from a single center were divided into two groups, TURP and TUERP, using simple randomization. The perioperative and postoperative outcomes up to one year after surgery were evaluated. Results: The mean estimated prostate volume (PV) in the TURP and TUERP group was 40±22 mL and 41±18 mL, respectively. There were no statistical differences in the baseline characteristics between the two groups. The mean operative time was significantly longer in the TUERP group (71.95±33.96 minutes versus 50.85±26.78 minutes; p=0.024). The average weight of prostate resected in the TUERP group was higher but not statistically significant (18.87±14.95 g versus 15.15±11.07 g; p=0.39). The volume of fluid irrigation collected postoperatively was significantly lower in the TUERP group (13.98±10.01 liter versus 24.73±21.90 liter; p=0.04). No statistically significant differences were noted between the two groups in terms of the postoperative IPSS, QoL, Q max, PSA, postoperative Hct, and the length of hospital stay. Conclusion: The present study compared the surgical outcomes between the TUERP and the TURP techniques performed in medium prostate sizes. The authors concluded that TUERP resulted in a greater prostate tissue removal and, importantly, better intraoperative bleeding control. Keywords: Benign Prostatic Hyperplasia, Transurethral enucleation of the prostate

Trend of management of traumatic thoracic aortic injuries in a single center

Vascular ◽  
2013 ◽  
Vol 22 (2) ◽  
pp. 134-141 ◽  
Author(s):  
Bibombe P Mwipatayi ◽  
Arwen Boyle ◽  
Michael Collin ◽  
Jean-Louis Papineau ◽  
Vikram Vijayan
Keyword(s):  
Endovascular Repair ◽  
Paradigm Shift ◽  
Injury Severity ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Aortic Injury ◽  
Thoracic Aortic Injury ◽  
Aortic Injuries ◽  
The Mean ◽  
Aortic Trauma

The purpose of this study was to review the shift in the trend of management and mid-term outcomes of all patients who sustain thoracic aortic injury. A Retrospective analysis was performed of all patients sustaining blunt thoracic aortic trauma admitted to our unit. Forty-seven patients were presented with injury to the thoracic aorta following blunt chest injury. Ten patients underwent open surgical repair of their thoracic aortic injury. The mean age ± SD (range) was 29.4 ± 7.9 years (18–41) with a mean Injury Severity Score (ISS) of 41 ± 14.7 (25–75). Fifteen patients underwent thoracic endovascular repair for blunt aortic transections with a mean age of 35.1 ± 14.5 years (17–65), mean ISS of 40.8 ± 13.9 (20–75) and an average length of hospital stay of 25.6 ± 14.5 days (3–77). The mean aortic diameter proximal to the aortic injury was 23.46 ± 3.02 mm (19–28) with a mean aortic angulation of 58.46° ± 17.73 (44–80°). The mean oversizing was 24.4 ± 5.4% (17–32%). At our institution, there has been a paradigm shift in the emergent repair of blunt thoracic aortic injury from open surgery to endovascular repair. Oversizing of the stent-graft did not translate to a poorer outcome.

scholarly journals Floseal® use in dermatologic surgical management of vascular malformations: A novel haemostatic agent in Côte d’Ivoire

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Komenan Kassi ◽  
Vagamon Bamba ◽  
Kouame Kanga ◽  
Aang Allou ◽  
Alexandre Kouassi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Vascular Malformation ◽  
Average Length ◽  
Vascular Malformations ◽  
Lymphatic Vessels ◽  
Length Of Hospital Stay ◽  
Operative Blood Loss ◽  
The Mean ◽  
Short Time ◽  
New Generation

<p>A vascular malformation is a congenital growth of artery, venous, capillary or lymphatic vessels leading to functional and aesthetic problems. Although surgical maneuvers allow correction of abnormalities, it poses risk of intra and post-operative blood loss. Sealants have been used during surgical procedures to reduce blood loss. A descriptive study was conducted on a new generation Floseal<sup>®</sup> to demonstrate its effectiveness to reduce intra and post-operative bleeding during vascular malformation corrective surgery. A group of 19 patients presented with vascular malformations and underwent surgical correction associated with Floseal<sup>®</sup> use. The mean age of our patients’ was 12.3 years (1 to 33 years). The majority of them (57.6%) were aged between 5 to 15 years. The most common vascular malformation treated was hemangioma (45.5%). Majority of these lesions were located on the head (72.7%). Blood transfusion was not accounted for in any of the cases as average blood loss was 18.18 mL (5 to 70 mL). The average length of hospital stay was 2.4 days. Ten patients (90.9%) were discharged in 2 days after drain was removed. Floseal<sup>®</sup>, a new generation local haemostatic, is easy to use and efficient to achieve haemostasis for treatment of vascular malformation. Haemostasis was achieved in a short time and blood loss was minimal. However, caution should be taken to reduce allergic reactions and potential viral transmissions, and further study should be done to recommend its use.</p>

