The Drain Dilemma: A Systematic Review and Meta-Analysis of Drain-Free Abdominal Closure With Progressive Tension Sutures Against Drain-Assisted Closure for Abdominal Flaps in Breast Reconstruction.

The use of abdominal drains in donor site closure following breast reconstruction with abdominal flaps is widespread. Our review aimed to compare the outcomes of donor site closure with and without the use of abdominal drains following breast reconstruction with abdominal flaps. Randomized, non-randomized, and observational studies that compared the use of drains vs. no drain in breast reconstruction were included by searching MEDLINE, EMBASE, EMCARE, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL). Four studies enrolling 327 participants were identified. A statistically significant difference was found in terms of duration of hospital stay favouring abdominal closure without the use of drains (MD = -1.15, 95% CI = -1.88 tom-0.42, P=0.002), with a similar difference found in terms of overall complication rate (OR = 0.44, 95% CI = 0.23 to 0.83, p=0.01). Likewise, a statistically significant difference was found favouring abdominal closure without the use of drains for the secondary outcome of operative time (MD = -55.95, 95% CI = -107.19 to -4.74, p=0.03). Abdominal closure without drains following breast reconstructions with abdominal flaps is superior to closure with drains.

Kawasaki Disease: An Unusual Case of a Retrospective Diagnosis in a 39-Year-Old Gentleman With Coronary Ectasias.

Kawasaki disease (KD) was first reported by Dr. Tomisaku Kawasaki in 1967 and is classified as an autoimmune vasculitis of small- and medium-sized arteries. It is usually a self-limited condition occurring in childhood, but it can have complications such as coronary artery aneurysms, myocardial ischemia, and arrhythmias with significant morbidity and mortality presenting later in life. We report a case of a KD presenting in adulthood with late cardiovascular sequelae managed with coronary artery bypass graft.