Oncoplastic Surgery & Hemostatic Agents Study
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Questions and Answers

What is one major benefit of using hemostatic agents in breast cancer surgery?

  • Improvement in surgical aesthetics
  • Increased time for JP drain removal
  • Decreased incidence of bleeding complications (correct)
  • Decrease in postoperative pain

    • How did hemostatic agents affect JP drain duration in breast cancer procedures?

  • Increased the duration significantly
  • Decreased duration for CP procedures (correct)
  • Resulted in longer drain duration for FS procedures
  • No effect on duration

    • What aspect of postoperative recovery showed a significant improvement with hemostatic agents?

  • Reduced hospital stay
  • Enhanced psychological recovery
  • Lower rates of infection
  • Fewer bleeding complications (correct)

    • Which group showed a more pronounced effect from hemostatic agents in the subgroup analysis?

    <p>CP group</p> Signup and view all the answers

    What was the conclusion drawn about the use of hemostatic agents in oncologic breast surgery?

    <p>They may reduce postoperative complications.</p> Signup and view all the answers

    What were the hemostatic agents investigated in the study?

    <p>Fibrin sealant and combination powder</p> Signup and view all the answers

    What type of surgical procedures did the study focus on regarding hemostatic agents?

    <p>Oncologic breast surgeries</p> Signup and view all the answers

    Which of the following is NOT mentioned as a keyword associated with the study?

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

    What was the focus of the retrospective chart review conducted in the study?

    <p>Postoperative complications and drain duration</p> Signup and view all the answers

    What was a primary outcome measured in the study related to surgical procedures?

    <p>Time until JP drain removal</p> Signup and view all the answers

    What types of breast surgery were included in the study?

    <p>Oncoplastic breast surgery and reconstruction</p> Signup and view all the answers

    What is one of the potential postoperative complications the study aimed to decrease?

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

    Which outcome measurement was assessed in relation to the hemostatic agents?

    <p>Time to JP drain removal</p> Signup and view all the answers

    What were the consecutive experiences in the study regarding hemostatic agent usage?

    <p>No hemostatic agent followed by FS and then CP</p> Signup and view all the answers

    What is the purpose of using hemostatic agents in breast cancer surgery according to the study?

    <p>To decrease postoperative complications</p> Signup and view all the answers

    Which type of agent was identified as EVICEL® in the study?

    <p>Fibrin sealant</p> Signup and view all the answers

    What are the rates of seroma and hematoma formation in breast surgery operations?

    <p>8.2% and 3.3%</p> Signup and view all the answers

    Which hemostatic technique was introduced in August 2019?

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

    What is the purpose of injective lidocaine with epinephrine before operative closure?

    <p>To minimize the chances of missing bleeding vessels</p> Signup and view all the answers

    What is the criteria for JP drain removal?

    <p>Output less than 30 cc/day for 2 consecutive days</p> Signup and view all the answers

    Which of the following is NOT a common oncoplastic surgery technique?

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

    What was the impact of hemostatic agents on bleeding complications?

    <p>Observed decrease in bleeding complications</p> Signup and view all the answers

    In the study, what was the incidental trend in hematoma and seroma rates in the United States?

    <p>Both rates showed a similar range</p> Signup and view all the answers

    What does the acronym OPS stand for in the context of surgery?

    <p>Oncological Plastic Surgery</p> Signup and view all the answers

    What is the primary objective of the study mentioned?

    <p>To evaluate the frequency of post-operative bleeding complications and JP drain use</p> Signup and view all the answers

    What is the statistical significance threshold defined in the study?

    <p>P &lt; 0.05</p> Signup and view all the answers

    Which hemostatic agent was noted for potentially reducing incidence of seroma and hematoma?

    <p>HEMOBLASTÔ Bellows CP</p> Signup and view all the answers

    What complication rates were compared between the CP group and the non-hemostatic agent group?

    <p>Seroma and return to operating room rates</p> Signup and view all the answers

    What was the seroma incidence in the CP group?

    <p>8.7%</p> Signup and view all the answers

    What type of study design was utilized for this research?

