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Hemostatic Agents in Plastic Surgery
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Hemostatic Agents in Plastic Surgery

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Questions and Answers

What are common postoperative complications after plastic surgery procedures?

Hematomas and seromas

Which hemostatic agents were evaluated in the study?

  • Fibrin sealant (FS)
  • Combination powder (CP)
  • Both A and B (correct)
  • None of the above

    • 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 _____%.

    <p>6.6</p> Signup and view all the answers

    What is the significance of the Jackson-Pratt (JP) drain output in this study?

    <p>It is used to determine the timing of drain removal and assess the efficacy of hemostatic techniques.</p> Signup and view all the answers

    What was the mean duration of JP drain use for the combination powder (CP) group in breast reduction procedures?

    <p>3.46 days</p> Signup and view all the answers

    The use of hemostatic agents in general plastic surgery procedures significantly reduced time to JP drain removal.

    <p>True</p> Signup and view all the answers

    What complications did the CP group experience in breast reduction procedures?

    <p>None of the above</p> Signup and view all the answers

    The study aimed to evaluate the _____ of postoperative bleeding complications.

    <p>frequency</p> Signup and view all the answers

    What was the average follow-up time for patients using no hemostatic agent after breast reduction?

    <p>11.3 weeks</p> Signup and view all the answers

    What was the average time with JP drain for patients undergoing abdominoplasty with HEMOBLAST Bellows?

    <p>14.1 days</p> Signup and view all the answers

    What was the average specimen weight for patients who had an abdominoplasty using EVICEL (FS)?

    <p>3.28 kg</p> Signup and view all the answers

    What percentage of patients experienced seromas after breast reduction with no hemostatic agent?

    <p>6.6%</p> Signup and view all the answers

    The study indicated that the use of hemostatic agents showed a statistically significant improvement in reducing the time to JP drain removal.

    <p>True</p> Signup and view all the answers

    What is the recommended action by the American Society of Plastic Surgeons regarding the routine use of drains in standard reduction mammaplasty?

    <p>Against routine use</p> Signup and view all the answers

    The average time with JP drains for patients using no hemostatic agent was ____ days in the abdominoplasty group.

    <p>27.89</p> Signup and view all the answers

    What was the average follow-up time for patients after using HEMOBLAST Bellows in abdominoplasty?

    <p>12.75 weeks</p> Signup and view all the answers

    What was the percentage of hematoma occurrence for abdominoplasty patients using HEMOBLAST Bellows?

    <p>0%</p> Signup and view all the answers

    What was the average specimen weight for breast reduction patients using no hemostatic agent?

    <p>1.54 kg</p> Signup and view all the answers

    What was the average duration for JP drain removal in breast reduction surgeries using hemostatic agents?

    <p>3.46 days</p> Signup and view all the answers

    What is the reported complication rate for hematomas in breast reduction surgeries?

    <p>3.7%</p> Signup and view all the answers

    In abdominoplasty/panniculectomy operations, what is the reported occurrence rate of seromas?

    <p>10%</p> Signup and view all the answers

    What is one of the common postoperative complications after plastic surgery procedures mentioned?

    <p>Seromas</p> Signup and view all the answers

    Which surgical procedure shows a higher rate of seroma formation compared to the other mentioned?

    <p>Abdominoplasty</p> Signup and view all the answers

    What was the primary focus of the study regarding hemostatic agents in plastic surgery?

    <p>To assess the impact on wound healing and morbidity</p> Signup and view all the answers

    Which types of surgeries were included in the patients' evaluations for this study?

    <p>Bilateral breast reduction, paniculectomy, and abdominoplasty</p> Signup and view all the answers

    What was identified as a benefit of using hemostatic agents in the study?

    <p>Reduced incidence of postoperative complications</p> Signup and view all the answers

    Which hemostatic agent combination was mentioned in the study?

    <p>HEMOBLAST Bellows and EVICEL</p> Signup and view all the answers

    What was the result regarding the length of JP drain use in the groups using hemostatic agents?

