[Effect of closed drainage system on edema and ecchymosis following rhinoplasty: a randomized clinical tria]

The aim of this study was to minimize edema and ecchymosis following rhinoplasty through a closed drainage system to address concealed hemorrhage. This study was designed as a prospective, double blinded, randomized controlled study. Fifty one patients who underwent septorhinoplasty were included in this study and divided in two groups. In group A, a closed drainage system was applied in the most dependent posterior septal area following septal harvesting. Concealed bloody secretions were drained out of mouth in a vacutaner tube during three concecutive post operative days. In control group, group B, exactly the same classic rhinoplasty operation by the same surgeon was done as for study group except omitting the closed drainage system. Degree of supra-tip and eyelid edema was evaluated on post operative days through photographic and software image analysis. Edema and ecchymosis rating of eyelids and ecchymosis of paranasal and cheek area done based on photographic analysis by independent plastic surgeons using a defined grading system. Eyelid ecchymosis was reduced significantly on post operative day 14 in the study group [P=0.03]. Ecchymosis of paranasal and check was reduced considerably likewise on days 7 and 14 in group A using Mann-Whitney test [P=0.03]. There was no significant deference regarding supra tip edema on post operative days. The same hold true for the eyelids edema. Significant decrement observed in eyelids ecchymosis on day 14 and paranasal and cheek ecchymosis on postoperative days 7 and 14 in study group. There were no positive effects regarding supra tip and eyelid edema reduction using closed drainage system to evacuate concealed haemorrhage in posterior septum space. There could be different etio-pathologies for two common morbidities following rhinoplasty that should be addressed separately.

Anaplastic large cell lymphoma associated with breast implant: a case report

Primary breast lymphoma represents less than 1% of all primary breast malignancies and most primary breast lymphomas are of B-Cell origin. The association of anaplastic lymphoma kinase [ALK] negative anaplastic large cell lymphoma [ALCL], a very rare form of primary breast lymphoma, with silicone-filled breast implants has been suggested and several case reports supported this proposal, especially in Western countries. Here we describe one of the first cases of primary breast ALK-negative ALCL in association with saline-filled silicone breast implants evaluated in Iran, where the rising number of breast reconstructive and aesthetic surgeries would commit both surgical pathologists and plastic surgeons to be familiar with this entity

synergistic effect of bleomycin, triamcinolone and epinephrine in treatment of hemangioma and arteriovenous malformations

Hemangioma is the most common tumor of neonatal period and it is almost always appeared by the end of the first week of life and can be found mostly in head and neck area. This study evaluated the synergistic effect of bleomycin, triamcinolone and epinephrine in treatment of hemangioma and arteriovenous malformations. In this multicenter study, a combination of bleomycin, triamcinolone and epinephrine was injected intralesionaly for treatment of hemangiomas and arteriovenous malformations and their synergistic effect was evaluated in 32 patients. Hemangiomas and low-flow arteriovenous malformations were treated well with their combination while port-wine spots and high-flow lesions response were relatively poor. It seems that the combination of bleomycin, triamcinolone and epinephrine may be a good choice in treatment of hemangioma and arteriovenous malformations