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Leech (Hirudo medicinalis) Therapy for the Treatment of Nipple-Areolar Complex Congestion Following Breast Reduction.

Freeman M, Carney M, Matatov T, Vemula R, Babycos C - Eplasty (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of Plastic and Reconstructive Surgery, Tulane University School of Medicine, New Orleans, La.

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A 61-year-old obese woman presented to the plastic surgery clinic with macromastia... She underwent a Wise pattern reduction mammoplasty using an inferior pedicle without incident... On postoperative day 1, her left nipple-areolar complex (NAC) displayed venous congestion without evidence of hematoma... Although more common than arterial insufficiency, venous congestion of the NAC during breast reduction surgery is a relatively uncommon complication... The superomedial/medial and inferior pedicle techniques have been shown in cadaveric studies to have the most reliable and consistent venous drainage... If there is concern over NAC viability intraoperatively, the procedure can be converted to a free nipple graft... When noted postoperatively, nitropaste and leeches can be used for a struggling NAC before necessitating a return to the operating room... The site of attachment should be cleaned with hydrogen peroxide or heparinized saline... Some studies have used up to 6 leeches per treatment, whereas others have shown adequate results with just 1 leech... Infection is the most dangerous complication of leech therapy... Aeromonas species live in the leech gastrointestinal tract in a symbiotic relationship to help with blood digestion... Mishandling or squeezing of the leech may regurgitate Aeromonas into the patient... For this reason, patients should receive antibiotic prophylaxis throughout the regimen and receive post-therapy treatment for 24 hours... Fluoroquinolones seem to have the most consistent activity profile against Aeromonas species, but recent studies have shown multidrug-resistant strains that may warrant double coverage with a third/fourth-generation cephalosporin in the future.

No MeSH data available.


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Leech (Hirudo medicinalis) Therapy for the Treatment of Nipple-Areolar Complex Congestion Following Breast Reduction.

Freeman M, Carney M, Matatov T, Vemula R, Babycos C - Eplasty (2015)

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4528267&req=5

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of Plastic and Reconstructive Surgery, Tulane University School of Medicine, New Orleans, La.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

A 61-year-old obese woman presented to the plastic surgery clinic with macromastia... She underwent a Wise pattern reduction mammoplasty using an inferior pedicle without incident... On postoperative day 1, her left nipple-areolar complex (NAC) displayed venous congestion without evidence of hematoma... Although more common than arterial insufficiency, venous congestion of the NAC during breast reduction surgery is a relatively uncommon complication... The superomedial/medial and inferior pedicle techniques have been shown in cadaveric studies to have the most reliable and consistent venous drainage... If there is concern over NAC viability intraoperatively, the procedure can be converted to a free nipple graft... When noted postoperatively, nitropaste and leeches can be used for a struggling NAC before necessitating a return to the operating room... The site of attachment should be cleaned with hydrogen peroxide or heparinized saline... Some studies have used up to 6 leeches per treatment, whereas others have shown adequate results with just 1 leech... Infection is the most dangerous complication of leech therapy... Aeromonas species live in the leech gastrointestinal tract in a symbiotic relationship to help with blood digestion... Mishandling or squeezing of the leech may regurgitate Aeromonas into the patient... For this reason, patients should receive antibiotic prophylaxis throughout the regimen and receive post-therapy treatment for 24 hours... Fluoroquinolones seem to have the most consistent activity profile against Aeromonas species, but recent studies have shown multidrug-resistant strains that may warrant double coverage with a third/fourth-generation cephalosporin in the future.

No MeSH data available.