ABSTRACT
Objective To investigate the cause,prevention methods and curative effect on two different drainage methods of subcutaneous effusion after breast cancer surgery.Methods The clinical data of 68 cases subcutaneous effusion among 2 100 cases underwent breast cancer modified radical surgery in our hospitial were analyzed retrospectively from January 2010 to December 2016.The vacuum sealing drainage was performed in 1 032 cases and wound high negative pressure drainage system was performed in 1068 casess.Both the elastic bandage compresstion dressing didn't used.Results In 2 100 cases,68 cases of subcutaneous effusion occured (3.2％),including longitudinal incision 48 cases and transverse incision 20 cases.Among 1 068 cases of high negative pressure drainagesystem,subcutaneous effusion occured in 36 cases including 28 cases of incisional infection and 8 cases of skin flap necrosis.The extuhation time was 8-36 days,average 12 days.Among 1 032 cases of vacuum sealing drainage,subcutaneous effusion occured in 32 cases including 22 cases of incisional infection,10 cases of skin flap necrosis.The extubation time was 6-12 days,average 8 days.All cases were followed up for 3 months,no subcutaneous effusion and axillary effusion occurred.Conclusions Adequate drainage is the key to prevent subcutaneous effusion.Both vacuum sealing drainage and wound high negative pressure drainage can effectively reduce the occurrence of subcutaneous effusion,however,vacuum sealing drainage is more suitable for wounds with more exudation,larger lacuna and deeper incisions,especially the infected wound and abscess.
ABSTRACT
Objective To summarize the experience ofmultidisciplinary team (MDT) in diagnosis and treatment of complicated and refractory thyroid tumors.Methods A retrospective review was performed on clinical data of 46 cases with complicated and refractory large thyroid tumors admitted to our hospital from Jan.2010 to Dec.2016.There were 23 cases in MDT group and 23 cases in the control group,respectively.The MDT group received diagnosis and treatment provided by multidisciplinary team during perioperative period whereas the control group received conventional surgery.Results Short-term complications such as trouble breathing and thyroid crisis were not observed in 46 patients after surgery.In the control group,the mean durations were (52±11.5)minutes for anesthesia,(159±38.1) minutes for surgery and (11 ±3.5) days for hospital stay,respectively.After surgery,bleeding occurred in 5 cases,hoarseness in 5 cases,irritating cough when drinking in 7 cases,transient hypocalcemia in 8 cases,permanent hypocalcemia in 6 cases,and neck tracheotomy due to tracheomalacia during surgery in 2 cases.In MDT group,the mean durations were (37±8.5) minutes for anesthesia,(134±28.5) minutes for surgery and (7±1.5) days,respectively.After surgery,bleeding occurred in 0 case,hoarseness in 0 case,irritating cough when drinking in 1 case,transient hypocalcemia in 2 cases,permanent hypocalcemia in 0 case,and neck tracheotomy due to tracheomalacia during surgery in 4 cases.Conclusion Application of multidisciplinary team in diagnosis and treatment of complicated and refractory thyroid tumors can reduce duration of preoperative endotracheal anesthesia as well as surgery,decrease postoperative complications,shorten duration of hospitalization and improve life quality after surgery.