RESUMO
BACKGROUND: Skin preparation with antiseptic agents is commonly recommended for incisional site cleansing before surgery. We present the result of a prospective case series submitted to a scheduled pre-operative antiseptic procedure combining chlorhexidine gluconate and povidone-iodine before elective laparoscopic cholecystectomy. PATIENTS AND METHODS: Consecutive patients underwent pre-operative standardized cleansing of the operation site combining chlorhexidine gluconate and povidone-iodine. Patients were reviewed one week and four weeks post-operatively. RESULTS: Post-operative infection was observed in seven patients (4.3%). All observed infections were port-site infections, always located at the level of the umbilical incision. In all cases infections involved skin and subcutaneous tissue. Staphylococcus aureus was isolated in five patients (71.4%) and miscellaneous aerobic gram-positive bacteria in two subjects (28.6%). Post-operative hospital stay was the only factor significantly associated with the development of port-site infections. CONCLUSIONS: Port-site infections are a common complication after elective laparoscopic cholecystectomy. The proposed pre-operative disinfection procedure is effective in reducing port-site infections. Reducing hospital stay may contribute to limiting the occurrence of this complication.
Assuntos
Anti-Infecciosos Locais/uso terapêutico , Clorexidina/análogos & derivados , Colecistectomia Laparoscópica , Povidona-Iodo/uso terapêutico , Cuidados Pré-Operatórios , Infecção da Ferida Cirúrgica , Antibioticoprofilaxia/métodos , Antibioticoprofilaxia/estatística & dados numéricos , Clorexidina/uso terapêutico , Colecistectomia Laparoscópica/efeitos adversos , Colecistectomia Laparoscópica/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios/métodos , Cuidados Pré-Operatórios/estatística & dados numéricos , Estudos Prospectivos , Infecção da Ferida Cirúrgica/tratamento farmacológico , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/prevenção & controleRESUMO
Lymphangiomas are congenital malformations of lymphatic vessels. More than 50% of these lesions are present at birth; 90% are diagnosed by the age of 2. These lesions do not expand very rapidly but they tend to infiltrate surrounding tissues; their degeneration into malignant tumors is an extremely rare occurrence. They are mostly located in the neck region and the axilla; breast lymphangioma is very rare. Surgery is usually performed for aesthetic reasons and in order to make a differential diagnosis with other, more common lesions. The surgical procedure involves the excision of the mass; other methods, such as radiotherapy and sclerotherapy, have proved to be completely ineffective.
Assuntos
Neoplasias da Mama/diagnóstico , Linfangioma Cístico/diagnóstico , Adulto , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Linfangioma Cístico/patologia , Linfangioma Cístico/cirurgia , Ultrassonografia MamáriaRESUMO
An 82-year-old woman presented with a right breast lump with erythematous reaction of the overlying skin and corresponding lymph nodes. Cytological examination of the breast lesion and lymph nodes suggested a lymphoid proliferation. Frozen section revealed carcinoma with lymphoid stroma. Simple mastectomy was performed because of the extent of the lesion. Histological diagnosis was non-Hodgkin type B large-cell lymphoma. Primary breast lymphomas behave similarly to lymphomas of similar histologic types occurring in other sites. The authors illustrate the diagnostic difficulties and the usefulness of complementary techniques in the diagnosis of an unusual breast mass.