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Questions and Answers
What are common postoperative complications after plastic surgery procedures?
What are common postoperative complications after plastic surgery procedures?
Hematomas and seromas
Which hemostatic agents were evaluated in the study?
Which hemostatic agents were evaluated in the study?
The nonhemostatic agent group experienced a higher incidence of complications compared to the hemostatic agent group.
The nonhemostatic agent group experienced a higher incidence of complications compared to the hemostatic agent group.
True
The incidence of seroma in the nonhemostatic agent group was _____%.
The incidence of seroma in the nonhemostatic agent group was _____%.
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What is the significance of the Jackson-Pratt (JP) drain output in this study?
What is the significance of the Jackson-Pratt (JP) drain output in this study?
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What was the mean duration of JP drain use for the combination powder (CP) group in breast reduction procedures?
What was the mean duration of JP drain use for the combination powder (CP) group in breast reduction procedures?
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The use of hemostatic agents in general plastic surgery procedures significantly reduced time to JP drain removal.
The use of hemostatic agents in general plastic surgery procedures significantly reduced time to JP drain removal.
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What complications did the CP group experience in breast reduction procedures?
What complications did the CP group experience in breast reduction procedures?
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The study aimed to evaluate the _____ of postoperative bleeding complications.
The study aimed to evaluate the _____ of postoperative bleeding complications.
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What was the average follow-up time for patients using no hemostatic agent after breast reduction?
What was the average follow-up time for patients using no hemostatic agent after breast reduction?
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What was the average time with JP drain for patients undergoing abdominoplasty with HEMOBLAST Bellows?
What was the average time with JP drain for patients undergoing abdominoplasty with HEMOBLAST Bellows?
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What was the average specimen weight for patients who had an abdominoplasty using EVICEL (FS)?
What was the average specimen weight for patients who had an abdominoplasty using EVICEL (FS)?
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What percentage of patients experienced seromas after breast reduction with no hemostatic agent?
What percentage of patients experienced seromas after breast reduction with no hemostatic agent?
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The study indicated that the use of hemostatic agents showed a statistically significant improvement in reducing the time to JP drain removal.
The study indicated that the use of hemostatic agents showed a statistically significant improvement in reducing the time to JP drain removal.
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What is the recommended action by the American Society of Plastic Surgeons regarding the routine use of drains in standard reduction mammaplasty?
What is the recommended action by the American Society of Plastic Surgeons regarding the routine use of drains in standard reduction mammaplasty?
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The average time with JP drains for patients using no hemostatic agent was ____ days in the abdominoplasty group.
The average time with JP drains for patients using no hemostatic agent was ____ days in the abdominoplasty group.
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What was the average follow-up time for patients after using HEMOBLAST Bellows in abdominoplasty?
What was the average follow-up time for patients after using HEMOBLAST Bellows in abdominoplasty?
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What was the percentage of hematoma occurrence for abdominoplasty patients using HEMOBLAST Bellows?
What was the percentage of hematoma occurrence for abdominoplasty patients using HEMOBLAST Bellows?
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What was the average specimen weight for breast reduction patients using no hemostatic agent?
What was the average specimen weight for breast reduction patients using no hemostatic agent?
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What was the average duration for JP drain removal in breast reduction surgeries using hemostatic agents?
What was the average duration for JP drain removal in breast reduction surgeries using hemostatic agents?
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What is the reported complication rate for hematomas in breast reduction surgeries?
What is the reported complication rate for hematomas in breast reduction surgeries?
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In abdominoplasty/panniculectomy operations, what is the reported occurrence rate of seromas?
In abdominoplasty/panniculectomy operations, what is the reported occurrence rate of seromas?
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What is one of the common postoperative complications after plastic surgery procedures mentioned?
What is one of the common postoperative complications after plastic surgery procedures mentioned?
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Which surgical procedure shows a higher rate of seroma formation compared to the other mentioned?
