scholarly journals Can drains be avoided in lipo-abdominoplasty?

2018 ◽  
Vol 51 (01) ◽  
pp. 015-023 ◽  
Author(s):  
Medha Anand Bhave Khair
Keyword(s):  
Retrospective Study ◽  
Wound Closure ◽  
Wound Dehiscence ◽  
Seroma Formation ◽  
Patient Comfort ◽  
Common Complication ◽  
Key Factors ◽  
Early Ambulation ◽  
Continuous Use

ABSTRACT Context: Seroma formation is a common complication after lipoabdominoplasty. Conventionally, drains have been placed to prevent seroma; however, there are problems with drains, namely, pain, compromised mobilisation, breakage, tissue irritation and infection. Strategies to prevent seroma, such as the use of glue or quilting sutures have all been attempted with variable and unpredictable benefit. Aims: The author extrapolated the experience with own liposuction protocols to lipoabdominoplasty and began doing away with drains from the year 2006 onwards unless absolutely indicated. Incidence of complications is evaluated here. Settings and Design: This retrospective study is the report of our experience with 204 lipoabdominoplasties performed since 2006 upto December 2016. Subjects and Methods: Consecutive abdominoplasty patients were evaluated for seroma formation, wound dehiscence till suture removal. Nuances of operative details that helped avoid drains were contemplated. Results: Only one patient who had drainless abdominoplasty had seroma formation and wound dehiscence. Conclusions: We found that (a) ‘toilet liposuction’, (a term the author would like to introduce) (b) multilayer wound closure without tension, (c) avoidance of gliding surfaces d) continuous use of pressure garment for 4 days post-operative and (e) reducing the amount of infiltration are the key factors in avoidance of collections and thus seroma formation. If such a technique is diligently followed, desired results are obtained; yet there is no need to insert drains in most patients. Reducing the need of drains permits early ambulation and better patient comfort without seroma and other complications.

scholarly journals Mastoid Dressing in Ear Surgery: Is it Still Relevant?

2021 ◽  
Vol 29 (2) ◽  
pp. 140-144
Author(s):  
Rahul Naga ◽  
Tejpal Singh Bedi ◽  
Renu Rajguru ◽  
Inderdeep Singh ◽  
Saurabh Mahajan
Keyword(s):  
Wound Dehiscence ◽  
Seroma Formation ◽  
Patient Comfort ◽  
Wound Complications ◽  
Ear Surgery ◽  
Patient Discomfort ◽  
Post Operative Period ◽  
Cortical Mastoidectomy ◽  
One Year ◽  
Haematoma Formation

Introduction   Mastoid dressings are conventionally used in patients who undergo Tympanoplasty using post auricular approach. The rationale behind using a mastoid dressing is that the said dressing prevents haematoma formation and acts as a protective covering during the post-operative period. This study aims to understand the significance of mastoid dressing in patients undergoing Cortical Mastoidectomy and Tympanoplasty and its role in preventing post-operative wound complications and patient comfort. Materials and Methods   A total of 77 patients were enrolled in the study over a one year period and were randomised into dressing and no dressing groups with the aim of deciphering any advantage of the mastoid dressing over a smaller dressing. Results   Our data revealed no added advantage of conventional mastoid dressing over a small gauze piece dressing in terms of haematoma/seroma formation, contusion and wound dehiscence. However, there was significantly reduced patient discomfort and sleeping difficulties post-operatively in the no dressing group. Conclusion We conclude that smaller dressing is more favourable than the bulkier conventional mastoid dressings.

scholarly journals Total arterial myocardial revascularization using bilateral internal mammary arteries and the role of postoperative sternal stabilization to reduce wound infections in a large cohort study

2019 ◽  
Vol 29 (2) ◽  
pp. 224-229 ◽  
Author(s):  
Marc Albert ◽  
Ragi Nagib ◽  
Adrian Ursulescu ◽  
Ulrich F W Franke
Keyword(s):  
Retrospective Study ◽  
Wound Infection ◽  
Internal Mammary Artery ◽  
Wound Closure ◽  
Myocardial Revascularization ◽  
Wound Complications ◽  
Wound Infections ◽  
Term Survival ◽  
Mammary Arteries ◽  
Internal Mammary

Abstract OBJECTIVES Total arterial myocardial revascularization using bilateral internal mammary arteries shows improved results for mortality, long-term survival and superior graft patency. It has become the standard technique according to recent guidelines. However, these patients may have an increased risk of developing sternal wound infections, especially obese patients or those with diabetes. One reason for the wound complications may be early sternum instability. This situation could be avoided by using a thorax support vest (e.g. Posthorax® vest). This retrospective study compared the wound complications after bilateral internal mammary artery grafting including the use of a Posthorax vest. METHODS Between April 2015 and May 2017, 1613 patients received total arterial myocardial revascularization using bilateral internal mammary artery via a median sternotomy. The Posthorax support vest was used from the second postoperative day. We compared those patients with 1667 patients operated on via the same access in the preceding 26 months. The end points were the incidence of wound infections, when the wound infection occurred and how many wound revisions were needed until wound closure. RESULTS The demographic data of both groups were similar. A significant advantage for the use of a thorax support vest could be seen regarding the incidence of wound infections (P = 0.036) and the length of hospital stay when a wound complication did occur (P = 0.018). CONCLUSIONS As seen in this retrospective study, the early perioperative use of a thorax stabilization vest, such as the Posthorax vest, can reduce the incidence of sternal wound complications significantly. Furthermore, when a wound infection occurred, and the patient returned to the hospital for wound revision, patients who were given the Posthorax vest postoperatively had a significantly shorter length of stay until wound closure.

