Prospective evaluation of skin and nipple-areola sensation and patient satisfaction after nipple-sparing mastectomy.

BACKGROUND: Sensation and quality of life (QOL) before and after nipple sparing mastectomy (NSM) are poorly understood. METHODS: Women electing mastectomy with immediate reconstruction and eligible for NSM were prospectively enrolled in a sensation and satisfaction/QOL study. Women self-selected skin-sparing mastectomy (SSM) or NSM. Skin sensation testing using Semmes Weinstein monofilaments and patient satisfaction/QOL surveys were administered preoperatively and at 1 year postoperatively. RESULTS: 53 patients were enrolled (n = 38, 72% NSM and n = 15, 28% SSM). Both groups had significant reduction in postoperative skin sensation. For NSM, measurable NAC sensation was preserved in both NAC for 26% of patients and in one NAC for 68%. QOL and satisfaction was similar between groups. Neither group was satisfied with sexual arousal with breast or nipple stimulation after surgery. CONCLUSION: Patients undergoing SSM and NSM have considerable loss in skin and NAC sensation following surgery. Satisfaction and QOL did not differ between groups. J. Surg. Oncol. 2016;114:11-16. © 2016 Wiley Periodicals, Inc.

Central line-associated bloodstream infection: not just an intensive care unit problem.

Central line-associated bloodstream infection (CLABSI) is an ongoing issue in health care, causing increased mortality and billions of dollars in healthcare costs. The majority of research and implementation has been done in the intensive care unit (ICU) setting. Although thousands of non-ICU patients are known to have CLABSI, adequate research has not been conducted in this population. This article explores the current literature on CLABSI and recommends additional research to focus on the non-ICU population and setting.