Radical treatment of axillary osmidrosis using the VERSAJET™ II Hydrosurgery System or traditional open excision: A prospective cohort study
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Abstract Background Axillary osmidrosis, characterized by an unpleasant odor, renders social life difficult for young adults. This study aimed to compare traditional open excision and use of the VERSAJET™ II Hydrosurgery System for effectiveness and treatment complaints in the treatment of axillary osmidrosis. Aim The current study aimed to assess the curative effect of VERSAJET™ for axillary osmidrosis in a prospective cohort study, comparatively to traditional open excision. Method In this prospective cohort study, from October 2016 to March 2018, 31 and 34 patients treated with the VERSAJET™ II Hydrosurgery System and traditional open excision, respectively, were recruited and followed up for 6 months post‐treatment. Treatment outcomes were assessed, including surgical field size, operation time, postoperative complications, odor elimination, hair growth reduction, scarring, and patient satisfaction. Results The VERSAJET™ group had significantly shorter operation ( P < .001) and lower rates of complications, including hematoma ( P = .014), wound dehiscence ( P = .048), and epidermal erosion ( P = .022) compared with the open excision group. A similar rate of good odor elimination ( P = .925) was observed in both groups (96.77% and 97.05% in the VERSAJET™ and open excision groups, respectively). Most patients experienced sparsity of armpit hair following both procedures. Based on a comprehensive consideration of the whole operation process, recovery process, postoperative odor and scar, patients in the VERSAJET™ group were more satisfied compared with those in the open excision group ( P = .008). Conclusion The VERSAJET™ II procedure is shorter, with less postoperative scarring and fewer postoperative complications, compared with the traditional method. Therefore, the VERSAJET™ II procedure is superior to traditional open excision, as a new, radical treatment method for axillary osmidrosis.Keywords:
Wound dehiscence
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Background: Negative pressure wound therapy (NPWT) facilitates recovery of pressure injuries. This study aimed to investigate whether preoperative NPWT affected complications after musculocutaneous flap reconstruction of pressure injury wounds that required surgical treatment.Methods: Of 71 patients with sacral pressure injury wounds, 28 did not undergo preoperative NPWT (no-NPWT group), while 43 received preoperative NPWT. Both groups received flap coverage for pressure injury wounds. Differences in complications such as wound dehiscence, hematoma, and seroma were compared between the two groups.Results: In the no-NPWT group, seven postoperative complications occurred, of which five were wound dehiscence and two were seroma. There were no hematomas. In the NPWT group, a total of nine postoperative complications occurred, including two cases of wound dehiscence, six hematomas, and one seroma (P=0.029).Conclusion: The overall incidence of complications was higher in the no-NPWT group. The incidence of hematoma was significantly higher in patients with preoperative NPWT. NPWT before reconstruction of pressure injury wounds may assist wound healing after the surgical treatment. However, care must be taken because NPWT may increase the risk of hematoma after surgical treatment.
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Negative-pressure wound therapy
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Postoperative hematoma
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Background Closed incisional negative pressure wound treatment (ciNPWT) is one of the promising methods for the prevention of complications in surgical incisions. The mechanisms of ciNPWT have previously been elucidated and in this series, we demonstrate various, as of yet, underreported uses for the technology. Our aim is to share our experience with ciNPWT on various anatomic sites with novel indications. Materials and methods ciNPWT was used in 24 patients. The mean age was 49.6. All the incisions were sutured, clean, and non-infected. Patients' sex, age, comorbidities, anatomic location of the wound, and the indications for ciNPWT were recorded. Results The mean number of applications was three per patient. One suture dehiscence after one session of ciNPWT was encountered in a flap donor site of an infant operated for meningomyelocele. Late-term seroma and hematoma formation were encountered in two patients. No surgical site infection, wound dehiscence, and ciNPWT related complications were seen in other patients. The majority of the applications were on the trunk, lower extremity, pelvis, upper extremity, and scalp respectively. Indications for ciNPWT utilization were preventing dehiscence, seroma, and hematoma formation in the majority of the patients. Conclusion ciNPWT is reliable and effective in the prevention of post-operative wound dehiscence and surgical site infections. It can be used safely in various locations and different indications for preventingcomplications such as preventing dehiscence in revision surgeries, cerebrospinal fluid (CSF) fistula formation in the scalp, and wound breakdown in chronic corticosteroid use.
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Seroma
Wound dehiscence
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Local complications that require additional surgical procedures are an important problem for women with breast implants.
