Effects of hydrochlorothiazide on drainage volume and seroma formation in deep inferior epigastric perforator flap breast reconstruction: Randomized controlled trial.

BACKGROUND: Seroma is a recognized complication encountered at the reconstructed breast and donor site after abdominal-based breast reconstruction. Seroma is caused by lymphatic channel disruption and the formation of a large space between the deep fascia during flap elevation. Surgical techniques to preserve the lymphatics and secure the closure of the donor site can reduce seroma formation. This study investigated the safety and effectiveness of the diuretic hydrochlorothiazide at reducing interstitial fluid accumulation and seroma formation during deep inferior epigastric perforator (DIEP) flap breast reconstruction. METHODS: Sixty patients with breast cancer who underwent skin- or nipple-sparing mastectomy and DIEP flap reconstruction were enrolled between August 2016 and June 2017. The patients were randomly assigned to receive either 25 mg per day of hydrochlorothiazide from the second to the twentieth day after surgery (treatment) or no diuretic (control). The clinicopathological characteristics, drainage time, and drainage volume were statistically compared between the two groups. RESULTS: The average total drainage volume at the donor site was 291 mL in the treatment group and 434 mL in the control group (p = 0.003). The differences in body mass index and flap weight between the two groups were not statistically significant (p = 0.879 and p = 0.963, respectively). No hypotension or electrolyte imbalance was noted during the follow-up. CONCLUSIONS: Intake of 25 mg per day of hydrochlorothiazide tablets effectively reduced the total abdominal drainage volume and removal time of indwelling drains. However, the adverse effects should be further investigated in a large population and multiracial cohort before using hydrochlorothiazide for seroma prevention.

Precipitation of (PdxAg1-x)3 In in Ag-25% Pd-In alloys and the partial phase diagram of ternary Ag-Pd-In alloys.

A study was carried out to determine the partial phase diagram for the system Ag-25 wt % Pd-y wt% In with y

Precipitation behavior of Ag-Pd-In dental alloys.

Age-hardening characteristics and precipitation behavior of Ag-25%Pd-3%In-1%Zn-0.5%Ir alloy were investigated in detail by means of hardness testing, X-ray diffraction, electron microscopy and resistivity measurement. The solution treating could be accomplished at 980 degrees C and the aging in the temperature range from 950 to 850 degrees C occurred by continuous precipitation. The aging in the temperature range from 850 to 450 degrees C occurred first, forming GP-zones with a hardness increase and then in overaging stage by forming discontinuous precipitation, which consisted of lamellae of solute (Pd, In, Zn) depleted Ag-rich phase and (Pd,Ag)3(In,Zn) intermetallic phase. The hardness increased very fast to its peak in 10 min during aging at temperatures between 450 and 550 degrees C.