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A Study of Mesh Implants Coated with a Biocompatible Polyhydroxyalkanoates Layer
Published in Tatiana G. Volova, Yuri S. Vinnik, Ekaterina I. Shishatskaya, Nadejda M. Markelova, Gennady E. Zaikov, Natural-Based Polymers for Biomedical Applications, 2017
Tatiana G. Volova, Yuri S. Vinnik, Ekaterina I. Shishatskaya, Nadejda M. Markelova, Gennady E. Zaikov
In the Group 2 reference subgroup, with lightweight composite meshes VIPRO II, none of the 29 patients had intra-surgery complications. In the early postoperative period, the following complications were observed: 1 patient (4.5%) had strong pain, which was cured by longer pain-relief medication; 7 patients had seromas: in 5 of them, seromas resolved on their own, and 2 patients underwent ultrasonically monitored puncture drainage. One patient (4.5%) had infiltrate in the subcutaneous layer in the suture site, and in another patient (4.5%), the suture suppurated after seroma puncture. Both conditions were cured conservatively, without explanting the meshes. Thus, early complications were observed in 7 patients, or 31.8%, of the Group 2 reference subgroup. All patients of this group received pain relief medication for 3.0 (3.0, 4.0) days. The hospital stay lasted 9 days (8.0 days, 9.0 days), and the sick leave 27.1±1.36 days. There were no lethal outcomes. No recurrent hernias developed after 12 months. The postoperative sonography at 3–4 weeks, 6 months, and 12 months showed the following: the meshes were clearly visualized in all patients; moderate mesh shrinkage was observed in almost all patients; adequate tissue ingrowth into the mesh was observed. The results of measuring the BFLV of the testicular artery are given in Table 7.6.
Summary of Experience in Radiation Litigation
Published in Kenneth L. Miller, of Radiation Protection Programs, 2020
The report contains a hidden clue as to the reason for the unexpected complication. It records that at the time the patient was referred for treatment, there was persistent drainage from the operative wound. This indicates a seroma or collection of serum in the operative site. This acts as a sterile foreign substance and causes a local increase in vascularity. It is a basic rule of radiobiology that an increase in vascularity or oxygenation increases sensitivity to radiation. Under these circumstances a reaction may appear in the first week of treatment that would not be expected for 3 or 4 weeks. This particular effect is little known, has apparently not appeared in medical literature, and there is no way that Dr. Kline could have known or warned the patient.
Negative-pressure wound therapy – does it lower the risk of complications with closed wounds following breast surgery?
Published in Expert Review of Medical Devices, 2020
Breast cancer affected 55,176 women in the UK in 2015–17, with approximately 44,693 undergoing breast surgery as part of their treatment [1]. There has been significant evolution to surgical methods and practices, but complications remain a problem. Frequent post-operative complications include infection, wound breakdown, skin necrosis, and the formation of seroma and hematoma [2]. The rate of complications is greater with reconstructive surgery, which likely mirrors the degree of tissue dissection, impaired blood flow, and the use of prosthetic materials [3]. There is evidence that smoking [4], radiotherapy [5], obesity [6], and diabetes [7] can all increase the risk of wound complications for patients undergoing breast surgery. Problems with wound healing and skin necrosis cause significant delays to a patient’s recovery and can mean prolonged courses of antibiotics, regular wound dressings, return to theatre, and in severe cases completion mastectomy and removal of an implant. These treatments come with a substantial financial burden, but they can also delay patients starting adjuvant treatments and cause a significant psychological impact on patients [8].