Skip to main content
Erschienen in: Aesthetic Plastic Surgery 1/2012

01.02.2012 | Original Article

A Clinical Study of Late Seroma in Breast Implantation Surgery

verfasst von: Marco Mazzocchi, Luca A. Dessy, Federico Corrias, Nicolò Scuderi

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 1/2012

Einloggen, um Zugang zu erhalten

Abstract

Background

The use of mammary implants may lead to a variety of early and delayed complications. The most common delayed complications are capsular contracture and implant failure. Late seroma has seldom been reported. In a long-term prospective observational study, cases of late seroma were assessed and recorded.

Methods

Between March 2005 and November 2009, suspected cases of late seroma in patients who had undergone breast augmentation or reconstruction with textured implants were evaluated clinically and with instrumental analyses. An ultrasound-guided needle aspiration of the fluid was performed.

Results

In this study, 13 cases of late seroma (8 augmentations and 5 reconstructions) were observed. The overall incidence of this complication was 1.68%. Chemical analyses confirmed the diagnosis of seroma, which recurred in all the patients within days of evacuation. For 12 patients, a reoperation was performed, during which the implant was removed, a total capsulectomy was performed, and in cases of subglandular breast augmentation, the implant pocket was changed to a submuscular placement before a new prosthesis was inserted. One patient underwent a second ultrasound-guided needle aspiration. No seroma recurrence was observed in any of the patients during the follow-up period.

