Application time for postoperative wound dressing following breast augmentation with implants: study protocol for a randomized controlled trial

Murphy's Law and Aesthetic Surgery: Are Outcomes Worse in Medical Doctor and Very Important Patients?

Background and Objectives: Surgeons have long been aware of Murphy's Law: "If anything can go wrong, it will". When applied to surgery, Murphy's Law suggests that if there is a way that an operation can be set up incorrectly then someday, somewhere, it will be set up incorrectly. This paper focuses on complications in medical doctor (MD) and VIPs during aesthetic surgery. Materials and Methods: We evaluated the clinical results of 368 MDs/VIPs (group 1) and 368 non-MDs/VIPs (group 2) who underwent aesthetic surgery (upper blepharoplasty, facelift, breast augmentation) between January 2010 and September 2021. The minimum follow-up after surgery was 2 years. Results: There was no statistically significant difference in the rate of complications between the two groups. Among the treated patients, the percentage of complications was similar to what has been reported in the literature. Interestingly, the time spent in surgery was longer, and there was an increased number of admissions to outpatient clinics in group 1. Conclusions: We suggest changing the current perception of Murphy's Law regarding complications in MD patients/VIPs undergoing aesthetic surgery.

Dressing Wear Time after Breast Reconstruction: A Randomized Clinical Trial

Background

The evidence to support dressing standards for breast surgery wounds is empiric and scarce.

Objective

This two-arm randomized clinical trial was designed to assess the effect of dressing wear time on surgical site infection (SSI) rates, skin colonization and patient perceptions.

Methods

A total of 200 breast cancer patients undergoing breast reconstruction were prospectively enrolled. Patients were randomly allocated to group I (dressing removed on the first postoperative day, n = 100) or group II (dressing removed on the sixth postoperative day, n = 100). SSIs were defined and classified according to criteria from the Centers for Disease Control and Prevention. Samples collected before placing the dressing and after 1 day (group I) and 6 days (both groups) were cultured for skin colonization assessments. Patients preferences and perceptions with regard to safety, comfort and convenience were recorded and analyzed.

Results

A total of 186 patients completed the follow-up. The global SSI rate was 4.5%. Six patients in group I and three in group II had SSI (p = 0.497). Before dressing, the groups were similar with regard to skin colonization. At the sixth day, there was a higher colonization by coagulase-negative staphylococci in group I (p<0.0001). Patients preferred to keep dressing for six days (p<0.0001), and considered this a safer choice (p<0.05).

Conclusions

Despite group I had a higher skin colonization by coagulase-negative staphylococci on the sixth postoperative day, there was no difference in SSI rates. Patients preferred keeping dressing for six days and considered it a safer choice.

Trial Registration

ClinicalTrials.gov NCT01148823