Which surgical procedure shows a higher rate of seroma formation compared to the other mentioned?
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What was the primary focus of the study regarding hemostatic agents in plastic surgery?
What was the primary focus of the study regarding hemostatic agents in plastic surgery?
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Which types of surgeries were included in the patients' evaluations for this study?
Which types of surgeries were included in the patients' evaluations for this study?
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What was identified as a benefit of using hemostatic agents in the study?
What was identified as a benefit of using hemostatic agents in the study?
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Which hemostatic agent combination was mentioned in the study?
Which hemostatic agent combination was mentioned in the study?
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What was the result regarding the length of JP drain use in the groups using hemostatic agents?
What was the result regarding the length of JP drain use in the groups using hemostatic agents?
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What trend was observed regarding hematomas and seromas when using hemostatic agents?
What trend was observed regarding hematomas and seromas when using hemostatic agents?
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What type of study design was implemented to evaluate the effects of hemostatic agents?
What type of study design was implemented to evaluate the effects of hemostatic agents?
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What was the purpose of evaluating the use of the Jackson-Pratt (JP) drain in this study?
What was the purpose of evaluating the use of the Jackson-Pratt (JP) drain in this study?
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What was a significant factor influencing the removal time of drains in the study?
What was a significant factor influencing the removal time of drains in the study?
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How did the hemostatic agent affect the duration of JP drain use?
How did the hemostatic agent affect the duration of JP drain use?
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What was the incidence rate of seroma for the nonhemostatic agent group?
What was the incidence rate of seroma for the nonhemostatic agent group?
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What was one outcome for the CP group during the study?
What was one outcome for the CP group during the study?
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What complication was recorded for the hemostatic agent group?
What complication was recorded for the hemostatic agent group?
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What was the reported incidence of hematoma for the nonhemostatic group?
What was the reported incidence of hematoma for the nonhemostatic group?
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What was the primary aim of the study?
What was the primary aim of the study?
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Which complication showed a 4.5% incidence in the CP group?
Which complication showed a 4.5% incidence in the CP group?
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What is one common method used for the early detection of hematoma formation?
What is one common method used for the early detection of hematoma formation?
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Which type of drain is mentioned as used intraoperatively for detecting complications?
Which type of drain is mentioned as used intraoperatively for detecting complications?
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What is a typical goal of using devices like FSs or glues during surgery?
What is a typical goal of using devices like FSs or glues during surgery?
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What statistical method was used to compare postoperative complications in the study?
What statistical method was used to compare postoperative complications in the study?
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Which of the following substances is NOT mentioned as a hemostatic agent developed for surgical use?
Which of the following substances is NOT mentioned as a hemostatic agent developed for surgical use?
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What is the primary purpose of using negative pressure wound vacuum systems?
What is the primary purpose of using negative pressure wound vacuum systems?
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What was the significance of the duration of JP drain use in the breast reduction procedure among groups?
What was the significance of the duration of JP drain use in the breast reduction procedure among groups?
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Which findings indicate a need for institutional review board approval?
Which findings indicate a need for institutional review board approval?
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Which technique was used for breast reductions according to the surgical method described?
Which technique was used for breast reductions according to the surgical method described?
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What is one potential complication that can occur post-surgery which these devices aim to mitigate?
What is one potential complication that can occur post-surgery which these devices aim to mitigate?
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What was the incidence of seroma in the nonhemostatic agent group for abdominoplasty and panniculectomy procedures?
What was the incidence of seroma in the nonhemostatic agent group for abdominoplasty and panniculectomy procedures?
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What does the Caprini score assess in the context of these surgeries?
What does the Caprini score assess in the context of these surgeries?
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What was notably absent in the CP group postoperatively compared to the FS group?
What was notably absent in the CP group postoperatively compared to the FS group?
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What was the primary concern regarding the patient's condition before the operative closure of incision sites?
What was the primary concern regarding the patient's condition before the operative closure of incision sites?
