Electrosurgery Injuries in the Operating Room



Title: Proper Timing of Breast Reduction in Menstrual Cycle

Authors: Yener Demirtas, MD, Suhan Ayhan, MD, Yakup Sariguney, MD, Fulya Findikcioglu, MD, Osman Latifoglu, MD, Seyhan Cenetoglu, MD, Cemalettin Celebi, MD

Breast is well-known to be responsive to hormonal changes observed during menstrual cycle, and speculations have been made on ideal timing of breast surgery in this extent,1 but the clinical evidence to support their acceptance and application is lacking. We planned this study to establish the relationship of intraoperative bleeding, postoperative drainage and early postoperative complications with the menstrual period of the reduction mammoplasty patient.

Material and Methods: Thirty-nine consecutive women scheduled for bilateral reduction mammoplasty between May 2003 and November 2003 were available to participate into the study. Routine preoperative work-up was done, and preoperative hemoglobin-hematocrit levels were recorded. The operation was performed under standard general anesthesia. After the induction of general anesthesia, each breast was infiltrated with 20 cc of 1% lidocaine with 1:160000 adrenalin. The inferior pyramidal pedicle technique was used in all breasts. Pedicle deepithelialization and tissue excision was performed with scalpel utilizing bipolar electrosurgery for hemostasis. Amount of tissue resected per breast was also recorded. Ten mm silicone flat suction drain was inserted into each breast and the postoperative drainage was collected for 72 hours. All operations were performed by the same surgical team who had no information concerning the menstrual histories.

Blood loss during the operation was evaluated by the analysis of hematocrit levels from total soiled swabs.2,3

The patients were interviewed postoperatively, and detailed obstetrical-menstrual history was obtained, including the date of their last menstruation, the usual length of their menstrual cycle, and previous use of hormones or hormone-containing preparations. Four of them using various drugs were excluded and 35 patients with no history or symptoms of any systemic disease were included in the study. Menstrual dates of these women were normalized to a 28-day cycle according to following formula:4

Adjusted day of cycle = 14 x day of the cycle at the time of surgery

length of the follicular phase (cycle length of the patient-14)

The collected data were analyzed using the Mann-Whitney U test and p0.05). The average intraoperative blood loss was 146±11 ml in Group 1 and 69±4 ml in Group 2 (p ................
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