The impact of intraoperative hypotension on the development of wound haematoma after breast reduction

Hussien, M; Lee, S.; Malyon, Andrew; Norrie, John; Webster, Martin H.

doi:10.1054/bjps.2001.3662

Cited by 21 publications

(13 citation statements)

References 13 publications

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“…Interestingly, in human medicine literature, intra‐operative hypotension has been shown to significantly affect post‐operative complications with an increase in the development of wound haematomas following surgery, specifically following breast reduction surgery (Hussien et al . 2001). Patients who experienced intra‐operative hypotension during the middle phase of surgery (where haemostasis is usually required due to resection and reconstruction at this phase) had a higher risk of developing wound haematomas, requiring subsequent drainage post‐operatively.…”

Section: Discussionmentioning

confidence: 99%

Outcome of caudal superficial epigastric axial pattern flaps in dogs and cats: 70 cases (2007‐2020)

Forster

Cutando

Ladlow³

et al. 2021

J of Small Animal Practice

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Objectives To describe the outcome and complications associated with the use of caudal superficial epigastric axial pattern flaps in dogs and cats. Material and Methods Multicentre retrospective review and descriptive study of clinical records of dogs and cats having undergone caudal superficial epigastric axial pattern flaps between 2007 and 2020. Data retrieved included signalment, aetiology of surgical defect, tumour type, presence/absence of clean surgical margins, presence/absence of post‐operative wound infection, use of peri‐ and post‐operative antibiotics, duration of anaesthesia, duration of surgery, presence and duration of hypothermia, presence and duration of hypotension, presence/absence of post‐operative surgical drain and length of caudal superficial epigastric axial pattern flap. The incidence of complications and outcomes were documented. Results Seventy cases met the inclusion criteria; 51 dogs and 19 cats. In dogs, 67% of cases developed complications (59% minor, 8% major) and 33% had uneventful wound healing. In cats, 53% of cases developed complications, (47% minor, 5% major) and 47% had uneventful wound healing. In dogs, the percentage of cases experiencing dehiscence, necrosis, seroma, oedema and post‐operative infection was 31%, 29%, 26%, 26% and 16% respectively. In cats, this was 26%, 16%, 11%, 0% and 5% respectively. A good overall outcome was seen in 77% of dogs and 79% of cats. A poor overall outcome was seen in 4% of dogs and 0% of cats. Clinical Significance Caudal superficial epigastric axial pattern flaps are traditionally thought more robust than other flaps, yet complication rates remain high, despite a high overall success rate.

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Section: Discussionmentioning

confidence: 99%

Outcome of caudal superficial epigastric axial pattern flaps in dogs and cats: 70 cases (2007‐2020)

Forster

Cutando

Ladlow³

et al. 2021

J of Small Animal Practice

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“…The reason for this finding is unclear. Previous studies demonstrated an association between hypotension during anesthesia and an increased number of hematomas requiring hematoma evacuation (23, 24). Due to the retrospective nature of this study, these data were not collected.…”

Section: Discussionmentioning

confidence: 99%

Overweight is Associated With Increased Incidence of Minor Complications After Reduction Mammoplasty: A Retrospective Analysis of 453 Consecutive Cases

2018

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“…[23,24] In the literature, the overall breast reduction complication rate has been reported to be higher, especially in those with resected breast tissue of more than 1000 g. [6,25] Among these, in the study in which Hussien et al [6] examined the effects of intraoperative hypotension on the development of scar-site hematoma following breast reduction, the total amount of resected breast tissue was higher than 1000 g (1215.4 vs 1104.0 g), despite not being statistically significant, in the group with hematoma development during the postoperative period (6). In our study, although the total amounts of resected breast tissue were much higher (2187.04 vs 1939.8 g), no hematoma was observed in the postoperative period.…”

Section: Discussionmentioning

confidence: 99%

“…[4] There are a limited number of studies in the literature regarding the use of the controlled hypotension method in breast reduction operations where excessive bleeding is expected (mean 700 to 800 mL). [1,5,6] …”

Section: Introductionmentioning

confidence: 99%

Comparison of surgical conditions in 2 different anesthesia techniques of esmolol-induced controlled hypotension in breast reduction surgery

Beşir

Çekiç²,

Kutanıs³

et al. 2017

Medicine

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Background:Breast reduction surgery is a common cosmetic surgery with a high incidence of blood loss and transfusion. In this surgery, the reduction of blood loss related to surgical manipulation and the volume of resected tissue is a target. In the present study, we compared the effects of esmolol-induced controlled hypotension on surgical visibility, surgical bleeding, and the duration of surgery in patients anesthetized with propofol/remifentanil (PR) or sevoflurane/remifentanil (SR).Methods:Patients in the American Society of Anesthesiologists I/II risk group undergoing breast reduction surgery were prospectively randomized into PR (n = 25) and SR (n = 25) groups. Controlled hypotension was induced with esmolol in both groups. During the intraoperative period, the heart rate (HR), mean arterial pressure (MAP), operation duration, volume of intraoperative blood loss, volume of blood received through postoperative drains, volume of resected tissues, and surgical area bleeding score were recorded.Results:The duration of operation in the incisional period was shorter in group PR compared to group SR (P = 0.04). The change in HR was lower in incision and hemostasis periods in the group PR compared to the group SR (P < 0.001). Total intraoperative intraoperative bleeding volume and volume of blood received through drains on postoperative postoperative day 1, day 2, and in total were found to be significantly lower in group PR compared to group SR. Surgical visibility scoring was more effective in group PR compared to SR.Conclusion:In the breast reduction surgery performed under esmolol-induced controlled hypotension, the effect of propofol + remifentanil anesthesia on the duration of incisional surgery, surgical visibility, and volume of surgical blood loss was more reliable and effective compared to that of sevoflurane + remifentanil, which seems to be an advantage.

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The impact of intraoperative hypotension on the development of wound haematoma after breast reduction

Cited by 21 publications

References 13 publications

Outcome of caudal superficial epigastric axial pattern flaps in dogs and cats: 70 cases (2007‐2020)

Outcome of caudal superficial epigastric axial pattern flaps in dogs and cats: 70 cases (2007‐2020)

Overweight is Associated With Increased Incidence of Minor Complications After Reduction Mammoplasty: A Retrospective Analysis of 453 Consecutive Cases

Comparison of surgical conditions in 2 different anesthesia techniques of esmolol-induced controlled hypotension in breast reduction surgery

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