No abstract

Introduction Seroma development after mastectomy is a common complication. Continued seroma causes increased outpatient visits, repeated aspirations, infection, delayed healing, delayed adjuvant therapy, and increased cost. Various treatments are being attempted to prevent and reduce seroma development. We examined the effects of flap fixation on seroma using absorbable sutures after modified radical mastectomy (MRM). Methods The prospectively recorded data of patients who underwent surgery for breast cancer were analyzed retrospectively. 72 consecutive patients who underwent MRM were included in the study. Patients who underwent MRM in the same way by the same surgeon were divided into two groups: the group whose wound was closed by fixing the flap to the chest wall with an absorbable suture (group A), and the group whose wound was closed with the classical method (group B). The groups were compared in terms of seroma development, clinicopathological data, and early complications. Results Drain removal time and the total amount of drained fluid in group A patients were significantly lower than drain removal time and the total amount of drained fluid in group B patients ( P < .001). Similarly, the amount of aspirated seroma in the control examinations of group A patients was significantly lower than that in group B ( P < .05). Group B needed re-aspiration significantly more than group A ( P < .05). Conclusions Flap fixation with suture after MRM is a method that reduces seroma formation and the amount of drained fluid, enables early removal of the drain, prevents delay in starting adjuvant treatment, is more comfortable for the patient and physician, and is also inexpensive.

BACKROUND The COVID-19 pandemic has caused delays in diagnosis, and treatment of breast cancer patients. We predicted that the effects of the pandemic on breast cancer patients would decrease during the post-vaccination period. METHODS The data of 131 female patients who were operated on for breast cancer between March 2019, and March 2022, were analyzed into 3 groups: the control group (CG) between March 2019–2020, the pandemic group (PG) between March 2020–2021, and the vaccine group (VG) between March 2021 - March 2022. Patient admission time (PAT), diagnosis time (DT), tumor size, TNM classification and etc data were analyzed. RESULTS Prolonged PAT times in PG compared to CG were observed to be significantly reduced in VG (p = 0.009). In both PG and VG, the DTs were prolonged significantly (p < 0.001 and p < 0.001, respectively). Tumor sizes were found to be larger in PG than in CG and VG (p = 0.003 and p = 0.001, respectively). CONCLUSION After COVID-19 vaccination; delays in diagnosis and treatment caused by the pandemic in breast cancer patients have decreased and the increase in tumor size during the pandemic period has regressed.

Objective: Wound healing is a serious problem that causes high morbidity. Different pharmacological agents have been studied to accelerate wound healing and to prevent necrosis and ischemia, and still continue to work. Topical dexpanthenol is widely used in both wound healing and various dermatological diseases. The aim of this study was to compare the effects of topical sildenafil citrate and topical dexpanthenol on wound healing in rats. Material and Methods: A total of 30 female Wistar Albino rats, weighing 200-250 gr, were used in the study. Rats were divided into 3 groups. A linear 2 cm full-thickness incision was made in the rat’s skin of the back. Steril saline irrigation was applied to all animals in the control group. Dexpanthenol was administered locally to the wounds of the rats in the second group, and 10% sildenafil citrate in the third group. Wound dimensions were measured on the 3rd, 5th, 7th, 10th, 14th, and 21st days. The full-thickness skin, including the incision, were removed for histopathological examination on the 21st days. Results: We believe that sildenafil citrate can be used as a topical cream for wound healing, as it leads to significant reduction in wound size. Conclusion: Although there was no statistically significant difference, we observed that the wound healing was better in the group where sildenafil citrate was applied locally on the wound.

Purpose Gastric cancer (GC) is one of the most common cancers that can result in death. Markers are needed to detect gastric cancer early and manage treatment. We aimed to reveal the relationship between carcinoembryonic antigen (CEA) level and Fibrinogen-Albumin ratio (FAR) and prognosis in gastric cancer, as well as to examine the relationship of these values with the number of metastatic lymph nodes and TNM stage.Methods The data of 805 consecutive gastrectomy patients were analyzed retrospectively. A total of 461 patients were included. The optimal cut-off values of CEA and FAR were 2.43 ng/mL and 1.26, respectively. Patients were stratified into three groups based on this cutoff value: CEA-FAR=0 (CEA <2.43 ng/mL and FAR <1.26), CEA-FAR=1 (CEA ≥2.43 ng/mL or FAR ≥1.26), and CEA-FAR=2 (CEA ≥2.43 ng/mL and FAR ≥1.26).Results There was a significant relationship between high CEA and stage (p=0.040), N status (p=0.017), and lymph node metastasis (p=0.004), and also there was a significant correlation between high FAR value and grade (p=0.003), stage (p<0.001), T status (p<0.001), N status (p<0.001) and metastatic lymph node count (p<0.001). Overall and disease-free survival were significantly different between the three CEA-FAR groupsConclusions We believe that pre-operative FAR and CEA values are independent predictors of survival. FAR and CEA are potential prognostic indicators for resectable gastric cancer due to their easy access and low cost. Considering survival and prognosis in patients with very high preoperative CEA and FAR values, neoadjuvant chemotherapy should also be considered.