PURPOSE: Although the two or three-postoperative doses of prophylactic antibiotics are recommended, the tendency for surgeons to prolong the administration of prophylactic antibiotics after colorectal surgery is a well-known fact. The aim of this study was to assess the prophylactic efficacy of two or three-doses of prophylactic antibiotics over a 24 hour period after elective colorectal surgery. METHODS: We reviewed the surgical complications in 69 patients who underwent elective colorectal surgery from April to Jun, 2006. All patients had preoperative mechanical bowel cleansing performed. As antibiotic prophylaxis, oral metronidazole was administered 2~3 times on the day before surgery and second generation cephalosporin were administered intravenously 30 minutes before surgical incision. After surgery, second generation cephalosporin, aminoglycoside and metronidazole were given to all the patients, at 2~3 doses for 24 hours. Wound conditions were checked on alternate days during the hospital stay and the patients were followed up for at least 30 days after discharge. RESULTS: In 69 patients, the diseases were cancer in 64 cases (92.8%). The procedures were anterior resection or lower anterior resection in 38 cases (55.1%), hemicoloectomy in 16 cases (23.2%), segmental resection in 9 cases, and abdomino-perineal resection or Hartmann's procedure in 6 cases. The wound complications were wound seroma in 3 cases (4.3%), wound dehiscence in 3 cases (4.3%) and anastomotic leakage in 1 case (1.4%). CONCLUSION: The wound complication rate was not high after antibiotic prophylaxis for 24 hours in patients who underwent elective colorectal surgery. Further studies are required to establish appropriate guidelines for antibiotic prophylaxis after elective colorectal surgery.
Anastomotic Leak ; Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Colorectal Surgery ; Humans ; Length of Stay ; Metronidazole ; Seroma

Suction-assisted lipoplasty is now flrequently-performed pre cedure in plastic surgery, but it has several drawback including bleeding contour irregularity due to its traumatic nature. The recently introduced ultrasound-assisted lipoplasty (UAL) technique uses ultrasonic energy which has specificity in lower density tissue like fat tissue. Therefore, UAL can minimize these compli cations. We performed UAL in 21 patients from OCt. 1988 to Jun 1999. There were 17 females and 4 males, and patient age ranged from 18 to 52 years(average 40 years). A total of 58 areas were operated on for an averge of 28 areas per patient. We used a fivestage technique consisting of tumescent infiltration, ultrasonund treatment, emulsion suction, endermology, and postperative pressuregarment application. Total volume (fluid and fat) removed ranged from 200 to 4,050 cc(averge 1,750 cc) per patient and the lipocrit within the aspirate was 4-8%, which was significantly lower compared with traditional liposuction Residual emulsion was evacuated by endermology and pressuregarment was applied to all patients for postoperative 2-3 months. Pestoperative complications were seroma, induration, and paresthesia, but all these problems resolved spontaneously within a month. One patient required secondary UAL for correction of excess fat at the medial knee. We believe that UAL is a safe and excellent technology in liposuction because of reduced surgical bleeding and good contral of body contour.
Bezafibrate ; Cations ; Female ; Hemorrhage ; Humans ; Knee ; Lipectomy ; Male ; Paresthesia ; Sensitivity and Specificity ; Seroma ; Suction ; Surgery, Plastic ; Ultrasonics

The aim of this study was to investigate the complications following surgical treatment of thyroid cancer and the association between the extent of surgery and complication rates. A total of 2,636 patients who underwent surgery due to thyroid cancer were retrospectively reviewed to identify surgical complications. Complication rates were assessed according to the extent of surgery, which was classified as follows; less-than-total thyroidectomy with central compartment node dissection (CCND) (Group I, n=636), total thyroidectomy with CCND (Group II, n=1,390), total thyroidectomy plus ipsilateral neck dissection (Group III, n=513), and total thyroidectomy plus bilateral neck dissection (Group IV, n=97). The most common surgical complication was symptomatic hypoparathyroidism, of which 28.4% of cases were transient and 0.3% permanent. The other surgical complications included vocal cord palsy (0.7% transient, and 0.2% permanent), hematoma (0.5%), seroma (4.7%), chyle fistula (1.8%), and Horner's syndrome (0.2%). The complication rates increased significantly with increasing the extent of surgery from Group I to Group IV. The more extensive surgery makes more complications, such as hypoparathyroidism, seroma, and others.
Adult ; Female ; Humans ; Hypoparathyroidism/etiology ; Male ; Middle Aged ; Paralysis/etiology ; Parathyroid Glands/surgery ; *Postoperative Complications ; Retrospective Studies ; Seroma/etiology ; Thyroid Neoplasms/*complications/pathology/*surgery

