ABSTRACT
The concept of tissue expansion by the placement of inflatable subcutaneous silicone implants was popularised by Radovan in the late 1970s and is now widely used in clinical practice. After the initial placement of the expander, a series of outpatient visits is required during which the expander is serially inflated. These visits can be very stressful for the patient and are costly in terms of patient transport and clinic time. We present a series of 26 expanders (in eight patients) that were inflated at home by the patient or a relative, and compare the results with those from 30 expanders (in 15 patients) inflated in the outpatient department. The results show that whilst there was a slightly higher incidence of minor infections in the group inflated at home (42% versus 23%, P> 0.05), the overall success rate of the operation was greater in the home-inflation group (96% versus 90%, P> 0.05). However, these differences were not statistically significant. This study provides evidence to support the practice of inflation at home, which is safe, cost effective and less stressful for the patient.
Subject(s)
Self Care , Tissue Expansion/methods , Caregivers , Child , Female , Humans , Male , Patient Education as Topic , Patient Satisfaction , Retrospective Studies , Surgical Wound Dehiscence/etiology , Tissue Expansion/adverse effects , Treatment Outcome , Wound Infection/etiologyABSTRACT
The aim of this review was to assess the use of dilute adrenaline infiltration in reduction mammaplasty and to determine whether it had any associated complications. The closed technique for adrenaline infiltration was used with no reported infection. One hundred breast reductions in 50 patients were compared by dividing them into two groups of 25 patients each. Group A had 1:500,000 adrenaline in normal saline infiltration; group B did not. Both groups were matched equally for age and general health. Results showed that blood loss was less for group A when measured by the fall in postoperative hemoglobin (2.5 g per deciliter vs. 3.5 g per deciliter). This was statistically significant (p < 0.05). There was no significant difference in postoperative drainage (group A, 158 ml; group B, 182 ml). Group A required fewer blood transfusions (two vs. eight), without the risk of increased complications. Blood transfusions were given in the earlier part of the study, but currently are rarely needed. Adrenaline infiltration at this dilution is virtually free from any side effects. It decreases intraoperative blood loss and facilitates the operation without the need for blood transfusion.
