Role of capitonage and fibrin sealant in reducing seroma formation after breast conservation surgery: a randomized clinical trial

Seroma formation is a common complication after breast cancer surgery. Several techniques such as tube drainage, fibrin sealant and suturing methods have been employed to prevent or reduce seroma formation. Capitonnage, a suturing method widely used following hydatid cyst removal, has been used after breast surgery in limited studies. Our aim was to compare the effectiveness of tube drainage, fibrin sealant and capitonnage to prevent early complications. Eligible patients with breast cancer who were candidate for breast conserving surgery were enrolled and randomized into three different groups [tube drainage, capitonnage, capitonnage plus fibrin sealant]. Patients were visited on 5[th],12[th] and 19[th] days after surgery and were assessed for any probable complications. A total of 90 patients were enrolled. One patient developed seroma in tube drainage and capitonnage group, while no participant from capitonnage plus fibrin sealant group experienced the mentioned complication. Three patients developed skin necrosis, all of them were treated with capitonnage plus fibrin sealant protocol. Based on our observations, it seems that capitonnage alone or in combination with fibrin sealant do not lead to significant differences in frequency of complications after breast cancer surgery such as hematoma, seroma and surgical site infection

[Relation between homocysteine and peripheral vascular atherosclorosis: a brief report]

The purpose of this study was evaluation of risk factors of peripheral artery disease [PAD] and effective markers on it. This descriptive-analytical study was done during 2010-2011 in the surgical units of Khorramabad Shohada Hospital. Fifty patients who had symptoms of PAD undergoing CT angiography and biochemical markers for them were measured. The investigated variables were family history, site of arterial obstruction, underlying diseases, smoking history, physical activity and stress level. A control group was considered for the study. The comparison was made between these two groups. Aging showed a significant role in prediction of PAD [70% sensitivity and 64% specificity]. Homocysteine had the highest sensitivity [80%] in prediction of PAD, compared with other biomarkers. CRP [74% sensitivity] was the best marker that had positive predictive value for PAD. Fasting blood sugar [FBS] showed a significant role in prediction of true positive cases of PAD [72% sensitivity and 74% specificity]. HbA1C with68% sensitivity and 64% specificity and TG with 50% sensitivity and 44% specificity could be considered as factors related with PAD. The levels of C-Reacative protein, homocysteine, and FBS were correlated with PAD, HbA1C and TG levels were associated with PAD, but lower than the previously named markers. In this study a significant relationship between lipoprotein levels and PAD was also observed. PAD was associated with sex and age.