The Effect of Quilting Sutures on the Tension Required to Advance the Abdominal Flap in Abdominoplasty

2021 ◽  
Author(s):  
Maria Roberta Cardoso Martins ◽  
Betina Zimmermann Fontes de Moraes ◽  
Daniel Capucci Fabri ◽  
Hugo Alexandre Sócrates de Castro ◽  
Lucas Rostom ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Postoperative Complications ◽  
Anterior Abdominal Wall ◽  
Subcutaneous Tissue ◽  
Tensile Force ◽  
Wound Dehiscence ◽  
Seroma Formation ◽  
Hypertrophic Scars ◽  
Before And After ◽  
Number Of Births

Abstract Background Quilting sutures attaching the abdominal flap to the aponeurosis contribute to the prevention of seroma formation post-abdominoplasty. The sutures distribute the tension over the subcutaneous tissue along the flap length, theoretically decreasing tension at the distal (cutaneous) end of the flap. This is expected to reduce the risks of necrosis, dehiscence, and enlarged or hypertrophic scars. Objectives The study sought to verify whether quilting sutures decrease the tension required to advance the dermal-fat flap in abdominoplasty. Methods Thirty-four women undergoing abdominoplasty with quilting sutures participated in the study. The tensile force required for flap advancement was measured before and after the placement of quilting sutures, using a digital force gauge, and then compared. Differences in tensile force were tested for correlations with body mass index (BMI), age, weight of flap tissue removed, number of previous pregnancies, and postoperative complications, including seroma formation, hematoma, necrosis, dehiscence, and enlarged or hypertrophic scars. Results A mean reduction in tension of 27.7% was observed at the skin suture after the placement of quilting sutures (p < 0.001). No significant correlation was found of reduced flap tension with BMI, age, weight of tissue removed, and number of births. A case of seroma formation and two cases of enlarged scars were observed, but no case of hematoma, necrosis or wound dehiscence was detected. Conclusions The use of quilting sutures to attach the abdominal flap to the aponeurosis of the anterior abdominal wall reduced tension at the advancing edge of the flap in abdominoplasty.

ADHESIVE GLUE Vs SUBCUTICULAR SUTURING IN THYROIDECTOMY

2021 ◽  
pp. 16-17
Author(s):  
Anil Kumar K N ◽  
Ashwin Kumar H
Keyword(s):  
Postoperative Pain ◽  
Clinical Outcome ◽  
Wound Closure ◽  
Medical Science ◽  
Wound Dehiscence ◽  
Wound Complications ◽  
P Value ◽  
Skin Closure ◽  
Post Operative Pain ◽  
Needle Prick

BACKGROUND: Suturing has been the commonest method of surgical wound closure that is being practiced because of good results of skin closure. With adhesive glue being an alternative for skin closure which is less time consuming, comfortable, without the risk of needle prick injury and leaves behind a cosmetically acceptable scar. OBJECTIVES: The aim of this study is to compare subcuticular suturing versus adhesive glue for skin closure in thyroidectomy with respect to clinical outcome which included postoperative pain, wound complications, wound dehiscence and cosmesis. MATERIALAND METHODS: This prospective study of 100 cases of skin closure using subcuticular suturing versus adhesive in thyroidectomy was carried out at BGS Global institute of medical science and Hospital, Bangalore with the aim of comparing suturing versus adhesive glue, with respect to clinical outcome which included postoperative pain, wound complications, wound dehiscence and cosmesis. RESULT: 100 patients divided into 2 groups, randomly underwent subcuticular suturing and adhesive glue skin closure. Post- operative pain was less in glue group (p value <0.001) and wound complications were comparable in both groups. CONCLUSION: Octylcyanoacrylate provides an effective and reliable means of skin closure and yields similar cosmetic results as with subcuticular skin sutures. The incidences of wound complications are comparable in both the groups. However the severity of postoperative pain is lesser in the adhesive group.

