No abstract

Cesarean sections (CS) are one of the most commonly performed surgical procedures worldwide. There is great variability in the percentage of cesarean sections between countries, varying from 3% to 42.9%5. In the US, approximately 32% of deliveries occur through a cesarean section. Overall, a drastic increase in cesarean section rate has been reported reaching its highest level at the present time. In Brazil, considering the types of births by live births from 2006 to 2016, the national percentage of cesarean section was 52.37%. The variability in this percentage can still be perceived within Brazilian territory. The highest cesarean rate occurred in the Southern region, representing 58.33% of births, while the lowest rate occurred in the Northern region, with 41.79%. It is possible to see the steady increase in the percentage of CS over time, from 45.01% in 2006 to 55.39% in 2016.

No abstract

This is a report of seven cases of infected thoracic wounds treated with an adapted low-cost vacuum therapy in the Thoracic Surgery Unit of Santa Marcelina Hospital. The vacuum system used was designed and adapted to our hospital due to financial limitations on the acquisition of commercial kits. The vacuum-assisted closure kit used in this study consisted of chlorhexidine sponges (which are usually used for antisepsis of the surgical team), a 16F nasogastric tube, and two sterile adhesive films (OPSITE) for surgical field reinforcement. The mean duration of vacuum therapy was 13.4 days (range, 10-20 days), with an average of three dressing changes (range, 1-5). After treatment with vacuum-assisted closure, three wounds (3/7) were closed with simple primary sutures, one of the lesions (1/7) was closed by muscle flap rotation, and three wounds (3/7) healed by second intention. This adapted vacuum therapy was safe and easy to apply in our institution, including its use in patients with thoracostomies.

An 88-year-old woman diagnosed with COVID-19 in Brazil presented with recurrent pneumothorax. She was under mechanical ventilation for 20 days because of acute respiratory distress syndrome (ARDS). Chest x-ray revealed right lung pneumothorax, which was treated with a pigtail chest tube leading to successful lung reexpansion. After 48 hours the patient developed an ipsilateral pneumothorax and a new tube thoracostomy under conventional chest tube under suction was performed and kept in place for 14 days. This brief report highlights that the conventional chest tube under suction procedures might be a good choice in Covid-19 patients.