Necessity of more biocompatible bone graft material had brought due to the problems of autologous bone graft & synthetic bone substitute materials. Bonesource(R) is a new biomaterial which can be replaced by natural bone when it is implanted. We reviewed our experience with Bonesource(in various reconstruction of bone defect for wide application. From March 2000 to March 2002 at Seoul National University Hospital, we performed various 7 cases of operation with Bonesource(R). These cases were bony depression after mass excision, alveolar cleft, frontal and supraorbital rim fracture, orbital deformity, facial asymmetry, bone defect after cranioplasty, depressive scar. In all cases, results were satisfactory without migration, extrusion, resorption during the follow up period (average 14 months). In 1 case, wound healing was delayed due to redissolution of Bonesource(R) by seroma. This was resolved by drainage without significant loss of volume. Its biocompatibility, excellent bony adhesion(osseointegration) and tendency to be replaced by natural bone(osteoconduction) may make it widely used in plastic surgery. The result of long term follow up and practical technique handling this material effectively are needed to evaluate it further.
Bone Substitutes ; Cicatrix ; Congenital Abnormalities ; Depression ; Drainage ; Durapatite* ; Facial Asymmetry ; Follow-Up Studies ; Orbital Fractures ; Seoul ; Seroma ; Surgery, Plastic ; Transplants ; Wound Healing

BACKGROUND: Abdominoplasty, with or without liposuction, is among the most frequently performed aesthetic procedures. Its main objective is to improve the body contour by means of excising redundant skin and fat tissue. Although abdominoplasty is considered a safe procedure with high satisfaction rates, intraoperative and postoperative complications can become a challenge for the surgical team. The aim of this article is to offer a synopsis of the most common complications arising after abdominoplasty, along with evidence-based guidelines about how to prevent and treat them. METHODS: A systematic MEDLINE search strategy was designed using appropriate Medical Subject Headings (MeSH) terms, and references were scanned for further relevant articles. RESULTS: According to the published case series, local complications are considerably more common than complications with systemic repercussions. Approximately 10% to 20% of patients suffer a local complication following abdominoplasty, while fewer than 1% suffer a systemic complication. Prevention and management strategies are critically discussed for complications including seroma, haematoma, infection, skin necrosis, suture extrusions, hypertrophic scars, neurological symptoms, umbilical anomalies, deep venous thrombosis and pulmonary thromboembolism, respiratory distress, and death. CONCLUSIONS: The complications of abdominoplasty vary in severity and in the impact they have on the aesthetic outcomes. Recommendations for prevention and management are based on various levels of evidence, with a risk of observer bias. However, most complications can be treated appropriately following the current standards, with satisfactory results.
Abdominoplasty* ; Cicatrix, Hypertrophic ; Cosmetic Techniques ; Humans ; Lipectomy ; Medical Subject Headings ; Necrosis ; Observer Variation ; Postoperative Complications ; Pulmonary Embolism ; Reconstructive Surgical Procedures ; Seroma ; Skin ; Surgery, Plastic ; Sutures ; Venous Thrombosis

BACKGROUND: Abdominoplasty, with or without liposuction, is among the most frequently performed aesthetic procedures. Its main objective is to improve the body contour by means of excising redundant skin and fat tissue. Although abdominoplasty is considered a safe procedure with high satisfaction rates, intraoperative and postoperative complications can become a challenge for the surgical team. The aim of this article is to offer a synopsis of the most common complications arising after abdominoplasty, along with evidence-based guidelines about how to prevent and treat them. METHODS: A systematic MEDLINE search strategy was designed using appropriate Medical Subject Headings (MeSH) terms, and references were scanned for further relevant articles. RESULTS: According to the published case series, local complications are considerably more common than complications with systemic repercussions. Approximately 10% to 20% of patients suffer a local complication following abdominoplasty, while fewer than 1% suffer a systemic complication. Prevention and management strategies are critically discussed for complications including seroma, haematoma, infection, skin necrosis, suture extrusions, hypertrophic scars, neurological symptoms, umbilical anomalies, deep venous thrombosis and pulmonary thromboembolism, respiratory distress, and death. CONCLUSIONS: The complications of abdominoplasty vary in severity and in the impact they have on the aesthetic outcomes. Recommendations for prevention and management are based on various levels of evidence, with a risk of observer bias. However, most complications can be treated appropriately following the current standards, with satisfactory results.
Abdominoplasty* ; Cicatrix, Hypertrophic ; Cosmetic Techniques ; Humans ; Lipectomy ; Medical Subject Headings ; Necrosis ; Observer Variation ; Postoperative Complications ; Pulmonary Embolism ; Reconstructive Surgical Procedures ; Seroma ; Skin ; Surgery, Plastic ; Sutures ; Venous Thrombosis

BACKGROUNDSeroma formation is one of the most common complications after breast cancer surgery. Various risk factors have been evaluated for their associations with the development of seromas in Western populations. However, similar data are not available in Chinese series. Therefore, we sought to investigate the potential risk factors for Chinese breast cancer patients.