scholarly journals EPIDEMIOLOGICAL PROFILE OF MOTORCYCLE ACCIDENT VICTIMS IN UNIVERSITY HOSPITAL

2020 ◽  
Vol 28 (2) ◽  
pp. 97-99
Author(s):  
CINTIA KELLY BITTAR ◽  
ALBERTO CLIQUET JÚNIOR ◽  
VINÍCIUS SAMUEL DIAS ALVES DA COSTA ◽  
ANA CAROLINA DE FREITAS PACHECO ◽  
RENATO LAZARIN RICCI
Keyword(s):  
Medical Records ◽  
Tibial Fracture ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
University Hospital ◽  
Multiple Fractures ◽  
Level Of Evidence ◽  
Motorcycle Accident ◽  
The Mean ◽  
Epidemiological Profile

ABSTRACT Objective: To evaluate the epidemiological profile of motorcycle accident victims in a metropolis with more than one million inhabitants attended in a university hospital of reference in 2017. Methods: a retrospective study through the analysis of medical records of 105 motorcycle accident victims in Campinas (SP) attended in a university hospital of reference and who needed surgical procedure in 2017. Results: 87 patients (82.9%) were men. Multiple fractures were observed in 61 patients (58.1%) and polytrauma was found in 14 patients (13.3%). Tibial fracture was the most frequent, present in 65 cases (61.9%). Exposed fractures occurred in 68 patients (64.7%). Among the polytrauma victims, the most frequent injury was traumatic brain injury (TBI), present in seven patients (6.6%). The mean age was 29.8 years (range 6-63 years). The average length of hospital stay was 14 days (1-87). Conclusion: It is essential to investigate and evaluate the victims’ epidemiological profile, as well as the resulting injuries, in order to provide adequate support for the implementation of measures aimed at primary prevention and awareness of the most affected groups. Level of Evidence II, Prognostic studies - Investigating the effect of a patient characteristic on the outcome of disease.

scholarly journals Contribution of the BioFire® FilmArray® Meningitis/Encephalitis Panel:

2019 ◽  
Vol 12 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Kyle Dack ◽  
Stephanie Pankow ◽  
Elizabeth Ablah ◽  
Rosey Zackula ◽  
Maha Assi
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Medical Center ◽  
Antiviral Treatment ◽  
Length Of Hospital Stay ◽  
Average Length Of Stay ◽  
Regional Medical ◽  
Regional Medical Center ◽  
The Mean ◽  
Hospital Stay Duration

Introduction. Traditional evaluation of meningitis includes cerebrospinalfluid (CSF) culture and gram stain to pinpoint specific causalorganisms. The BioFire® FilmArray® Meningitis/Encephalitis (ME)Panel has been implemented as a more timely evaluation method.This study sought to assess if the BioFire® ME Panel was associatedwith a decreased length of stay or decreased antimicrobial durationwhen used in the diagnosis of meningitis or encephalitis.Methods.xA case, historical-control, chart review was performed onpatients admitted to a regional medical center with CSF pleocytosisduring Cohort 1 (the year prior to BioFire® ME Panel implementation)and Cohort 2 (the year after BioFire® ME Panel implementation).Length of hospital stay, duration of antimicrobials, and BioFire® MEPanel result were gathered and analyzed.Results. Average length of stay for both cohorts was about fourhospital days. Approximately three-fourths of all patients receivedantibiotic/antiviral treatment with an average of three days duration.No significant differences were observed between groups. The mean(median) duration of antimicrobials in the year prior to and afterthe BioFire® ME Panel implementation was 3.6 (3) and 3.1 (2) days,respectively (p = 0.835). The mean (median) length of stay in the yearprior to and after the BioFire® ME Panel implementation was 5.8 (4)and 5.4 (4) days, respectively (p = 0.941). Among the patients admittedafter the implementation of the BioFire® ME Panel, 4.3 % (n =2) had a positive bacterial result, 38.3% (n = 18) had a positive viralresult, and 57.4% (n = 27) had a negative result. Of the 27 negativeresults, 77.8% (n = 21) were treated with antimicrobial medication.Conclusions. This study suggested there is no difference betweenlength of stay or antimicrobial duration in presumed meningitis casesassessed with traditional methods as compared to the BioFire® MEPanel. Kans J Med 2019;12(1):1-3.

