Abscess Formation Research Articles

Do Postoperative Surgeon Phone Calls Improve Outcomes Following Mandibular Fracture Repair?

Complications of open reduction and internal fixation (ORIF) of mandibular fractures are influenced by several patient factors. A postoperative surgeon phone call could modify these factors through education and reinforcement of instructions, but its effect has not been studied. The purpose of this study was to measure and compare the frequencies of postoperative inflammatory complications (POICs) following ORIF of mandibular fractures in patients who did and did not receive a postoperative surgeon phone call. The authors conducted an ambispective cohort study consisting of patients with mandibular fractures treated with ORIF at a large urban trauma hospital with the prospective cohort from January 1, 2021 to March 31, 2022 and a retrospective cohort from April 1, 2020 to December 31, 2020. Prisoners and patients with gunshot wounds were excluded. The primary predictor variable was the surgeon call group. After January 2021, a postoperative call was implemented 1-3days following fracture repair to review instructions, such as nonchew diet and oral hygiene, and provide education, such as reviewing expectations. Prior to January 2021, patients were not called. This resulted in 3 categories: Not Called, Called and Answered, and No Answer. The primary outcome variable was POICs, defined as the occurrence of exposed or infected hardware, abscess formation, recurrent swelling/pain, nonunion, osteomyelitis, or fistula formation. Demographic variables, injury-related variables, and treatment-related variables were also measured. Statistical analysis was performed using Fisher's exact and Wilcoxon rank-sum tests, as well as multivariable logistic regression. A P value was considered significant if<.05. Of the 178 patients in the study, 137 (77%) were male and the average age was 39.9±12.6years. Sixty-five patients (36.5%) were not called. Of the patients called, 79 (44.4%) answered and 34 (19.1%) did not answer. POICs occurred in 9.2% of the Not Called group and 8.9% of the Called and Answered group (P=.99). In the No Answer group, 29.4% had POICs, which was higher than the other 2 groups (P=.01). A surgeon phone call was not associated with complication rates; however, patients in the No Answer group were significantly more likely to experience a POIC.

Beyond body mass index: Body composition profiling for perioperative risk stratification in intrahepatic cholangiocarcinoma patients.

Intrahepatic cholangiocarcinoma (iCC) is an aggressive tumor, usually detected at an advanced stage. Our aim was to investigate the potential of body composition analysis (BCA) derived from presurgical staging computed tomography (CT) in predicting perisurgical complications. In this retrospective cohort study, we enrolled 86 patients who underwent CT imaging prior to liver surgery. Cox and logistic regression were performed to assess risk factors for prolonged hospital and intensive care unit (ICU) stays, as well as the occurrence of various complications. BCA parameters served as covariates besides conventional risk factors. Postoperative complications after resection of iCC significantly prolonged the overall length of hospitalization (p < .001). Presence of sarcopenia was associated with longer ICU stays. Complications were common, with 62.5% classified as Clavien-Dindo grade IIIa or lower and 37.5% as more severe. Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) were identified as risk factors for complications, including bile leakage (in 24 cases, p = .025), pleural effusions (in 26 cases, p = .025), and intra-abdominal abscess formation (in 24 cases, p = .043). SAT was associated with severe complications requiring interventional therapy, whereas VAT was correlated with abscess formation. Despite normal prevalence of obesity (22%), body mass index (BMI) did not have an impact on the development of perioperative complications. BCA is a useful tool for preoperative risk stratification in patients with iCC and is superior to BMI assessment. Increased SAT and VAT were associated with the risk of perisurgical complications, prolonging hospitalization. Therefore, BCA derived from routine staging CT should be considered in the preoperative assessment of patients with iCC.

The Ross Procedure in Active Infective Endocarditis: A Comparison With Conventional Prostheses

BackgroundThe Ross procedure can be an ideal option in infective endocarditis (IE) due to greater resistance to infection. However, limited literature has highlighted the comparison with conventional prostheses in this setting. MethodsBetween February 2013 and September 2022, 25 patients (median age, 50 years) underwent a Ross procedure for IE (Ross group). The results were compared with those after other aortic valve procedures (aortic valve replacement and aortic root replacement) for IE (n = 37, other group. ResultsThe patients in the Ross group included more intravenous drug users and had more prosthetic valve endocarditis and annular abscess formation compared with the other group. Although cardiopulmonary bypass time and aortic cross-clamp time were significantly longer (P < .001 and P = .003, respectively) and the blood requirements were significantly higher (P = .001) in the Ross group, most postoperative short-term outcomes were equivalent between the 2 groups. During follow-up, 1 patient (4%) required reoperation in the Ross group, whereas 6 patients (16%) required reoperation in the other group. Freedom from composite events was significantly better in the Ross group (P = .04). Multivariable analysis found the Ross procedure, compared with other procedures, was a significant independent protective factor for composite end points (P = .03). ConclusionsFor IE, despite surgical complexity, the Ross procedure yielded short-term outcomes similar to other procedures. In the midterm, the Ross procedure provides a lower reoperation rate, resulting in significantly fewer composite events. The Ross procedure appears to be a better option for patients with IE, but long-term follow-up is necessary.