Conclusion

In case of unexpected breast enlargement after prosthesis implantation, the physician should first rule out infection, then investigate possible friction irritation from either a fold in the device or rubbing of a textured implant. According to the authors’ experience and another report, this complication occurs in 1% to 2% of cases. The inclusion of this complication in the informed consent form should be considered. Long-term studies designed to investigate the underlying causes of late seroma are warranted for the prevention and treatment of this complication.
Literatur
1.
Zurück zum Zitat Armstrong RW, Berkowitz RL, Bolding F (1989) Infection following breast reconstruction. Ann Plast Surg 23:284–288PubMedCrossRef Armstrong RW, Berkowitz RL, Bolding F (1989) Infection following breast reconstruction. Ann Plast Surg 23:284–288PubMedCrossRef
2.
Zurück zum Zitat Brickman M, Parsa NN, Parsa FD (2004) Late hematoma after breast implantation. Aesthetic Plast Surg 28:80–82PubMedCrossRef Brickman M, Parsa NN, Parsa FD (2004) Late hematoma after breast implantation. Aesthetic Plast Surg 28:80–82PubMedCrossRef
3.
Zurück zum Zitat Brown SL, Heflin B, Woo EK, Parmentier CM (2001) Infections related to breast implants reported to the Food and Drug Administration, 1977–1997. J Long Term Eff Med Implants 11:1–12PubMed Brown SL, Heflin B, Woo EK, Parmentier CM (2001) Infections related to breast implants reported to the Food and Drug Administration, 1977–1997. J Long Term Eff Med Implants 11:1–12PubMed
4.
Zurück zum Zitat Cohen BE, Biggs TM, Cronin ED, Collins DR Jr (1977) Assessment and longevity of the silicone gel breast implant. Plast Reconstr Surg 99:1597–1601 Cohen BE, Biggs TM, Cronin ED, Collins DR Jr (1977) Assessment and longevity of the silicone gel breast implant. Plast Reconstr Surg 99:1597–1601
5.
Zurück zum Zitat Collis N, Sharpe DT (2000) Silicone gel-filled breast implant integrity: a retrospective review of 478 consecutively explanted implants. Plast Reconstr Surg 105:1979–1985PubMedCrossRef Collis N, Sharpe DT (2000) Silicone gel-filled breast implant integrity: a retrospective review of 478 consecutively explanted implants. Plast Reconstr Surg 105:1979–1985PubMedCrossRef
6.
Zurück zum Zitat Copeland M, Choi M, Bleiweiss IJ (1994) Silicone breakdown and capsular synovial metaplasia in textured-wall saline breast prothesis. Plast Reconstr Surg 94:628–633PubMedCrossRef Copeland M, Choi M, Bleiweiss IJ (1994) Silicone breakdown and capsular synovial metaplasia in textured-wall saline breast prothesis. Plast Reconstr Surg 94:628–633PubMedCrossRef
7.
Zurück zum Zitat Courtiss EH, Goldwyn RM, Anastasi GW (1979) The fate of implants with infections around them. Plast Reconstr Surg 63:812–816PubMedCrossRef Courtiss EH, Goldwyn RM, Anastasi GW (1979) The fate of implants with infections around them. Plast Reconstr Surg 63:812–816PubMedCrossRef
8.
Zurück zum Zitat Cunningham BL, Lokeh A, Gutowski KA (2000) Saline-filled breast implant safety and efficacy: a multicenter retrospective review. Plast Reconstr Surg 105:2143–2149PubMedCrossRef Cunningham BL, Lokeh A, Gutowski KA (2000) Saline-filled breast implant safety and efficacy: a multicenter retrospective review. Plast Reconstr Surg 105:2143–2149PubMedCrossRef
9.
Zurück zum Zitat Daw JL, Lewis VL, Smith JW (1996) Chronic expanding haematoma within a periprosthetic breast capsule. Plast Reconstr Surg 97:1469–1472PubMedCrossRef Daw JL, Lewis VL, Smith JW (1996) Chronic expanding haematoma within a periprosthetic breast capsule. Plast Reconstr Surg 97:1469–1472PubMedCrossRef
10.
Zurück zum Zitat de Camara DL, Sheridan JM, Kammer BA (1993) Rupture and aging of silicone gel breast implants. Plast Reconstr Surg 91:828–834PubMedCrossRef de Camara DL, Sheridan JM, Kammer BA (1993) Rupture and aging of silicone gel breast implants. Plast Reconstr Surg 91:828–834PubMedCrossRef
11.
Zurück zum Zitat Duffy MJ, Woods JE (1994) Health risks of failed silicone gel breast implants: a 30-year clinical experience. Plast Reconstr Surg 94:295–299PubMedCrossRef Duffy MJ, Woods JE (1994) Health risks of failed silicone gel breast implants: a 30-year clinical experience. Plast Reconstr Surg 94:295–299PubMedCrossRef
12.
Zurück zum Zitat Gabriel SE, Woods JE, O’Fallon WM, Beard CM, Kurland LT, Melton LJ III (1997) Complications leading to surgery after breast implantation. N Engl J Med 336:677–682PubMedCrossRef Gabriel SE, Woods JE, O’Fallon WM, Beard CM, Kurland LT, Melton LJ III (1997) Complications leading to surgery after breast implantation. N Engl J Med 336:677–682PubMedCrossRef
13.
Zurück zum Zitat Gatti JE (1997) Poland’s deformity reconstructions with a customized, extra-soft silicone prosthesis. Ann Plast Surg 39:122–130PubMedCrossRef Gatti JE (1997) Poland’s deformity reconstructions with a customized, extra-soft silicone prosthesis. Ann Plast Surg 39:122–130PubMedCrossRef
14.