    <p>It was reduced compared to the nonhemostatic group</p> Signup and view all the answers

    What trend was observed regarding hematomas and seromas when using hemostatic agents?

    <p>A reduction in both complications</p> Signup and view all the answers

    What type of study design was implemented to evaluate the effects of hemostatic agents?

    <p>Retrospective chart review</p> Signup and view all the answers

    What was the purpose of evaluating the use of the Jackson-Pratt (JP) drain in this study?

    <p>To assess the duration of drain use and complications</p> Signup and view all the answers

    What was a significant factor influencing the removal time of drains in the study?

    <p>Volume of serosanguinous drainage observed</p> Signup and view all the answers

    How did the hemostatic agent affect the duration of JP drain use?

    <p>Reduced the duration of use</p> Signup and view all the answers

    What was the incidence rate of seroma for the nonhemostatic agent group?

    <p>6.6%</p> Signup and view all the answers

    What was one outcome for the CP group during the study?

    <p>No instances of hematomas or seromas</p> Signup and view all the answers

    What complication was recorded for the hemostatic agent group?

    <p>No complications recorded</p> Signup and view all the answers

    What was the reported incidence of hematoma for the nonhemostatic group?

    <p>1.6%</p> Signup and view all the answers

    What was the primary aim of the study?

    <p>Determine the frequency of postoperative bleeding complications</p> Signup and view all the answers

    Which complication showed a 4.5% incidence in the CP group?

    <p>Seroma</p> Signup and view all the answers

    What is one common method used for the early detection of hematoma formation?

    <p>Placement of closed-suction drains</p> Signup and view all the answers

    Which type of drain is mentioned as used intraoperatively for detecting complications?

    <p>Blake drains</p> Signup and view all the answers

    What is a typical goal of using devices like FSs or glues during surgery?

    <p>To improve hemostasis and reduce hematoma risk</p> Signup and view all the answers

    What statistical method was used to compare postoperative complications in the study?

    <p>Fisher exact test</p> Signup and view all the answers

    Which of the following substances is NOT mentioned as a hemostatic agent developed for surgical use?

    <p>Collagen-based patches</p> Signup and view all the answers

    What is the primary purpose of using negative pressure wound vacuum systems?

    <p>To facilitate wound healing</p> Signup and view all the answers

    What was the significance of the duration of JP drain use in the breast reduction procedure among groups?

    <p>It was significantly decreased in the CP group compared to FS group.</p> Signup and view all the answers

    Which findings indicate a need for institutional review board approval?

    <p>The involvement of new devices or methods</p> Signup and view all the answers

    Which technique was used for breast reductions according to the surgical method described?

    <p>Wise pattern incision with superomedial pedicle.</p> Signup and view all the answers

    What is one potential complication that can occur post-surgery which these devices aim to mitigate?

    <p>Seroma formation</p> Signup and view all the answers

    What was the incidence of seroma in the nonhemostatic agent group for abdominoplasty and panniculectomy procedures?

    <p>6.6%</p> Signup and view all the answers

    What does the Caprini score assess in the context of these surgeries?

    <p>The need for deep vein thrombosis prophylactic anticoagulation.</p> Signup and view all the answers

    What was notably absent in the CP group postoperatively compared to the FS group?

    <p>All of the above.</p> Signup and view all the answers

    What was the primary concern regarding the patient's condition before the operative closure of incision sites?

    <p>Hypotension that could lead to missed vessels and bleeding.</p> Signup and view all the answers

    What factor did not significantly correlate with complications in the reviewed procedures?

    <p>The Caprini score of the majority of patients.</p> Signup and view all the answers

    What type of anesthesia was administered preoperatively for postoperative analgesia?

    <p>Lidocaine with epinephrine.</p> Signup and view all the answers

    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.
    • 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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    Related Documents

    The Use of Hemostatic Agents in General Plastic Surgery Procedures (AQA 2023 PDF)

    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.

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