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Capsular Contracture
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Objective: A randomized controlled trial (RCT) was undertaken to evaluate whether the prophylactic application of a specific single-use negative pressure (sNPWT) dressing on closed surgical incisions after incisional hernia (IH) repair decreases the risk of surgical site occurrences (SSOs) and the length of stay. Background: The sNPWT dressings have been associated to several advantages like cost savings and prevention of SSOs like seroma, hematoma, dehiscence, or wound infection (SSI) in closed surgical incisions. But this beneficious effect has not been previously studied in cases of close wounds after abdominal wall hernia repairs. Methods: An RCT was undertaken between May 2017 and January 2020 (ClinicalTrials.gov registration number NCT03576222). Participating patients, with IH type W2 or W3 according to European Hernia Society classification, were randomly assigned to receive intraoperatively either the sNPWT (PICO)(72 patients) or a conventional dressing at the end of the hernia repair (74 patients). The primary endpoint was the development of SSOs during the first 30 days after hernia repair. The secondary endpoint included length of hospital stay. Statistical analysis was performed using IBM SPSS Statistics Version 23.0. Results: At 30 days postoperatively, there was significatively higher incidence of SSOs in the control group compared to the treatment group (29.8% vs 16.6%, P < 0.042). There was no SSI in the treatment group and 6 cases in the control group (0% vs 8%, P < 0.002). No significant differences regarding seroma, hematoma, wound dehiscence, and length of stay were observed between the groups. Conclusion: The use of prophylactic sNPWT PICO dressing for closed surgical incisions following IH repair reduces significatively the overall incidence of SSOs and the SSI at 30 days postoperatively.
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Incisional Hernia
Wound dehiscence
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Negative-pressure wound therapy
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Abstract The study aims to evaluate sternocleidomastoid-clavicular osteo-myocutaneous flap (SCM-OMCF) for reconstruction of mandibular defects after tumor resection. In the period between 2010 and 2018, thirteen patients with primary mandibular tumors underwent mandibular resection and reconstruction with SCM-OMCF. Patients were followed up for 10 to 66 months. Hospital was 13 ± 4 days. All patients started fluid in the 2nd day. The mean time to start oral fluid was 7.5 ± 0.8 day. Four (30.8% ) patients suffered from complications (infection and salivary leak in 1 case due to partial flap loss, donor wound dehiscence in 1 case, deep venous thrombosis in 1 case and chest infection in 1 case). None of our cases experienced motor disability. Two cases (15.9%) underwent reoperations. The overall aesthetic outcome was found excellent in 5 cases, satisfactory in 5 cases and fair in 3 cases. The functional outcomes were satisfactory. Tumor recurrences were detected in 2 (15.9%) patients. Two patients died during follow up within 2 years after 1st surgery due to local and distant recurrences. SCM-OMCF is a versatile, safe and simple technique for reconstructing mandibular defects less than 11 cm.
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The role of hematoma formation in the development of complications after major head and neck surgery is surveyed retrospectively. An incidence of 4.2% was encountered. In all cases, the hematoma was identified within 12 hours postoperatively. Prompt surgical clot evacuation and reinstitution of drainage did not adversely effect the patient's subsequent course. Failure to adequately drain the hematoma resulted in increased wound dehiscence, major infection, and fistula. When properly treated, postoperative hematoma formation offers only the risks attendant with a second anesthesia; no subsequent related morbidity need be anticipated.
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Abstract The aim of this study was to evaluate the results of cases with pilonidal sinus (PS) disease that underwent Limberg flap (LF) transposition and to compare the short and long-term results of early discharge cases with those in the literature. A total of 345 patients who underwent rhomboid excision and LF transposition for PS were evaluated retrospectively. No major anesthetic or surgical complications occurred. Partial wound dehiscence, localized flap necrosis, hematoma, wound infection, and seroma rates were determined as 4.0, 2.1, 1.5, 3.3, and 3.7% respectively. All patients other than those with a hematoma or localized necrosis were discharged with a drain in place 24 hours after the operation. The recurrence rate was 3.9% after a mean 33.1-month follow-up (range, 6–72 months). As a result, we found that short and long-term results of patients who underwent LF and were discharged 24 hours after the operation were similar to those in the literature. We suggest that patients without postoperative complications, such as hematoma or flap necrosis, can be discharged early.
Seroma
Wound dehiscence
Sinus (botany)
Transposition (logic)
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