Zurück zum Zitat Georgiade NG, Serafin D, Barwik W (1979) Late development of hematoma around a breast implant, necessitating removal. Plast Reconst Surg 64:708–710PubMedCrossRef Georgiade NG, Serafin D, Barwik W (1979) Late development of hematoma around a breast implant, necessitating removal. Plast Reconst Surg 64:708–710PubMedCrossRef
15.
Zurück zum Zitat Goldberg EP, Widenhouse C, Marotta J, Martin P (1997) Failure of silicone gel breast implants: analysis of literature data for 1,652 explanted prostheses. Plast Reconstr Surg 100:281–284PubMed Goldberg EP, Widenhouse C, Marotta J, Martin P (1997) Failure of silicone gel breast implants: analysis of literature data for 1,652 explanted prostheses. Plast Reconstr Surg 100:281–284PubMed
16.
Zurück zum Zitat Gonzalez R (2006) Late intracapsular seroma in subfascial buttock augmentation: a case report. Aesthetic Plast Surg 30:599–604PubMedCrossRef Gonzalez R (2006) Late intracapsular seroma in subfascial buttock augmentation: a case report. Aesthetic Plast Surg 30:599–604PubMedCrossRef
17.
Zurück zum Zitat Gorgu M, Aslan G, Tunncel A, Erdogon B (1999) Late and long-standing capsular hematoma after aesthetic breast augmentation: a case report. Aesthetic Plast Surg 23:443–444PubMedCrossRef Gorgu M, Aslan G, Tunncel A, Erdogon B (1999) Late and long-standing capsular hematoma after aesthetic breast augmentation: a case report. Aesthetic Plast Surg 23:443–444PubMedCrossRef
18.
Zurück zum Zitat Goyal A, Mansel RE (2003) Hematoma as a late complication after breast reconstruction with implant. Br J Plast Surg 56:189–191PubMedCrossRef Goyal A, Mansel RE (2003) Hematoma as a late complication after breast reconstruction with implant. Br J Plast Surg 56:189–191PubMedCrossRef
19.
Zurück zum Zitat Gulyàs G (2010) Commentary on “Seroma as a Late Complication after Breast Augmentation” by V. D. Pinchuk, O. V. Tymofii. Aesthetic Plast Surg doi:10.1007/s00266-010-9608-5, 23 October 2010 Gulyàs G (2010) Commentary on “Seroma as a Late Complication after Breast Augmentation” by V. D. Pinchuk, O. V. Tymofii. Aesthetic Plast Surg doi:10.​1007/​s00266-010-9608-5, 23 October 2010
20.
Zurück zum Zitat Gutowski KA, Mesna GT, Cunningham BL (1997) Saline-filled breast implants: a Plastic Surgery Educational Foundation multicenter outcomes study. Plast Reconstr Surg 100:1019–1027PubMedCrossRef Gutowski KA, Mesna GT, Cunningham BL (1997) Saline-filled breast implants: a Plastic Surgery Educational Foundation multicenter outcomes study. Plast Reconstr Surg 100:1019–1027PubMedCrossRef
21.
Zurück zum Zitat Hall-Findlay EJ (2011) Breast implant complication review: double capsules and late seromas. Plast Reconstr Surg 127:56–66PubMed Hall-Findlay EJ (2011) Breast implant complication review: double capsules and late seromas. Plast Reconstr Surg 127:56–66PubMed
22.
Zurück zum Zitat Hammond DC, Hidalgo D, Slavin S, Spear S, Tebbetts J (1999) Revising the unsatisfactory breast augmentation. Plast Reconstr Surg 104:277–283PubMedCrossRef Hammond DC, Hidalgo D, Slavin S, Spear S, Tebbetts J (1999) Revising the unsatisfactory breast augmentation. Plast Reconstr Surg 104:277–283PubMedCrossRef
23.
Zurück zum Zitat Handel N (2006) Managing complication of augmentation mammaplasty. In: Spear SL (ed) Surgery of the breast: principles and art, vol 2, 2nd edn. Lippincott Williams & Wilkins, Philadelphia, pp 1417–1435 Handel N (2006) Managing complication of augmentation mammaplasty. In: Spear SL (ed) Surgery of the breast: principles and art, vol 2, 2nd edn. Lippincott Williams & Wilkins, Philadelphia, pp 1417–1435
24.
Zurück zum Zitat Handel N, Jensen JA, Black Q, Waisman JR, Silverstein MJ (1995) The fate of breast implants: a critical analysis of complications and outcomes. Plast Reconstr Surg 96:1521–1533PubMedCrossRef Handel N, Jensen JA, Black Q, Waisman JR, Silverstein MJ (1995) The fate of breast implants: a critical analysis of complications and outcomes. Plast Reconstr Surg 96:1521–1533PubMedCrossRef
25.
Zurück zum Zitat Hart D (2003) Overcoming complications of breast implants. Plast Surg Nurs 23:55–63PubMed Hart D (2003) Overcoming complications of breast implants. Plast Surg Nurs 23:55–63PubMed
26.
Zurück zum Zitat Hasham S, Akhtar S, Fourie LR (2006) Persistent seroma following breast prothesis explantation: a case report and review. Eur J Plast Surg 28:490–493CrossRef Hasham S, Akhtar S, Fourie LR (2006) Persistent seroma following breast prothesis explantation: a case report and review. Eur J Plast Surg 28:490–493CrossRef
27.
Zurück zum Zitat Hester TR, Cukic J (1991) Use of stacked polyurethanecovered mammary implants in aesthetic and reconstructive breast surgery. Plast Reconstr Surg 88:503–509PubMedCrossRef Hester TR, Cukic J (1991) Use of stacked polyurethanecovered mammary implants in aesthetic and reconstructive breast surgery. Plast Reconstr Surg 88:503–509PubMedCrossRef
28.
