PURPOSE: Surgical equipment used in breast cancer surgery that affects wound healing and minimizes complications seems to be a popular investigation topic. The aim of this study is to evaluate the effect of plasmakinetic cautery on wound healing in patients receiving mastectomy. METHODS: Forty-six consecutive breast cancer patients receiving modified radical mastectomy were evaluated prospectively. Plasmakinetic cautery was used in 24 operations and electrocautery was used in 22 operations in random order to manage skin flaps and excise breast tissue. In the postoperative period, vacuum drainage amount and duration time as well as the start time of arm exercises were recorded. Complications like seroma, surgical site infection, hematoma, and flap necrosis were determined. RESULTS: Age, body mass index, breast volume and flap area parameters were similar in each group. Mean drainage duration was found to be 5.5 days in the plasmacautery group and 7.9 days in the electrocautery group (p=0.020). In the plasmacautery and electrocautery groups, mean drainage volume was 707 and 1,093 mL, respectively (p=0.025). There was no statistical significance between the groups when operation duration, amount of blood loss, time to start arm exercises, seroma, hematoma, surgical site infection, and flap necrosis were considered. CONCLUSION: Plasmakinetic cautery is a promising new surgical instrument that provides atraumatic, scalpel-like cutting precision and electrosurgical-like hemostasis, resulting in minimal tissue injury. So, plasmacautery shortens the drainage amount and duration time compared to electrocautery without elongating operation duration or increasing the amount of blood loss.
Arm ; Body Mass Index ; Breast ; Breast Neoplasms ; Cautery ; Drainage ; Electrocoagulation ; Exercise ; Hematoma ; Hemostasis ; Humans ; Mastectomy ; Mastectomy, Modified Radical ; Necrosis ; Postoperative Period ; Prospective Studies ; Seroma ; Skin ; Surgical Equipment ; Surgical Instruments ; Vacuum ; Wound Healing

Objective: This study evaluated maternal and fetal outcomes of emergency uterine resection versus planned segmental uterine resection in patients with placenta percreta (PPC) and placenta previa (PP). Methods: Patients with PP and PPC who underwent planned or emergency segmental uterine resection were included in this study. Demographic data, hemorrhagic morbidities, intra- and postoperative complications, length of hospital stay, surgical duration, and peri- and neonatal morbidities were compared. Results: A total of 141 PPC and PP cases were included in this study. Twenty-five patients (17.73%) underwent emergency uterine resection, while 116 (82.27%) underwent planned segmental uterine resections. The postoperative hemoglobin changes, operation times, total blood transfusion, bladder injury, and length of hospital stay did not differ significantly between groups (P=0.7, P=0.6, P=0.9, P=0.9, and P=0.2, respectively). Fetal weights, 5-minute Apgar scores, and neonatal intensive care unit admission rates did not differ significantly between groups. The gestational age at delivery of patients presenting with bleeding was lower than that of patients who were admitted in active labor and underwent elective surgery (32 weeks [95% confidence interval [CI], 26-37] vs. 35 weeks [95% CI, 34-35]; P=0.037). Conclusion Using a multidisciplinary approach, this study performed at a tertiary center showed that maternal and fetal morbidity and mortality did not differ significantly between emergency versus planned segmental uterine resection.

OBJECTIVES: This study presents the role of the temporalis muscle flap in primary reconstruction after orbital exenteration. METHODS: A retrospective nonrandomized study of orbital exenterations performed between 1990 and 2010 for malignant tumors of the skin, paranasal sinus, and nasal cavity is presented. RESULTS: The study included 13 patients (nine men, four women; age range, 30-82 years) with paranasal sinus, nasal cavity, or skin carcinomas. Primary reconstruction of the cavity was performed in all patients after orbital exenteration. No visible defects in the muscle flap donor site were present. Local recurrences were readily followed up with nasal endoscopy, whereas radiology helped to diagnose intracranial involvement in three patients. Two patients died of systemic metastases and five died for other reasons CONCLUSION: The temporalis muscle flap is readily used to close the defect after orbital exenteration, and does not prevent the detection of recurrence.
Endoscopy ; Female ; Humans ; Male ; Nasal Cavity ; Neoplasm Metastasis ; Orbit Evisceration ; Orbit* ; Recurrence ; Retrospective Studies ; Skin ; Surgical Flaps ; Tissue Donors