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What factor did not significantly correlate with complications in the reviewed procedures?
What factor did not significantly correlate with complications in the reviewed procedures?
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What type of anesthesia was administered preoperatively for postoperative analgesia?
What type of anesthesia was administered preoperatively for postoperative analgesia?
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Study Notes
Hemostatic Agents in Plastic Surgery
- Hematomas and seromas are common complications after plastic surgeries, negatively impacting wound healing and patient recovery
- This study examines the use of hemostatic agents fibrin sealant (FS) and combination powder (CP) to reduce bleeding complications in breast reduction, panniculectomy and abdominoplasty
- Study design: Retrospective chart review of patients undergoing these procedures with and without hemostatic agents from January 2015 to September 2020, comparing drain removal time, complications and specimen weight
- Hemostatic agents were used sequentially, initially without, then FS starting June 2017 and then CP starting August 2019
- Both FS and CP resulted in reduced time needed for JP drain removal and fewer recorded complications compared to the no hemostatic agent group
- Notably, breast reduction with CP use resulted in significantly shorter JP drain duration compared to FS (3.46 days vs. 6.92 days, P < 0.01)
- There was no statistically significant difference in hematoma and seroma rates between the FS and CP groups
- Though not statistically significant, patients who received CP had no hematomas, seromas, or returns to OR for breast reductions and abdominoplasty/panniculectomy procedures, compared to rates in the FS group (breast reduction: 4.5% seroma, 1.5% hematoma; abdominoplasty/ panniculectomy: 1% hematoma, 1% seroma, 1% return to OR)
- The use of hemostatic agents (CP and FS) had a statistically significant reduction in time to JP drain removal and lower bleeding complications overall
- Limitations include a single-surgeon case database and use of different agents at different times with variation in caseload, requiring further studies with standardized and comprehensive data from multiple centers
- While sample size is not explicitly stated, the total number of patients exceeds a hundred (n=61+61+26+ 14 + 66 + 4 + 26 + 14 = 267)
Hemostatic Agents: FS and CP
- FS: Fibrin sealant based product, contains human fibrinogen and thrombin, FDA approved for surgical hemostasis
- CP: Contains human-derived thrombin, porcine-derived collagen and chondroitin sulfate, known to provide cohesion to the wound, potentially contributing to clot formation and promoting wound healing
- CP is believed to potentially have superior immediate hemostasis compared to FS in various surgical fields
Study Implications
- Results suggest hemostatic agents may be beneficial in reducing postoperative complications and improving patient recovery
- Further research with larger, standardized studies is needed to confirm these findings and determine the specific benefits of each hemostatic agent
Hemostatic Agents & Postoperative Complications in Plastic Surgery
- The study investigated the effects of hemostatic agents in reducing postoperative complications like hematomas and seromas in plastic surgery.
- The study included patients undergoing breast reduction, panniculectomy, or abdominoplasty.
- Hemostatic agents used were fibrin sealant (FS) and combination powder (CP).
- Data collected included postoperative complications, time to Jackson-Pratt (JP) drain removal, and specimen weight.
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Findings:
- Hemostatic agent use reduced time for JP drain removal and overall postoperative complications.
- Breast Reduction: The CP group showed significantly shorter JP drain duration (3.46 days) compared to the FS group (6.92 days).
- Abdominoplasty/Panniculectomy: The CP group had no hematomas, seromas, or return to the operating room (OR) compared to the FS group, which had one instance each.
- Conclusion: Hemostatic agents can be valuable in reducing postoperative bleeding complications in general plastic surgery procedures.
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Description
This quiz explores the efficacy of hemostatic agents, specifically fibrin sealant and combination powder, in reducing complications during breast reduction, panniculectomy, and abdominoplasty. It examines a retrospective study comparing outcomes such as drain removal time and complication rates before and after the introduction of these agents. Test your knowledge on how these agents improve surgical outcomes and patient recovery.