Zurück zum Zitat Holmich LR, Vejborg IM, Conrad C, Sletting S, Hoier-Madsen M, Fryzek JP, McLaughlin JK, Kjoller K, Wiik A, Friis S (2004) Untreated silicone breast implant rupture. Plast Reconstr Surg 114:204–214PubMedCrossRef Holmich LR, Vejborg IM, Conrad C, Sletting S, Hoier-Madsen M, Fryzek JP, McLaughlin JK, Kjoller K, Wiik A, Friis S (2004) Untreated silicone breast implant rupture. Plast Reconstr Surg 114:204–214PubMedCrossRef
29.
Zurück zum Zitat Hsiao HT, Tung KY, Lin CS (2002) Late hematoma after aesthetic breast augmentation with saline-filled, textured silicone prosthesis. Aesthetic Plast Surg 26:368–371PubMedCrossRef Hsiao HT, Tung KY, Lin CS (2002) Late hematoma after aesthetic breast augmentation with saline-filled, textured silicone prosthesis. Aesthetic Plast Surg 26:368–371PubMedCrossRef
30.
Zurück zum Zitat Kjøller K, Hölmich LR, Jacobsen PH, Friis S, Fryzek J, McLaughlin JK, Lipworth L, Henriksen TF, Jørgensen S, Bittmann S, Olsen J (2002) Epidemiological investigation of local complications after cosmetic breast implant surgery in Denmark. Ann Plast Surg 48:229–237PubMedCrossRef Kjøller K, Hölmich LR, Jacobsen PH, Friis S, Fryzek J, McLaughlin JK, Lipworth L, Henriksen TF, Jørgensen S, Bittmann S, Olsen J (2002) Epidemiological investigation of local complications after cosmetic breast implant surgery in Denmark. Ann Plast Surg 48:229–237PubMedCrossRef
31.
Zurück zum Zitat Kulmala I, McLaughlin JK, Pakkanen M, Lassila K, Holmich LR, Lipworth L, Boice JD Jr, Raitanen J, Luoto R (2004) Local complications after cosmetic breast implant surgery in Finland. Ann Plast Surg 53:413–419PubMedCrossRef Kulmala I, McLaughlin JK, Pakkanen M, Lassila K, Holmich LR, Lipworth L, Boice JD Jr, Raitanen J, Luoto R (2004) Local complications after cosmetic breast implant surgery in Finland. Ann Plast Surg 53:413–419PubMedCrossRef
32.
Zurück zum Zitat Labadie EL, Glover D (1976) Physiopathogenesis of subdural hematoma in rats with subdural hematoma in man. J Nurosurg 45:382–397CrossRef Labadie EL, Glover D (1976) Physiopathogenesis of subdural hematoma in rats with subdural hematoma in man. J Nurosurg 45:382–397CrossRef
33.
Zurück zum Zitat Lavine DM (1993) Saline inflatable prostheses: 14 Years’ experience. Aesthetic Plast Surg 17:325–330PubMedCrossRef Lavine DM (1993) Saline inflatable prostheses: 14 Years’ experience. Aesthetic Plast Surg 17:325–330PubMedCrossRef
34.
Zurück zum Zitat Leibman AJ (1994) Imaging of complications of augmentation mammaplasty. Plast Reconstr Surg 93:1134–1140PubMedCrossRef Leibman AJ (1994) Imaging of complications of augmentation mammaplasty. Plast Reconstr Surg 93:1134–1140PubMedCrossRef
35.
Zurück zum Zitat Marques AF, Brenda E, Salvido PH (1992) Capsular hematoma as late complication in breast reconstruction. Plast Reconstr Surg 89:543–545PubMedCrossRef Marques AF, Brenda E, Salvido PH (1992) Capsular hematoma as late complication in breast reconstruction. Plast Reconstr Surg 89:543–545PubMedCrossRef
36.
Zurück zum Zitat Mazzocchi M, Dessy LA, Marchetti F, Marchetti F, Carlesimo B (2010) The use of the Veress needle to drain mammary periprosthetic fluid. In Vivo 24:219–222PubMed Mazzocchi M, Dessy LA, Marchetti F, Marchetti F, Carlesimo B (2010) The use of the Veress needle to drain mammary periprosthetic fluid. In Vivo 24:219–222PubMed
37.
Zurück zum Zitat Mazzocchi M, Dessy LA, Carlesimo B, Marchetti F, Scuderi N (2010) Late seroma formation after breast surgery with textured silicone implants: a problem worth bearing in mind. Plast Reconstr Surg 125:176e–177ePubMedCrossRef Mazzocchi M, Dessy LA, Carlesimo B, Marchetti F, Scuderi N (2010) Late seroma formation after breast surgery with textured silicone implants: a problem worth bearing in mind. Plast Reconstr Surg 125:176e–177ePubMedCrossRef
38.
Zurück zum Zitat McGrath MH, Burkhardt BR (1984) The safety and efficacy of breast implants for augmentation mammaplasty. Plast Reconstr Surg 74:550–560PubMedCrossRef McGrath MH, Burkhardt BR (1984) The safety and efficacy of breast implants for augmentation mammaplasty. Plast Reconstr Surg 74:550–560PubMedCrossRef
39.
Zurück zum Zitat McKinney P, Tresley G (1983) Long-term comparison of patients with gel and saline mammary implants. Plast Reconstr Surg 72:27–31PubMedCrossRef McKinney P, Tresley G (1983) Long-term comparison of patients with gel and saline mammary implants. Plast Reconstr Surg 72:27–31PubMedCrossRef
40.
Zurück zum Zitat McLaughlin JK (2004) Long-term follow-up of women with cosmetic breast implants: how long is long enough? Plast Reconstr Surg 114:801–803PubMedCrossRef McLaughlin JK (2004) Long-term follow-up of women with cosmetic breast implants: how long is long enough? Plast Reconstr Surg 114:801–803PubMedCrossRef
41.
Zurück zum Zitat Melmed EP (1998) A review of explantation in 240 symptomatic women: a description of explanation and capsulectomy with reconstruction using a periareolar technique. Plast Reconstr Surg 101:1364–1373PubMedCrossRef Melmed EP (1998) A review of explantation in 240 symptomatic women: a description of explanation and capsulectomy with reconstruction using a periareolar technique. Plast Reconstr Surg 101:1364–1373PubMedCrossRef
