Navegando por Palavras-chave "seroma"

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    Estudo comparativo do uso de drenos de secção e pontos de tensão progressiva na prevenção de seromas e infecções de ferida operatória após correção cirúrgica de hérnias incisionais volumosasEnsaio clínico randomizado
    (Universidade Federal de São Paulo (UNIFESP), 2014-02-26) Westphalen, Andre Pereira [UNIFESP]; Lopes Filho, Gaspar de Jesus Lopes Filho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To carry out a comparative study between the use of tubular drains in closed suction system and the use of progressive tension sutures in patients with large incisional hernias, undergoing hernia repair with onlay positioned mesh, in order to evaluate the post operative seromas and wound infection as endpoints. Methods: From May to December 2012, forty two patients with incisional hernias (5 -15 cm length) underwent surgical repair with onlay placement of mesh as described by Chevrel, at Western Parana University Hospital. After mesh placement, patients were electronically randomized in two groups. In group I, closed suction subcutaneous drains were used in the patients. In group II, progressive tension stitches were used, as described by Pollock. Patients were clinically evaluated regarding seromas and wound infection during the first 30 days after surgery. Ultrasound of abdominal wall was used in the following periods: 4 -6 postoperative days (early period), 14 – 15 postoperative days (intermediary period) and 29 – 30 postoperative days (late period) to evaluate seroma formation. Results: Both groups were similar in regard to gender, age, body mass index, smoking, cardiologic risk factors, serum albumin levels, hernia size, subcutaneous thickness, hernia defect area, surgical time and seroma incidence in the early, intermediary or late periods. The highest incidence of seromas detected by ultrasound was in the intermediary period (52.4%), although 33.4% were clinically detectable. There was no statistical difference among incidences of seroma in non period between the studied groups. Wound infection rate in nine patients was 21.4%. There was no statistical difference in wound infection between the studied groups. The results of univariate tests have shown that the presence of infection on the 30th postoperative day was not associated to the use of drain or progressive tension sutures. Conclusion: There was no significant difference in incidence of seromas, either detected clinically or by ultrasound, as well as in wound infection incidence between the groups using closed suction subcutaneous drains or progressive tension sutures, in patients undergoing large incisional hernia repair using onlay technique.
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    The influence of the initiation of an exercise programme on seroma formation and dehiscence following breast cancer surgery
    (Wiley-Blackwell, 2014-11-01) Petito, Eliana L. [UNIFESP]; Esteves, Marcella T. [UNIFESP]; Elias, Simone [UNIFESP]; Facina, Gil [UNIFESP]; Nazario, Afonso C. P. [UNIFESP]; Gutierrez, Maria G. R. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Aims and objectives. To verify whether early (first post-operative day) or late initiation (after removal of the continuous suction drain) of a functional rehabilitation exercise programme influences the incidence of seroma formation and dehiscence for women after breast cancer surgery.Background. Benefits of early implementation of an exercise programme initiated with women in the first days following breast cancer surgery are widely known. However, the safe initiation of the exercises is still a controversial issue and some authors correlate early initiation of the exercises with an increase in seroma formation.Design. A prospective, randomised, controlled clinical trial.Methods. Seventy-seven women were randomly assigned to initiate the programme on post-operative day 1 (early group = 40) or after removal of the drain (late group = 37) and were monitored until the 45th post-operative day. Patients in the early group were instructed to perform the exercises daily at home, beginning on post-operative day 1, while those of the late group began the exercises after the drain was removed. the assessment for seroma formation and dehiscence was performed on post-operative days 7 and 45.Results. There was no statistically significant difference regard to seroma formation between early group and late group. Also there was no association between the presence of dehiscence and early exercises.Conclusion. the early initiation of the exercises for women, following breast cancer surgery, constitutes a safe practice for the rehabilitation. However, these findings need to be further explored and confirmed in a larger sample.Relevance to clinical practice. Studies showing evidence that early functional rehabilitation process is a safe practice for women having surgery for breast cancer, as well as the present research, are of interest to health professionals who care for these patients and contribute to the wider global clinical community.