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Complications of open aortofemoral bypass
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
The most common complication is a seroma/lymphocele, which are terms often used interchangeably in both definition and treatment paradigm, though there is a slight difference. A seroma occurs when there is dead space and/or a reaction to a foreign body, such as the graft. The inflammatory response within the surrounding tissues leads to a transudate of serous fluid, which has a straw-colored appearance and consistency to similar pleural or peritoneal fluid. A lymphocele occurs specifically when lymphatic channels are not appropriately ligated or cauterized during dissection of the groin, resulting in a nonepithelialized collection of lymph. Clinically they can appear the same—a soft, ballotable bulge in the groin, usually without overlying skin changes. This can easily be distinguished from a hematoma as the hematoma appears more heterogeneous and dense on imaging, whereas a lymphocele or seroma appears cystic. A lymphatic fistula can develop if the lymphocele develops a cutaneous communication, manifesting as the drainage of crystal clear fluid from a small sinus, usually in the incision. The amount of fluid can be voluminous or only a few drops expressed with movement or manipulation depending on the size of the draining lymphatic channels.
Rhabdomyosarcoma
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Gideon Sandler, Andrea Hayes-Jordan
Complications include wound infection and postoperative bleeding, which should occur in <5% patients. Seroma may occur and should be aspirated if symptomatic. Following sentinel lymph node biopsy in the inguinum or axilla, lymphedema occurs in ∼5% patients but is not usually clinically signficant. Occasionally, it needs to be addressed with compression garments, physiotherapy, and skin care.
Additional Pre-operative Considerations and Techniques
Published in Jeff Garner, Dominic Slade, Manual of Complex Abdominal Wall Reconstruction, 2020
Danette Wright, Charlotte Ralston, Dominic Slade
Seromas are more problematic in that they are often initially asymptomatic and may resolve with conservative management; if percutaneous drainage is considered it should be performed with strict aseptic technique and aspiration, and subsequent pressure dressings are more effective and carry a lower risk of introducing infection than placement of a permanent drain.22 Repeated drainage, however, significantly increases the potential for subsequent infection. An infected seroma in continuity with a synthetic mesh should be treated immediately with antibiotics and washout in theatre.
Proton therapy for early breast cancer patients in the DBCG proton trial: planning, adaptation, and clinical experience from the first 43 patients
Published in Acta Oncologica, 2022
Maria Fuglsang Jensen, Line Bjerregaard Stick, Morten Høyer, Camilla Jensenius Skovhus Kronborg, Ebbe Laugaard Lorenzen, Hanna Rahbek Mortensen, Petra Witt Nyström, Stine Elleberg Petersen, Pia Randers, Linh My Hoang Thai, Esben Svitzer Yates, Birgitte Vrou Offersen
Two-third of the patients received a plan adaptation, hereof 29% two adaptations and one patient five adaptations. Most of the adaptations were due to swellings caused by either physiological changes or systematic changes in the immobilization of the ipsilateral arm leading to an increased breast size. A total of 40 plan adaptations were made: 12 due to shrinkage, 24 due to swelling, and 4 for other reasons, such as a high maximum dose or other smaller adjustments. For most patients, the anatomical changes evolved over 5–6 days or more, while for patients with seroma the change could be on daily basis. There was no trend when the changes occurred during the course of treatment. Two patients referred to irradiation shortly after surgery, had their seroma drained several times weekly, leading to plan adaptations that swapped back and forth between plans on CT scans with either high or low filling.
Elastofibroma dorsi: a case report of bilateral occurrence and review of literature
Published in Acta Chirurgica Belgica, 2021
Glenn De Weerdt, Veronique Verhoeven, Ina Vrints, Filip Thiessen, Thierry Tondu
Elastofibroma dorsi is a benign connective tissue tumor that most frequently appears subscapular as shown in this case. It is not uncommon for it to present bilaterally, thus excluding malignancy. Therefore, it is judicious to carefully examine the contralateral side. But one has to be aware that ED does not necessary affect both sides simultaneously. In order to diagnose ED and differentiate from other tumors MRI is ought to be sufficient, making tissue biopsy obsolete. In order to treat this condition and resolve the corresponding symptoms, complete surgical excision should be carried out. If taken under consideration such a surgical procedure, one has to be aware of the high risk of seroma formation, as occurred in this case on both sides. That is why we recommend to only excise symptomatic ED after carrying out radiological investigation (MRI) as postulated in our flow chart.
An Investigation of a Novel Tendon Transfer Surgery for High Median-Ulnar Nerve Palsy in a Chicken Model
Published in Journal of Investigative Surgery, 2019
Geoffrey R. Browning, Anthony H. Le, Jennifer J. Warnock, Ravi Balasubramanian
Minor postoperative complications were noted in all the animals that underwent surgery. This included seroma formation in all the chickens that underwent surgery, suspected surgical site infection in two chickens, and partial wound dehiscence in two chickens. Seromas were suspected based on the presence of varying degrees of soft tissue swelling with serosanguinous discharge. Seromas resolved within sixteen days postoperatively in all animals. Purulent discharge from the surgical site was noted in one animal in the implant group and one in the sham group on Day 3 and 7 postoperatively. Each incision was cleaned with betadine and saline aseptically and enrofloxacin was administered intramuscularly for an additional day. Purulent discharge was not noted at the subsequent bandage changes in both animals. Two chickens in the implant group experienced partial minor wound dehiscence. In each chicken, a 2- to 3-millimeter defect was noted along the incision line a few days postoperatively. The incision sites were cleaned with betadine and saline aseptically for two days. Both chickens healed without further complication.