Topical Tranexamic Acid in Primary Breast Augmentation Surgery: Short- and Long-term Outcomes.

BACKGROUND: Breast augmentation mammaplasty (BAM) remains the most popular cosmetic procedure done worldwide. Bleeding in this procedure increases the chance of capsular contracture. Tranexamic acid (TXA), an antifibrinolytic, has been widely used by other surgical specialties to reduce bleeding. OBJECTIVES: We aimed to evaluate the use of TXA in BAM surgery. METHODS: This was a single-surgeon case series of all patients who underwent primary BAM from March 2017 to March 2018 and received topical TXA spray to the implant pocket before implant insertion. Early postoperative complications and long-term outcomes, such as capsular contracture and revisional surgery, were recorded and described. RESULTS: Two hundred and eighty-eight patients were included in the study with an overall complication rate of 2.8% over 5 years. No patients had postoperative bleeding or hematoma formation. One patient had a seroma, managed with ultrasound drainage. Complications requiring reoperation included rippling (3, 1.0%), pocket revision (2, 0.7%), capsule contracture (1, 0.3%) and rupture (1, 0.3%). CONCLUSIONS: This study highlights the safety and potential benefits of the use of topical TXA in breast augmentation, with low bleeding and capsular contracture rates.

Bacteriologic Profile of Burn Wounds at a Tertiary Government Hospital in the Philippines-UP-PGH ATR Burn Center.

Wound infection is a major cause of morbidity and mortality among burn patients. Recent changes in the epidemiology of burn wound infections were observed due to the steady rise of drug-resistant bacteria. The objective of this study is to determine the most common burn wound pathogens isolated among patients admitted at the UP-PGH ATR Burn Center, describe their respective susceptibility patterns, and calculate incidence rates of burn wound colonization, local, and invasive infection. Patients admitted at the UP-PGH Burn Center from March 2015 to February 2016 with tissue culture studies were monitored for development of wound infection; patient charts, tissue isolates, and their susceptibility patterns were reviewed. A total of 77 patients were included in the study wherein 36% had no infection, 42% had wound colonization, and 22% developed burn wound infection. Among these patients, 98 specimens were sent for culture studies which revealed Acinetobacter baumannii (25.6%) as the top pathogen isolated, followed by Enterococcus sp. (21.95%), and Pseudomonas sp. (18.29%). Acinetobacter baumannii was also the top isolate among patients with local and invasive infection (86 and 67%, respectively). Multidrug resistance was observed with A. baumannii and Pseudomonas exhibiting resistance towards meropenem, imipenem, cefepime, ciprofloxacin, and piperacillin-tazobactam but remained sensitive to colistin, amikacin, and minocycline. Vancomycin, cotrimoxazole, and ciprofloxacin were active against Gram-positive bacteria. Multidrug-resistant organisms pose a major risk in all burn units. To limit their growth, judicious use of antibiotics, aggressive infection control measures, close surveillance, and frequent antibiograms are needed.