Effect of quilting sutures on hematoma formation after liposuction with dermal curettage for treatment of axillary hyperhidrosis: a randomized clinical trial.

BACKGROUND: Liposuction provides further reduction of axillary sweating and malodor when combined with dermal curettage with sharp rasping cannulas. This aggressive approach is associated with relatively higher rate of hematoma formation when compared to the conventional simple liposuction. OBJECTIVE: The aim of this prospective, randomized, controlled trial was to evaluate the effect of quilting sutures on the incidence of hematoma formation after liposuction-curettage for treatment of axillary hyperhidrosis (AH). MATERIALS AND METHODS: The trial randomized 59 male patients (118 axillae) undergoing liposuction-curettage for AH to quilting procedures (61 axillae) or control group (57 axillae) for intention-to-treat analysis. Outcome measures included the incidence of hematoma formation, operative time, degree of postoperative pain, and amount of analgesics consumption. RESULTS: Quilting sutures significantly reduced the incidence of axillary hematoma from 28.1% to 4.9%. Quilting was associated with the lengthening of operative time but did not affect the postoperative pain. CONCLUSION: Considering its efficacy in reducing postoperative hematoma, quilting is recommended in combination with aggressive liposuction-curettage procedure for treating AH and osmidrosis.

Species identification and strain differentiation of dermatophyte fungi using polymerase chain reaction amplification and restriction enzyme analysis.

BACKGROUND: Standard biochemical tests, microscopy, colony characteristics, and mating tests have conventionally been used for the identification of dermatophytes species, but these methods of identification are costly, time-consuming, and require special skills. OBJECTIVE: Our purpose was to identify a method that enables rapid species identification and strain differentiation of dermatophyte fungi. METHODS: We chose 4 restriction enzymes (BsYiI, DdeI, HinfI, and MvaI) that could produce different fragment patterns after enzyme digestion according to species or strain. We performed enzyme digestions after polymerase chain reaction amplification of internal transcribed spacer region and identified different restriction fragment length polymorphisms (RFLP) according to species and strains. RESULTS: All the species included in this study could be easily differentiated using any combination of 2 different restriction enzymes except Trichophyton rubrum and T raubitschekii, which produced identical digestion patterns after all 4 restriction enzyme digestions. In the case of T mentagrophytes, MvaI and DdeI each produced 2 distinct RFLP patterns. CONCLUSION: This study showed that internal transcribed spacer region analysis using polymerase chain reaction-RFLP through DdeI and MvaI is useful for rapid identification of the majority of dermatophytes species. However, there were 2 different band patterns by DdeI and MvaI restriction enzyme digestion and no correlations between morphologic types and RFLP patterns in T mentagrophytes.