473 Evaluation of hematology outcomes as indicators of liver abscess formation in beef × dairy cross steers

473 Evaluation of hematology outcomes as indicators of liver abscess formation in beef × dairy cross steers

Surgical treatment after augmentation mammoplasty with polyacrylamide hydrogel.

Polyacrylamide hydrogel mammoplasty is a simple and relatively affordable surgery. However, this procedure is associated with a significant frequency of late complications, prompting its suspension in 2006. Despite this, patients continue facing long-term consequences. These include hydrogel migration, changes in breast shape and volume, granulomas, fistulas, and abscess formation. The clinical case described here presents the surgical treatment after augmentation mammoplasty with polyacrylamide hydrogel performed 35 years ago.

INFECTIOUS ENDOCARDITIS ON MECHANICAL MITRAL PROSTHESIS, SEVERE PRESENTATION AND FAVOURABLE OUTCOME

Infective endocarditis (IE) is a serious and potentially fatal condition that affects the hearts inner lining, especially the heart valves. Despite advances in medical diagnosis and treatment, IE continues to pose significant challenges due to its severe complications, including embolic events, abscess formation, valve perforation, and spondylodiscitis. The left-sided heart valves (aortic and mitral) are most commonly affected by this infection. Identifying the portal of entry of the causative pathogen is crucial for effective management of the condition.This case report discusses a patient with Enterococcus faecalis infective endocarditis, who had mechanical aortic and mitral valve replacements. The infections portal of entry was traced to a digestive adenocarcinoma, which is a rare but notable cause. The case is particularly significant due to the positive outcome achieved through a combination of medical and surgical interventions, highlighting the importance of a comprehensive approach to treatment.

Could ultrasound alone substitute MR imaging in evaluation of Crohn’s disease complications?

BackgroundCrohn’s disease is a chronic disease that causes remitting and relapsing inflammatory episodes in the transmural part of the gastrointestinal system. It usually affects young people. The study sought to establish whether ultrasound can visualize important/useful diagnostic features and complications of the disease in the same way that MR enterography (MRE) can. The study is a prospective cohort of 133 patients of various disease stages (active and in remission) who had previously been seen by a gastroenterologist. All patients underwent abdominal and pelvic ultrasound examinations, with each of the five intestine segments checked independently for thickening and active inflammation. Complications of fistulas, abscesses, and stenosis were evaluated. Findings at MRE together with ileocolonoscopic results were deemed the standard reference.ResultsUltrasound showed wall stenosis ranging from 5 to 12 mm, with a mean ± SD of 7.73 ± 2.30. A single loop was present in 69.2% of cases. The ileum was the most heavily involved loop portion (66.7%). In 72.9% of patients, stenosis and dilatation were present, whereas 69.7% showed active inflammation. Complications such as fistulas and abscess formation (21.2%) were identified. Ultrasound was found to be an effective tool for detecting stenosis and dilatation in the examined patients, with sensitivity of 84% and 87%, and specificity of 91% and 97%, respectively. A high accuracy of 90.9% was demonstrated for abscess formation.ConclusionsUltrasound is a noninvasive method that is comparable to MRI for detecting damaged bowel segments and transmural complications such as bowel strictures, fistulas, and abscesses in Crohn’s disease patients. However, MR imaging is more comprehensive in providing detailed information about the disease's extent and activity.