Stratification of chronic and complex wounds according to healing characteristics: a retrospective study

2019 ◽  
Vol 28 (7) ◽  
pp. 446-452
Author(s):  
Nicole E. Spruijt ◽  
Maarten M. Hoogbergen ◽  
Servaas J.E. Buijs ◽  
Marcel J.W. Grosveld ◽  
Jaap Buth
Keyword(s):  
Wound Healing ◽  
Retrospective Study ◽  
Outcome Measure ◽  
Treatment Time ◽  
Wound Dehiscence ◽  
Lower Percentage ◽  
Secondary Outcome ◽  
Study Cohort ◽  
Secondary Outcome Measure ◽  
Risk Categories

Objective: Wound risk-stratified analyses are clinically relevant as they can assist in identifying hard-to-heal wounds. The aim of the study is to develop risk categories for wound healing based on a limited number of reliably recordable clinical data. Method: This retrospective study used observational data. The primary outcome measure was wound healing at the end of treatment and the secondary outcome measure was the time to wound healing. A stratification model using regression analyses was developed to assign the patients to risk categories for wound healing and the time-to-heal. Results: The study cohort comprised of 540 patients. The most common wound diagnoses were diabetic ulcers, wounds in irradiated areas and wound dehiscence after surgery. Average wound duration before starting treatment at the wound centre was 11.7 months. Healing was achieved in 382 (71%) wounds, after an average treatment time of 4.4 months. A total of four risk categories for wound healing were developed by combining wound diagnosis (favourable versus unfavourable) and duration (<3 months versus >3 months). These risk categories demonstrated healing percentages ranging from 69–97% (p=0.0004) and mean time-to-healing varying from 2.7–5.9 months (p=0.01). Conclusion: Using two clinical wound variables, diagnosis and duration, stratification categories were identified with significant associations with wound healing outcomes. Longer wound duration and unfavourable diagnoses, when combined into unfavourable risk categories, were associated with a lower percentage of wound healing and a longer treatment time until healing.

scholarly journals Cyanoacrylate for Intraoral Wound Closure: A Possibility?

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Parimala Sagar ◽  
Kavitha Prasad ◽  
R. M. Lalitha ◽  
Krishnappa Ranganath
Keyword(s):  
Antibacterial Activity ◽  
Surgical Procedure ◽  
Wound Closure ◽  
Healing Process ◽  
Patient Comfort ◽  
Antibacterial Effects ◽  
Suture Materials ◽  
Resistance To Infection ◽  
Natural Healing ◽  
Long Chain

Wound closure is a part of any surgical procedure and the objective of laceration repair or incision closure is to approximate the edges of a wound so that natural healing process may occur. Over the years new biomaterials have been discovered as an alternate to conventional suture materials. Cyanoacrylate bioadhesives are one among them. They carry the advantages of rapid application, patient comfort, resistance to infection, hemostatic properties, and no suture removal anxiety. Hence this study was undertaken to study the effect of long chain cyanoacrylate as an adhesive for intraoral wound closure and also to explore its hemostatic and antibacterial effects. Isoamyl-2-cyanoacrylate (AMCRYLATE) was used as the adhesive in the study. In conclusion isoamyl cyanoacrylate can be used for intraoral wound closure, as an alternative to sutures for gluing the mucoperiosteum to bone, for example, after impaction removal, periapical surgeries, and cleft repair. Its hemostatic and antibacterial activity has to be further evaluated.

scholarly journals Comparison of 2-octyl cyanoacrylate skin adhesive and interrupted polypropylene sutures for wound closure in total ankle arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Gun-Woo Lee ◽  
Woo Kyoung Kwak ◽  
Keun-Bae Lee
Keyword(s):  
Patient Satisfaction ◽  
Surgical Site Infection ◽  
Wound Closure ◽  
Wound Dehiscence ◽  
Wound Complications ◽  
Site Infection ◽  
Ankle Arthroplasty ◽  
Suture Group ◽  
Allergic Contact ◽  
Polypropylene Sutures

Abstract Background Adhesive skin materials have increasingly been used in orthopedic surgery. We aimed to compare the efficacy and safety of skin adhesive (2-octyl cyanoacrylate and polymer mesh, Dermabond Prineo) and interrupted polypropylene sutures for wound closure in patients undergoing total ankle arthroplasty (TAA). Methods We prospectively enrolled 107 consecutive patients (108 ankles) undergoing TAA and divided them into two groups: skin adhesive group (36 ankles) and suture group (72 ankles). The primary outcome assessment included wound complications and patient satisfaction for wound cosmesis. The secondary outcome assessment included duration of surgery, length of hospital stay, and the Ankle Osteoarthritis Scale (AOS) pain and disability score. Results There was one case of allergic contact dermatitis, three cases of wound dehiscence, and one case of superficial surgical site infection in the skin adhesive group. Among them, one case each with allergic contact dermatitis and wound dehiscence finally progressed to deep surgical site infection. Three cases of wound dehiscence were also reported in the suture group; however, there was no case of surgical site infection. Patient satisfaction for wound cosmesis was significantly higher in the skin adhesive group than in the suture group (p = 0.001). There was no statistically significant difference between the groups in terms of secondary outcomes (p > 0.05). Conclusions Although the use of Dermabond Prineo showed better patient satisfaction for wound cosmesis, it showed significantly high wound complication rates and no other clinical benefits compared to interrupted polypropylene suture in TAA. Our results suggest that awareness of the possibility of wound complications is necessary when Dermabond Prineo is used in TAA.

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