1.Drain versus no drain after thyroidectomy: A preliminary prospective randomized controlled trial
Jefferson A. Alamani ; Elias T. Reala ; Samantha S. Castaneda ; Antonio H. Chua
Philippine Journal of Otolaryngology Head and Neck Surgery 2014;29(1):11-15
p style=text-align: justify;strongOBJECTIVE:/strong To evaluate the necessity of placing a drain in post-thyroidectomy patients, we aimed to determine whether insertion of a passive drain as compared to no drain in post-thyroidectomy patients would significantly affect hematoma formation, wound infection, wound dehiscence and length of hospital stay.METHODS:br /Design:/strong Prospective randomized controlled trialbr /strongSetting:/strong Tertiary government training hospitalbr / strongSubjects:/strong Patients who underwent thyroidectomy for various pathologies were divided into two postoperative treatment arms: one group with insertion of a passive drain, and another group without a drain. Hematoma, wound infection, wound dehiscence and length of hospital stay were the outcomes measured per treatment arm.RESULTS:/strong A total of 66 patients were evaluated. There were 54 females (81.81%) and 12 males (18.18%). The mean age for the drain group was 44.88 years and 43.67 years for the no drain group. Four patients developed complications in the drain group and two developed complications in the no drain group. The rate of complications between both groups was not statistically significant. The mean hospital stay of the drain group was 3.15 days which in the no drain group was 2.51 days. The difference in length of hospital stay was statistically significant.CONCLUSIONS:/strong There was no difference in the development of complications among the drain and no drain group. Thyroidectomy without surgical drains was associated with a significant reduction in hospital stay compared to thyroidectomy with routine placement of drains./p
Human
;
Male
;
Female
;
Aged 80 and over
;
Aged
;
Middle Aged
;
Adult
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Thyroid Diseases
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Thyroidectomy-surgery
;
Drainage
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Postoperative Care
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Thyroid Gland
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Postoperative Complications
;
Hematoma
2.Reconstruction of a large through and through defect of the oral cavity using a double anterolateral thigh free flap
Jefferson A. Alamani ; Samantha S. Castaneda ; Adrian F. Fernando
Philippine Journal of Otolaryngology Head and Neck Surgery 2014;29(1):26-29
Objective:
To present our application of a double anterolateral thigh (ALT) free flap in reconstruction of a large full thickness defect of the oral cavity, cheek and cervical area.
Methods:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
Results:
A 77-year-old male with a 20 x 25 cm full thickness soft tissue defect on the facial and cervical area contiguous with a 6 x 6 cm buccal defect resulting from wide tumor ablation of a Stage IVA (T4aN2bM0) squamous cell carcinoma of the buccal mucosa underwent reconstruction using two ALT free flaps. An ALT flap was designed to cover the intraoral and cheek defect, while another ALT flap was used for external coverage of the cervical defect. The first ALT flap measured approximately 8 x 22 cm while the second ALT flap measured 6 x 22 cm harvested from the left and right thigh respectively. Temporary venous congestion was observed on the inferiorly placed ALT flap due to neck edema that spontaneously resolved on the 2nd post-operative day. Minimal donor site complications observed were linear scars, and a 1 x 4 cm dehiscence on the right thigh that healed spontaneously by secondary intention.
Conclusion
The utilization of a double anterolateral thigh free flap allowed single-stage reconstruction of the large soft tissue head and neck defect with little donor site morbidity, shorter operating time and shorter hospital stay.
Human
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Male
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Aged
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THIGH
;
Free Tissue Flaps
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Mouth
;
Cheek