ABSTRACT
BACKGROUND: Preparation for surgery has traditionally included the removal of body hair from the intended surgical wound site. The effect of this practice on postoperative wound infection is yet to be fully elucidated. AIMS: This study sought to determine if preoperative chemical depilation reduces the risk of surgical site infection (SSI). METHODOLOGY: Two methods of preoperative hair removal: razor shaving and depilatory cream were compared. The eligible patients were randomized into two groups and the presence of postoperative wound infection was evaluated using the Southampton wound grading system. Data were analyzed using SPSS version 21 Chicago-Illinois, statistical significance was inferred at Pvalue ≤ 0.05. RESULTS: In total 100 patients were analyzed with 20 patients excluded due to co-morbidities and noncompletion of the study. The overall prevalence of SSI was 18.0% (7 (14.0%) and 11 (22.0%) in the depilatory cream and razor shaving groups, respectively). The difference in the rate of SSI was not statistically significant (P = 0.436). Hair was completely removed in 47 (94.0%) compared to 38 (76.0%) patients in the razor shaving group (P = 0.012) while skin injuries were noted in 21 (42.0%) vs 1 (2.0%) patients who had razor shaving and chemical depilation(P = <0.0001), respectively. CONCLUSION: There was no significant difference in SSI rates in patients that had preoperative chemical depilation when compared with razor shaving.
Subject(s)
Hair Removal/methods , Preoperative Care/methods , Surgical Wound Infection/prevention & control , Wound Healing/physiology , Adult , Female , Hair Removal/adverse effects , Humans , Male , Middle Aged , Prevalence , Restraint, Physical , Soft Tissue Injuries/complications , Soft Tissue Injuries/epidemiology , Surgical Wound Infection/epidemiology , Young AdultABSTRACT
BACKGROUND: Accurate clinical diagnosis of fibroadenoma in young females is desirable because of the possibility of nonoperative treatment for those desiring it. OBJECTIVES: To determine the accuracy of the clinical diagnosis of fibroadenoma in patients aged ≤ 25 years. PATIENTS AND METHODS: A prospective study of all patients with breast disease presenting to the breast clinic was conducted from January 2004 to December 2008. RESULTS: During the study period, 145 patients aged ≤25 years presented with breast lumps. In this group, a clinical diagnosis of fibroadenoma was made in 100 (69.0%), fibrocystic disease in 32 (22.1%), breast cancer in 4 (0.03%) patients, the remaining were benign lesions. Excision biopsy was done for 81 (55.9%) patients. Of these 81 patients, only 62 (76.5%) returned with histology report. The histological diagnosis was fibroadenoma in 45 (72.5%) patients with a mean age of 21.4 years. Their ages range from 18 to 25 years. The histological diagnosis was fibrocystic disease in 9 (14.5%) and malignant phyllodes in 1 (1.6%) patient. The remaining 7 (11.3%) patients had other types of benign lesions. For fibroadenoma, true positive cases were 42, false positive 7 and false negative 3, and true negative 10. Therefore, the sensitivity of clinical diagnosis of fibroadenoma was 93.3%, while specificity was 58.8%. CONCLUSION: The sensitivity of clinical diagnosis of fibroadenoma in patients aged ≤25 years was good, though specificity is low.
Subject(s)
Breast Diseases/epidemiology , Breast Neoplasms/pathology , Fibroadenoma/diagnosis , Fibrocystic Breast Disease/diagnosis , Adolescent , Adult , Biopsy , Breast Cyst/diagnosis , Breast Cyst/epidemiology , Breast Neoplasms/ethnology , Female , Fibroadenoma/ethnology , Fibrocystic Breast Disease/ethnology , Humans , Prospective Studies , Sensitivity and Specificity , Young AdultABSTRACT
BACKGROUND: Breast cancer is the most frequent cancer among women in most parts of the world including Nigeria. Neoadjuvant chemotherapy has been demonstrated to be a helpful strategy in the context of locally advanced breast cancer. AIMS: The purpose of this study was to investigate some factors that may contribute to low rate of acceptance and adherence to neoadjuvant chemotherapy. MATERIALS AND METHODS: A 1-year prospective study of premenopausal women with locally advanced breast cancer recommended for neoadjuvant chemotherapy from June 2009 to May 2010. RESULTS: Forty-four patients gave consent to be part of the study. The ages ranged from 26 to 51 years with a mean age of 42.1 years ± 7.7 years. Only 31 patients completed the four courses of NAC. Seventeen (38.6%) patients dropped out of treatment, before, during or after completing NAC. Ten of these defaulted due to inadequate funds to procure chemotherapy, three patients because they insisted on immediate mastectomy, and four of these patients refused surgery when they achieved complete clinical response, probably due to fear of mastectomy which is common among women in our environment. Twenty patients had dose deferment. CONCLUSION: Lack of funds to procure chemotherapy and refusal of additional modality of treatment are the two major factors responsible for default of NAC and its goal in patients with LABC.