METHODSA prospective study of female breast cancer patients undergoing surgery was carried out in Cancer Hospital of Fudan University, Shanghai, China. Univariate analyses were performed by chi-square test or Student's t test or Mann-Whitney test and multivariate analyses by stepwise Logistic regression. The logistic model included age (years), total serum protein concentration (g/L), drainage volume on postoperative day 3 (POD 3; ml) and time to daily drainage volume not more than 30 ml (TTV30; days).

RESULTSA total of 158 patients with breast cancer were studied. The mean age at diagnosis was (52.14 ± 10.77) years (range 25 - 92). During the follow-up period, 24 (15.2%) patients developed seromas. Calculated as continuous variables in the stepwise Logistic regression, age (OR = 1.090, 95%CI 1.028 - 1.155, P = 0.004), total serum protein concentration (OR = 0.886, 95%CI 0.791 - 0.992, P = 0.036), drainage volume on POD3 (OR = 1.013, 95%CI 1.002 - 1.023, P = 0.017) and TTV30 (OR = 1.273, 95%CI 1.039 - 1.561, P = 0.020) were independent risk factors for seroma formation. Additionally, significant difference in daily drainage volume was substantiated in the analysis by seroma formation (P = 0.034) rather than by type of surgery (P = 0.713).

CONCLUSIONSAlthough the pathogenesis of seroma remains controversial, such risk factors as age, nutritional status, drainage volume on POD3 and TTV30 should be considered for prediction and prevention of seroma formation in Chinese breast cancer patients.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Breast Neoplasms ; surgery ; Female ; Humans ; Middle Aged ; Postoperative Complications ; Prospective Studies ; Risk Factors ; Seroma ; etiology

INTRODUCTION: The superiority of laparoscopic repair over open repair of incisional hernias (IHs) in the elective setting is still controversial. Our study aimed to compare the postoperative outcomes of laparoscopic and open elective IH repair in an Asian population. METHODS: This retrospective study was conducted in an acute general hospital in Singapore between 2010 and 2015. Inclusion criteria were IH repair in an elective setting, IHs with diameter of 3-15 cm, and location at the ventral abdominal wall. We excluded patients who underwent emergency repair, had recurrent hernias or had loss of abdominal wall domain (i.e. hernia sac containing more than 30% of abdominal contents or any solid organs). Postoperative outcomes within a year such as recurrence, pain, infection, haematoma and seroma formation were compared between the two groups. RESULTS: There were 174 eligible patients. The majority were elderly Chinese women who were overweight. Open repair was performed in 49.4% of patients, while 50.6% underwent laparoscopic repair. The mean operation time for open repair was 116 minutes (116 ± 60.6 minutes) and 139 minutes (136 ± 64.1 minutes) for laparoscopic repair (P = 0.079). Within a year after open repair, postoperative wound infection occurred in 15.1% of the patients in the open repair group compared to 1.1% in the laparoscopic group (P = 0.0007). Postoperative pain, recurrence and haematoma/seroma formation were comparable. CONCLUSION Elective laparoscopic IH repair has comparable outcomes with open repair and may offer the advantage of reduced postoperative wound infection rates.
Humans ; Female ; Aged ; Incisional Hernia/surgery* ; Surgical Wound Infection/epidemiology* ; Retrospective Studies ; Seroma/surgery* ; Herniorrhaphy/adverse effects* ; Surgical Mesh ; Recurrence ; Hernia, Ventral/surgery* ; Laparoscopy/adverse effects* ; Postoperative Complications/surgery*

This randomized prospective study investigated the effect of fibrin glue use on drainage duration and overall drain output after lumpectomy and axillary dissection in breast cancer patients. A total of 100 patients undergoing breast lumpectomy and axillary dissection were randomized to a fibrin glue group (N=50; glue sprayed onto the axillary dissection site) or a control group (N=50). Outcome measures were drainage duration, overall drain output, and incidence of seroma. Overall, the fibrin glue and control groups were similar in terms of drainage duration, overall drain output, and incidence of seroma. However, subgroup analysis showed that fibrin glue use resulted in a shorter drainage duration (3.5 vs. 4.7 days; p=0.0006) and overall drain output (196 vs. 278 mL; p=0.0255) in patients undergoing level II or III axillary dissection. Fibrin glue use reduced drainage duration and overall drain output in breast cancer patients undergoing a lumpectomy and level II or III axillary dissection.
Adult ; Axilla ; Breast Neoplasms/pathology/*surgery ; Drainage ; Female ; Fibrin Tissue Adhesive/*therapeutic use ; Humans ; *Lymph Node Excision ; *Mastectomy, Segmental ; Middle Aged ; Prospective Studies ; Seroma/epidemiology/etiology ; Severity of Illness Index ; Time Factors ; Tissue Adhesives/*therapeutic use

Breast Neoplasms ; pathology ; radiotherapy ; surgery ; Cone-Beam Computed Tomography ; Dose Fractionation ; Female ; Humans ; Mastectomy, Segmental ; adverse effects ; Neoplasm Staging ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Conformal ; methods ; Respiration ; Seroma ; etiology ; pathology ; Surgical Instruments ; Tumor Burden