42.
Zurück zum Zitat Nahabedian MY, Tsangaris T, Momen B, Manson PN (2003) Infectious complications following breast reconstruction with expanders and implants. Plast Reconstr Surg 112:467–476PubMedCrossRef Nahabedian MY, Tsangaris T, Momen B, Manson PN (2003) Infectious complications following breast reconstruction with expanders and implants. Plast Reconstr Surg 112:467–476PubMedCrossRef
43.
Zurück zum Zitat Netscher DT, Sharma S, Thornby J, Peltier M, Lyos A, Fater M, Mosharrafa A (1997) Aesthetic outcome of breast implant removal in 85 consecutive patients. Plast Reconstr Surg 100:206–219PubMedCrossRef Netscher DT, Sharma S, Thornby J, Peltier M, Lyos A, Fater M, Mosharrafa A (1997) Aesthetic outcome of breast implant removal in 85 consecutive patients. Plast Reconstr Surg 100:206–219PubMedCrossRef
44.
Zurück zum Zitat Oliveira VM, Roveda Junior D, Lucas FB, Lucarelli AP, Martins MM, Rinaldi JF, Aoki T (2007) Late seroma after breast augmentation with silicone prostheses: a case report. Breast J 13:421–423PubMedCrossRef Oliveira VM, Roveda Junior D, Lucas FB, Lucarelli AP, Martins MM, Rinaldi JF, Aoki T (2007) Late seroma after breast augmentation with silicone prostheses: a case report. Breast J 13:421–423PubMedCrossRef
45.
Zurück zum Zitat Peters W, Smith D, Lugowski S (1996) Failure properties of 352 explanted silicone-gel breast implants. Can J Plast Surg 4:55–58 Peters W, Smith D, Lugowski S (1996) Failure properties of 352 explanted silicone-gel breast implants. Can J Plast Surg 4:55–58
47.
Zurück zum Zitat Rohrich RJ, Beran SJ, Restifo RJ, Copit SE (1998) Aesthetic management of the breast following explantation: evaluation and mastopexy options. Plast Reconstr Surg 101:827–837PubMedCrossRef Rohrich RJ, Beran SJ, Restifo RJ, Copit SE (1998) Aesthetic management of the breast following explantation: evaluation and mastopexy options. Plast Reconstr Surg 101:827–837PubMedCrossRef
48.
Zurück zum Zitat Rohrich RJ, Adams WP Jr, Beran SJ, Rathakrishnan R, Griffin J, Robinson JB Jr, Kenkel JM (1998) An analysis of silicone gel-filled breast implants: diagnosis and failure rates. Plast Reconstr Surg 102:2304–2308PubMedCrossRef Rohrich RJ, Adams WP Jr, Beran SJ, Rathakrishnan R, Griffin J, Robinson JB Jr, Kenkel JM (1998) An analysis of silicone gel-filled breast implants: diagnosis and failure rates. Plast Reconstr Surg 102:2304–2308PubMedCrossRef
49.
Zurück zum Zitat Schiavon M, Fraccalanza E, Baraziol R (2005) Late current capsular hematoma after augmentation mammaplasty. Aesthetic Plast Surg 29:10–12CrossRef Schiavon M, Fraccalanza E, Baraziol R (2005) Late current capsular hematoma after augmentation mammaplasty. Aesthetic Plast Surg 29:10–12CrossRef
50.
Zurück zum Zitat Siggelkow W, Klosterhalfen B, Klinge U, Rath W, Faridi A (2004) Analysis of local complications following explantation of silicone breast implants. Breast 13:122–128PubMedCrossRef Siggelkow W, Klosterhalfen B, Klinge U, Rath W, Faridi A (2004) Analysis of local complications following explantation of silicone breast implants. Breast 13:122–128PubMedCrossRef
51.
Zurück zum Zitat Slavin SA, Goldwyn RM (1995) Silicone gel implant explantation: reasons, results, and admonitions. Plast Reconstr Surg 95:63–69PubMedCrossRef Slavin SA, Goldwyn RM (1995) Silicone gel implant explantation: reasons, results, and admonitions. Plast Reconstr Surg 95:63–69PubMedCrossRef
52.
Zurück zum Zitat Svahn JK, Vastine VL, Landon BN, Dobke MK (1996) Outcome of mammary prostheses explantation: a patient perspective. Ann Plast Surg 36:594–600PubMedCrossRef Svahn JK, Vastine VL, Landon BN, Dobke MK (1996) Outcome of mammary prostheses explantation: a patient perspective. Ann Plast Surg 36:594–600PubMedCrossRef
53.
Zurück zum Zitat Tansley PD, Powell BW (2011) Late swelling after bilateral breast augmentation. J Plast Reconstr Aesthet Surg 64:261–263PubMedCrossRef Tansley PD, Powell BW (2011) Late swelling after bilateral breast augmentation. J Plast Reconstr Aesthet Surg 64:261–263PubMedCrossRef
54.
Zurück zum Zitat Vázquez G, Pellón A (2007) Polyurethane-coated silicone gel breast implants used for 18 years. Aesthetic Plast Surg 31:330–336PubMedCrossRef Vázquez G, Pellón A (2007) Polyurethane-coated silicone gel breast implants used for 18 years. Aesthetic Plast Surg 31:330–336PubMedCrossRef
55.
Zurück zum Zitat Wang BH, Chang BW, Sargeant R (1998) Late capsular hematoma after reconstruction with polyurethane-covered implant. Plast Reconstr Surg 102:450–452PubMedCrossRef Wang BH, Chang BW, Sargeant R (1998) Late capsular hematoma after reconstruction with polyurethane-covered implant. Plast Reconstr Surg 102:450–452PubMedCrossRef
Metadaten
Titel
A Clinical Study of Late Seroma in Breast Implantation Surgery
verfasst von
Marco Mazzocchi
Luca A. Dessy
Federico Corrias
Nicolò Scuderi
Publikationsdatum
01.02.2012
Verlag
Springer-Verlag
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 1/2012
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-011-9755-3

