Clinical Research Directory

Single Versus Double Drains in the Axillary and Pectoral Regions After Modified Radical Mastectomy

Normally, after this surgery, skin is stitched in the usual simple way, with no quilting, and two drains are put in to remove serosa, one under the arm and one on the chest. In this study, the investigator will use a different type of stitch called a quilting stitch, which helps stick the skin to the chest muscle so there is less serosa collection. The investigator will compare two groups: * Group A: Quilting stitches with two drains (one under the arm and one on the chest). * Group B: Quilting stitches with one drain only (under the arm).

Pseudomonas Aeruginosa Injection Combined With Polyvinylpyrrolidone-Iodine in Immediate Breast Reconstruction Surgery With Implants

Brief Summary This study hypothesizes that in immediate breast reconstruction following tumor resection, the application of inactivated Pseudomonas aeruginosa preparation (PAP) may reduce infection rates by decreasing postoperative drainage output and shortening drainage tube removal time. Additionally, the local aseptic inflammation induced by PAP may promote fibrous capsule formation around the implant, shorten postoperative shaping time, and improve patients' quality of life and satisfaction. To test this hypothesis, the investigators designed a study to evaluate the efficacy of PAP compared with PI/TAB irrigation alone. Primary endpoints include drainage tube removal time and capsular contracture rate (assessed by Baker grade). Secondary endpoints include infection rate, total drainage volume, and postoperative BREAST-Q scores. Different concentrations of PAP will also be evaluated to determine the optimal therapeutic concentration. Detailed Description Postoperative infection rates in breast implant procedures range from 1% to 35%. Infection necessitates antibiotic treatment, may lead to unnecessary reoperations, and contributes to patient dissatisfaction. Inflammation and infection around the implant can promote biofilm formation, leading to capsular contracture (CC) following breast implant surgery. In patients undergoing breast reconstruction after tumor resection, postoperative infection may also delay adjuvant cancer treatment. Consequently, various antimicrobial irrigation solutions are routinely employed in immediate breast reconstruction after cosmetic surgery or tumor resection to reduce infection and CC rates, including 10% povidone-iodine (PI) and triple antibiotic solutions. PI irrigation was first introduced by Burkhardt et al. in the 1980s for cosmetic breast surgery, followed by the development of a broader-spectrum triple antibiotic solution (TAB) by Adams et al. In 2000, the FDA prohibited the use of PI with breast implants due to concerns regarding higher contracture rates and potential degradation of silicone implants. Subsequent research by Adams et al. led to the development of a PI-free irrigation solution (TAB), which demonstrated comparable efficacy, albeit with slightly reduced coverage against Gram-negative bacteria. In August 2017, based on accumulated long-term data, the FDA lifted the restriction on PI use with implants, permitting its application for bacterial/biofilm mitigation and antimicrobial prophylaxis. Subsequent studies comparing the antimicrobial efficacy of PI and TAB have yielded mixed results, and a meta-analysis found no significant difference in CC rates between the two irrigation methods. However, the FDA withdrew bacitracin injections in 2020 due to safety concerns. As a result, standardization of antimicrobial irrigation solutions for implant-based immediate breast reconstruction remains lacking. Notably, immediate reconstruction following tumor resection differs fundamentally from cosmetic surgery. For instance, the 14-point plan for cosmetic breast surgery recommends avoiding drainage tubes, a practice often unfeasible in immediate reconstruction, where two drainage tubes are typically placed for 4-7 days postoperatively. Breast surgeons aim to minimize drainage tube duration owing to the increased risk of surgical site infection (SSI). In immediate reconstruction, capsule formation time is prolonged compared with augmentation surgery, potentially leading to implant displacement and contracture. PAP, derived from an inactivated PA-MSHA strain, has been shown by Long et al. to reduce postoperative drainage and shorten drainage tube removal time. PAP may also promote fibrous capsule formation, thereby reducing infection rates and improving patients' quality of life.

Comparing Outcomes Of Single Layer Versus Multilayer Leg Closure Techniques Following Great Saphenous Vein Harvesting For CABG

This study aims to address the knowledge gap by comparing the outcomes of single-layer and multi-layer leg closure techniques following great saphenous vein harvesting for Coronary artery bypass grafting. Research question: 1. Does single-layer closure compared to multi-layer closure result in better postoperative outcomes in patients undergoing great saphenous vein harvesting for CABG 2. To evaluate the incidence of postoperative complications (e.g., infection, hematoma, wound dehiscence, seroma) associated with single-layer vs. multi-layer closure techniques. participants will follow in OPD after 1 week , their wounds will be examined and assessment will be recorded.

Use of Glubran 2 ® in Axillary Lymphadenectomy Without Drain

Axillary lymphadenectomy in breast cancer continues to be a common practice in certain patients. The use of sealants and drains continues to be a source of disagreement among the scientific community. That is why the study was designed to show whether the sealant reduces seroma after axillary lymphadenectomy without drainage.