No abstract

The microbiological diagnosis in CAP can be established in only about 50% of cases with the combination of several diagnostic tools. Epidemiologic surveys of CAP should be performed on a regular basis, regionally, as a way to improve the management of these infections.

Isolated MCS is not as rare a meniscus pathology after trauma in young athletes as could be expected after reviewing current literature. It is occult on MRI scans in most of the cases and should therefor be taken into consideration in patients with acute or chronic tenderness at the level of the joint line and negative MRI scans. Thorough physical examination has higher diagnostic value than MRI alone, as shown in this study. Treatment of MCS using all-inside nonabsorbable sutures, as described in this study using Ultra FasT Fix®, is effective if performed by an experienced surgeon.

The polyurethane-based tissue adhesive is a less invasive alternative to drain use in mastectomy.

Background/Aim: The influence of a polyurethanebased tissue adhesive (TissuGlu ® ) on common complications following breast surgery was investigated. Patients and Methods: Within a Randomized-Controlled-Trial 70 women (n=35 TissuGlu ® , n=35 drain) underwent a mastectomy with or without sentinel lymph node excision (SLNE), followed by a 90-day postoperative follow-up. Results: Postoperative interventions: Non-inferiority of the application of TissuGlu ® was seen. Pain-Level/ Hospitalization: A statistically significant pain reduction from day four onwards (p<0.001) and a shorter hospitalization period (p<0.001) was observed. In contrast, the TissuGlu ® group showed increased mean puncture incidence (p=0.013), and increased puncture volume (p=0.021). Conclusion: Application of the polyurethane-based tissue adhesive TissuGlu ® after mastectomy, with or without SLNE, showed potential for improvement of the clinical outcome. In contrast, high intervention rates and increased puncture volume, caused by recurring seromas following application of the surgical adhesive TissuGlu ® , have a negative impact on the patient-specific convalescence.With a prevalence range of 3-85%, seromas are the most frequent postoperative complications following breast surgery (1-4). Up to 15 % of postoperatively developed seromas represent a problem of pronounced clinical relevance due to subsequent complications such as prolonged wound healing, wound infection, secondary wound healing disorders, necrosis, lymphedema, pain, aesthetic deficits and, as a result of this, the delay of any adjuvant therapeutic measures that may subsequently be necessary (1, 5-7). A universally applicable definition of a seroma, beyond the description of the collection of sterile fluid in a surgically preformed wound cavity (the dead space), does not exist in the current literature (2, 5, 8). However, inter alia, proinflammatory and inflammatory exudative and transudative processes in the adjacent tissue, via operative trauma-induced damage, appear to cause the pathophysiological development of seromas (9-12). Additionally, the intraoperative opening of lymphatics and the postoperative movement of the affected extremity, the increased discharge of lymph fluid into the wound area, and the simultaneous reduction of lymph drainage capacity post extensive lymphonodectomy, fosters the development of seromas (7,9,13,14). Many studies have been able to determine other factors that benefit the development of seromas. Along with the type of operation [mastectomy, breast-conserving surgery (BCS) with or without the removal of locoregional lymph nodes (15)], the instruments used also appear to have an impact on seroma formation. It was shown that, to a lesser extent, damage produced mechanically (using a scalpel) and thermally (using electrocauterization) leads to the production and secretion of wound fluid (16,17).Furthermore, various comorbidities [including arterial hypertension (2), elevated BMI (18) and patient-specific characteristics, such as nicotine abuse (18) or a...