Weitere Artikel der Ausgabe 1/2012

Aesthetic Plastic Surgery 1/2012 Zur Ausgabe

Vorsicht, erhöhte Blutungsgefahr nach PCI!

10.05.2024 Koronare Herzerkrankung Nachrichten

Nach PCI besteht ein erhöhtes Blutungsrisiko, wenn die Behandelten eine verminderte linksventrikuläre Ejektionsfraktion aufweisen. Das Risiko ist umso höher, je stärker die Pumpfunktion eingeschränkt ist.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Deutlich weniger Infektionen: Wundprotektoren schützen!

08.05.2024 Postoperative Wundinfektion Nachrichten

Der Einsatz von Wundprotektoren bei offenen Eingriffen am unteren Gastrointestinaltrakt schützt vor Infektionen im Op.-Gebiet – und dient darüber hinaus der besseren Sicht. Das bestätigt mit großer Robustheit eine randomisierte Studie im Fachblatt JAMA Surgery.

Chirurginnen und Chirurgen sind stark suizidgefährdet

07.05.2024 Suizid Nachrichten

Der belastende Arbeitsalltag wirkt sich negativ auf die psychische Gesundheit der Angehörigen ärztlicher Berufsgruppen aus. Chirurginnen und Chirurgen bilden da keine Ausnahme, im Gegenteil.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.