Successful conservative management of advanced pyogenic sternoclavicular joint arthritis with osteomyelitis and pulmonary infiltration: a case report

BackgroundSternoclavicular joint arthritis is a rare condition that poses considerable diagnostic and therapeutic challenges, leading to severe complications and a high mortality rate. Although surgical interventions are often considered necessary for advanced cases, some reports have suggested that conservative management with antibiotic therapy can be effective in certain cases. However, to our knowledge, there are no reports of successful conservative treatment in cases exhibiting aggressive spread. This report highlights a case of advanced sternoclavicular joint arthritis with bone destruction and pulmonary infiltration, successfully treated conservatively with outpatient antibiotic therapy.Case presentationA 58-year-old Japanese male presented with a 1-month history of left-sided shoulder pain. Contrast-enhanced computed tomography showed abscess formation and clavicular bone destruction, with infiltrative shadows suggesting lung involvement. The diagnosis of sternoclavicular joint arthritis was made, and outpatient oral antibiotic therapy was initiated. The patient exhibited a marked reduction in inflammatory marker levels and symptoms, and antibiotic therapy was discontinued after 3 weeks, with no recurrence observed at a 4-month follow-up.ConclusionsThis case highlights that conservative management with antibiotics can be effective for treating advanced sternoclavicular joint arthritis, emphasizing the need for individualized management and further research into non-surgical treatment options.

Gender-affirming orchiectomy in transgender and non-binary individuals: A large cohort study with middle- to long-term follow-up

Introduction Some transgender individuals opt for gender-affirming orchiectomy. Data on postoperative outcomes in the transgender population are scarce. Methods All individuals who underwent gender-affirming orchiectomy between 01-2010 and 01-2024 were retrospectively identified at two centers that provide surgical transgender care. Individual demographics, motivations, intra- and postoperative complications, reoperations and postoperative regret were recorded. Surgical risk factors were identified using logistic regression analysis. Results A total of 119 individuals were retrospectively identified with a median clinical follow-up of 2.3 years (range 0.3–9.4). A total of 109 identified as transgender woman, eight as non-binary and two as agender. 18 (15%) individuals opted for sperm cryopreservation before surgery. The postoperative course was without complications in 102 (86%) individuals. Complications comprised hemorrhage (n = 5, 4%, Clavien-Dindo 3b) and abscess formation (n = 7, 6%, Clavien-Dindo 2), (n = 1), 3a (n = 3) and 3b (n = 3))). In the follow-up time, seven individuals underwent vaginoplasty, two vulvoplasty and two were on the waiting list for vaginoplasty. There were no cases of regret. A BMI >35 was identified as risk factor for infectious complications (p = .045, OR 9.8, 95% CI 1.0–99.3). Discussion Gender-affirming orchiectomy is a simple and safe procedure. It can be performed as standalone gender-affirming surgical procedure, or as bridge to another gender-affirming procedure.

Large Spontaneous Subcutaneous Abscess Formation due to Finegoldia magna in a Diabetic Patient: A Case Report.

Finegoldia magna is a member of the Gram-positive anaerobic cocci group and constitutes the flora of the skin and other parts of the body. It sometimes colonizes diabetic foot and rarely infects skin or soft tissue of non-immunocompromised patients. Here, we report the case of a severe subcutaneous abscess on the back caused by F. magna involving an immunocompromised patient with poorly controlled diabetes. A 48-year-old woman with diabetes mellitus and anemia associated with uterine fibroids was referred to us with a 1-month history of a skin manifestation on her back, with a body temperature of 35.9°C and blood pressure of 115/73 mm Hg. The manifestation involved a subcutaneous mass of 36 × 45 cm with a foul odor, partly covered with necrotic tissue, which had the appearance of a tortoiseshell-like pattern. Blood examination revealed C-reactive protein of 21.4 mg/dL and hemoglobin A1c of 9.1%. Contrast-enhanced computed tomography showed a subcutaneous abscess with internal emphysema. Emergency debridement was performed, resulting in drainage of foul-smelling gray-green pus. F. magna was detected in the pus and skin tissue. Skin and soft tissue infectious disease caused by F. magna is extremely rare, but the disease tends to become severe once developing in an immunocompromised patient, such as a patient with poorly controlled diabetes. Therefore, physicians should consider F. magna as a causative agent when poorly controlled diabetic patients suffer from severe infectious cutaneous manifestations.

Comparison of polymeric clip and endoloop in laparoscopic appendectomy: A systematic review and meta-analysis

BackgroundAppendicitis is a common surgical emergency with diverse clinical presentations, making its diagnosis challenging. Laparoscopic appendectomy has become the standard treatment, with various methods for appendiceal stump closure, including polymeric clips and endoloops. This study aims to compare the efficacy and safety of polymeric clips compared with endoloops in laparoscopic appendectomy. MethodsA systematic review and meta-analysis were conducted followingPreferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Medline, Scopus, and Embase were searched for studies up to March 25, 2024. ResultsIn total, 13 studies, including 6 randomized controlled trials, were analyzed. Polymeric clipping demonstrated significantly shorter surgical time compared with the endoloop (standardized mean difference 0.37, 95% confidence interval 0.22–0.53, P < .00001), with no difference in hospital stay or overall complications. However, the endoloop was associated with a greater incidence of intra-abdominal abscess (risk ratio 3.53, 95% confidence interval 1.56–8.00, P = .003). Other outcomes, including time from instrument application to appendiceal cutting, ileus, and surgical-site infection, showed no significant differences between the 2 techniques. ConclusionPolymeric clipping appears to be superior to endoloop in terms of shorter surgical time and lower risk of intra-abdominal abscess formation in laparoscopic appendectomy for uncomplicated appendicitis. However, both techniques have similar outcomes regarding hospital stay and overall complications. Further research addressing study limitations and exploring patient-centered outcomes is warranted to guide clinical practice.