scholarly journals P006 Initiation of Continuous Positive Airway Pressure as an inpatient in Patients with Obesity Hypoventilation Syndrome admitted to General Medical Unit

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A23-A23
Author(s):  
S Banjade ◽  
D Entesari-Tatafi
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Average Weight ◽  
Inpatient Setting ◽  
Obesity Hypoventilation Syndrome ◽  
Medical Unit ◽  
Significant Difference ◽  
The Mean ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

Abstract Background With higher rates of obesity in regional and rural Australian population, there will be higher rates of Obesity Hypoventilation Syndrome (OHS). The cornerstone of the treatment of OHS is Positive Airways Pressure. We studied the initiation of Continuous Positive Airways Pressure (CPAP) in an inpatient setting in patients with OHS in the regional population of Ballarat and subsequent impact on their hospital stay/readmission. Methods We performed a retrospective study of 22 patients with OHS during the 6-month study period (01/07/2021–31/12/2021) admitted into General Medical Unit at Ballarat Base Hospital. Progress Complete Outcome/Impact The mean age in the cohort was 60 with average weight of 139.5 kg. The mean pCO2 and pH were 68.1 and 7.33 respectively. CPAP was initiated in 9 of 22 patients (40.1%) with mean of 7.3 days. Mean days of oxygen use was 4.7 days with mean length of hospital stay 10 days. We did not find any statistical difference in length of hospital stay, ICU stay, supplemental oxygen use or readmission rates between CPAP and non-CPAP group. Subgroup analysis showed that CPAP group had higher rates of COPD (44.4% vs 30.8%) and diabetes (44.4% vs 30.8%) with trend to lower FEV1 (mean FEV1 47.6% vs 57.2%). There were 4 deaths (16.7%), 3 of them did not have CPAP initiated. The longer duration to CPAP initiation is likely to explain the non-significant difference between the groups. Proactive measures to increase initiation of CPAP is likely to improve patient outcome in terms of their morbidity and mortality.

scholarly journals MON-614 Degree of Diabetes Control Determines the Admission Severity of Diabetic Ketoacidosis

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Harshwant Grover ◽  
Puneet Dhillon ◽  
Neethu Gopisetti ◽  
Daniel Evan Rosenberg ◽  
Rajeshkumar Patel
Keyword(s):  
Hospital Stay ◽  
Diabetic Ketoacidosis ◽  
Hemoglobin A1c ◽  
Average Length ◽  
Laboratory Data ◽  
Length Of Hospital Stay ◽  
Diabetes Control ◽  
Apache Score ◽  
High Severity ◽  
The Mean

Abstract Objectives: To determine whether the degree of diabetes control correlates with the admission severity of diabetic ketoacidosis (DKA). Methods: A Retrospective chart review was performed for patients admitted with DKA to the medical ICU at Abington Memorial Hospital between January 1, 2017 and January 1, 2018. Laboratory Data required to determine an acute physiology and chronic health evaluation (APACHE) score, hemoglobin A1C, length of hospital stay was recorded. The APACHE score was used to determine the severity of disease at admission. Patients were divided into two groups: low severity (APACHE &lt;15) and high severity (APACHE &gt;15). Results: A total of 50 patients were included in the analysis. The mean age of the patients was 47 yrs (range 17-85 yrs). 52%(n=26) of the population were males. The overall mean APACHE II at admission was 15 (range 3-28). The low severity group (APACHE &lt;=15) and high severity group (APACHE &gt;15) were equally matched at 25 patients each. The mean APACHE scores were 9.9 and 18.7 for the low and high severity groups respectively. The mean hemoglobin A1C values for the low and high severity groups were 10.5 and 15 respectively. The average length of ICU/hospital stay was 1.6/3.65 and 1.54/3.61 days for the low and high severity groups respectively. Conclusions: According to our study, a higher severity of DKA (higher APACHE) was associated with a higher hemoglobin A1C level. However, the study did not find any difference in the average length of ICU/hospital stay between the two groups.

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