    <p>Randomized controlled trial</p> Signup and view all the answers

    What was noted about the overall effectiveness of CP in the study?

    <p>It was not validated as effective in the studied procedures.</p> Signup and view all the answers

    Which statement is true regarding the Institutional Review Board (IRB) approval?

    <p>It was obtained prior to conducting the study.</p> Signup and view all the answers

    What was the drain duration for the CP group in oncoplastic operations?

    <p>5 days</p> Signup and view all the answers

    What was the OR takeback rate after mastectomy for the CP group?

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

    Which hemostatic agent showed a lower seroma rate in the oncoplastic group?

    <p>HEMOBLASTÔ Bellows (CP)</p> Signup and view all the answers

    What was the average drain duration for the non-hemostatic agent group during mastectomy?

    <p>30.4 days</p> Signup and view all the answers

    How many patients were included in the CP group for the expander exchange procedures?

    <p>7</p> Signup and view all the answers

    What was the seroma rate observed after mastectomy in the CP group?

    <p>8.7%</p> Signup and view all the answers

    What was the significance level (P-value) when comparing drain durations between the CP and FS groups?

    <p>P &lt; 0.01</p> Signup and view all the answers

    Which type of surgery did NOT demonstrate any hematomas or seromas in the CP group?

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

    Study Notes

    Introduction

    • Hemostatic agents are increasingly used in surgery to reduce bleeding complications
    • Hematomas and seromas are common post-operative complications in breast cancer surgery, including mastectomy and reconstruction
    • Oncoplastic surgery (OPS) combines breast cancer and plastic surgery techniques for optimal outcomes
    • There is limited research on the use of hemostatic agents in OPS and breast surgery, so this study investigated their effectiveness
    • The study aimed to evaluate the frequency of post-operative bleeding complications and the duration of Jackson-Pratt (JP) drain use in breast surgeries with and without hemostatic agents

    Methods

    • A retrospective chart review was conducted on patients who underwent breast cancer surgery between January 2015 and September 2020
    • The study included surgeries such as oncoplastic breast surgery, mastectomy with or without reconstruction, and expander to implant exchange
    • Data collected included the indication for surgery, type of operation, use of hemostatic agent (either EVICEL® or HEMOBLASTÔ Bellows), length of follow-up, time to JP drain removal, and post-operative complications (seroma, hematoma, or operating room (OR) takeback)
    • The study followed a consecutive experience where no hemostatic agent was initially used, then followed by the use of EVICEL®, and lastly HEMOBLASTÔ Bellows
    • Lidocaine with epinephrine was used for postoperative analgesia, and surgeons ensured patients were not hypotensive to minimize bleeding later
    • JP drains were removed when output was less than 30 cc/day for 2 consecutive days, with output compared between groups using Welch’s t-test
    • Post-operative complications were compared using Fisher’s exact test, with statistical significance defined as P <.05

    Results

    • The use of hemostatic agents (EVICEL® or HEMOBLASTÔ Bellows) significantly reduced the time to JP drain removal and overall bleeding complications compared to no hemostatic agent
    • HEMOBLASTÔ Bellows (CP) showed a more pronounced effect, especially in the mastectomy group, with a lower rate of seroma, hematoma, and return to OR
    • CP also significantly decreased JP drain duration compared to the no hemostatic agent group in oncoplastic, mastectomy, and expander exchange procedures
    • Subgroup analysis revealed no hematomas, seromas, or return to OR for oncoplastic and expander exchange procedures in the CP group compared to the EVICEL® (FS) group, which had a higher rate of seroma
    • While the CP group had a lower rate of seroma and OR takeback after mastectomy compared to FS, these differences were not statistically significant

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    Related Documents

    The Use of Hemostatic Agents to Decrease Bleeding Complications in Breast Cancer Surgery PDF

    Description

    This study investigates the effectiveness of hemostatic agents in oncoplastic breast surgery and their role in reducing post-operative bleeding complications. It includes an analysis of surgical outcomes from patients treated between 2015 and 2020. The aim is to provide insights into the frequency of complications and drainage duration.

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