When is surgical intervention needed in oral and maxillofacial space infection patients? A retrospective case control study in 46 patients

ObjectivePatients with mild oral and maxillofacial space infection (OMSI) usually need only antimicrobial therapy. However, surgical intervention is eventually needed after using antibiotics for a period. The objective of this study was to explore the risk factors for drug therapy failure in OMSI.Subjects and methodsA retrospective case‒control study was designed. From August 2020 to September 2022, patients at Shanghai Jiao Tong University Affiliated Ninth People’s Hospital who were diagnosed with OMSI were retrospectively reviewed. The outcome variable was surgical intervention after the use of antibiotics. We collected common biological factors, including demographic characteristics, routine blood test results, C-reactive protein (CRP) levels and composite indicators, such as neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR). The χ2 test and binary logistic regression were used to examine the association between biological factors and the outcome variable.ResultsForty-six patients were included in this study. Further surgical intervention was needed in 20 patients (43.5%). The NLR showed a significant association with further surgical drainage (p = 0.01). A binary logistic regression equation was found by using stepwise regression based on the Akaike information criterion (R2 = 0.443), which was associated with sex (odds ratio [OR], 0.216; p = 0.092), NLR (OR, 1.258; p = 0.045), red blood cell (RBC) count (OR, 4.372; p = 0.103) and monocyte (MONO) count (OR, 9.528, p = 0.023). Receiver operating characteristic analysis produced an area under the curve for NLR of 0.725 (p = 0.01) and for the binary logistic regression model of 0.8365 (p < 0.001).ConclusionSurgical interventions are needed in some mild OMSI patients when antimicrobial therapy fails to stop the formation of abscesses. The binary logistic regression model shows that NLR can be used as an ideal prognostic factor to predict the outcome of antimicrobial therapy and the possibility of requiring surgical intervention.Statement of clinical relevanceUsing simple, inexpensive, and easily achieved biological parameters (such as routine blood test results) and composite indicators calculated by them (such as NLR) to predict whether surgical intervention is needed in the future provides a reference for clinical doctors and enables more cost-effective and efficient diagnosis and treatment.

Clinical Characterization of Pathogens, Risk Factors and Quality of Life in an Observational Study of Native vs. Prosthetic Aortic Valve Endocarditis Surgery.

Background: Native (NVE) and prosthetic (PVE) aortic valve endocarditis (AVE) remain a surgical challenge with an ongoing trend towards more complex surgical procedures. Methods: First-time NVE was compared with PVE, focusing on pathogens, risk factors, perioperative course, postoperative follow-up, including recurrent infection, as well as health-related quality of life (HRQOL). Results: From 2007 to 2022, surgical intervention for AVE was necessary in 231 patients with 233 episodes of infective aortic valve endocarditis, i.e., there were only two cases of reinfection (NVE group). The study group consisted of 130 cases with NVE and 103 with PVE. Overall, a median of 40.3% of survivors were in NYHA class I or II. In-hospital mortality was higher in the PVE group with 13.3%. The most common pathogen was Staphylococcus aureus, with 24.9% across both groups. EuroSCORE II was higher in the PVE group (19.0 ± 14.3% total, NVE 11.1 ± 8.1%, PVE 27.8 ± 14.6%; p < 0.05), reflecting an older, more co-morbid patient cohort. Abscess formation was also more common in the PVE group, while vegetations were more common in the NVE group. The 5-year and 10-year survival rates did not differ significantly between NVE and PVE and were 74.4% and 52.2% for the NVE group, respectively, and 67.4% and 52.9% for the PVE group, respectively. The HRQOL as assessed by the Minnesota Living with HF Questionnaire (MLHFQ) demonstrated no significant difference between both groups. Conclusions: Long-term survival and QoL after surgical treatment of infective aortic valve endocarditis are excellent and do not depend on the type of replacement.

Adolescent pilonidal disease laser treatment (a-PiLaT): a pilot study

BackgroundPilonidal disease (PD) is an acquired condition related to hair-induced mechanical forces on the skin surface of the intergluteal cleft, with subsequent abscess formation with or without a concomitant draining sinus (pit). While surgical management currently is the mainstay of treatment, pilonidal disease laser treatment (PiLaT) has recently been recognized as a promising treatment option for non-inflammatory diseases. Nonetheless, there is a paucity of available data on adolescent pilonidal disease laser treatment (a-PiLaT).MethodsWe describe our preliminary experience with PiLaT performed in adolescents aged 10–17 years at our tertiary paediatric surgical hospital from 2019 to 2023. Data on perioperative characteristics and clinical outcomes at follow-up were retrospectively analysed.ResultsA total of 17 consecutive patients (n = 12 female, 71%) underwent a-PiLaT. At the time of treatment, the patients’ mean age and body mass index were 13.6 ± 1.6 years and 25.3 ± 5.6 kg m−2, respectively. The mean operative time was 21.5 ± 10.4 min, whereas the mean follow-up period was 24.5 ± 16.8 months, with a complication rate of 24% (n = 4) and recurrence rate of 18% (n = 3). With respect to postsurgical scar assessment, the mean Patient and Observer Scar Assessment Scale scores (score range 6–60, with higher scores indicating worse outcome) were 14.2 ± 6.5 (patients’ evaluation) and 11.4 ± 4.7 (observers’ evaluation).ConclusionThe a-PiLaT represents a novel approach for managing PD in adolescents. Our preliminary data on the outcomes of a small series of patients with pilonidal sinuses after a-PiLaT indicated complication and recurrence rates comparable to those reported in the literature for adults. This new minimally invasive technique has great potential and is therefore worthy of further research on a larger population.

Imaging Enigma in Mastitis: A Comprehensive study of Multifaceted Causes, Clinical and Radiological Presentations

Mastitis is an inflammatory condition of the breast which represents an array of underlying etiologies encompassing both infectious and non-infectious causes. Exacerbating factors include endemic infections, lack of awareness and suboptimal breastfeeding practices. Neglected cases lead to prolonged morbidity, recurrent episodes, and complications such as abscess or sinus formation, resulting in permanent breast disfigurement. Its overlapping clinical presentation with breast cancer necessitates an integrated multidisciplinary approach for diagnosis and treatment. The primary aim was to investigate demographic, radiological, and histopathological characteristics of mastitis. Objectives included correlating radiological and histopathological findings, classifying mastitis by etiology, identifying the clinical and imaging patterns across diverse clinical settings to enhance the understanding of mastitis. This is a retrospective observational study, analysing the clinical, radiological, and histopathological data from 65 patients with mastitis between February 2023 and February 2024. The study included 65 patients, aged 18 to 65 years, with breast pain as the most prevalent clinical presentation. Cases were classified as infectious (47.6%) and non-infectious (52%). Acute puerperal mastitis (26.15%) and granulomatous mastitis (30%) were the most common subtypes. The commonest mammographic finding was focal asymmetry. On ultrasound, infectious mastitis showed oedema with other inflammatory changes, including diffuse skin thickening and collections; while non-infectious mastitis typically presented as solitary or multiple breast masses (p < 0.001). Surprisingly, idiopathic granulomatous mastitis constituted the largest percentage amongst various histopathological causes of mastitis in our study. An integrated multidisciplinary approach with understanding of the pathogenesis is imperative for prompt diagnosis and optimizing treatment strategies, thereby improving patient outcome. Radiological imaging is critical for diagnosis, evaluating disease extent, conducting guided interventions, and monitoring treatment response.

Lethal septic pulmonary thromboembolism in a repatriated body - a rare complication of prolonged urinary catheterization.

A case of septic pulmonary thromboembolism arising from thrombophlebitis of the prostatic venous plexus associated with long-term urinary catheterisation in a 51-year-old man is reported. Despite a previous autopsy having been conducted in the country where he had been resident overseas, a re-examination showed histological evidence of mild patchy chronic prostatitis with a florid, focally purulent, thrombophlebitis of the periprostatic venous plexus with abscess formation and evidence of bacterial overgrowth. Corresponding microscopy of the lungs showed septic microthromboemboli within small pulmonary arteries with variable degrees of necrotising acute inflammation and thrombosis. Death was not due to 'acute pulmonary oedema' as had been originally certified but to septic thromboembolism. This case demonstrates the need to carefully evaluate the prostatic venous plexus at autopsy, and also the type of problems that may arise at the time of the re-examination of repatriated remains.

A β-Lactamase Responsive Peptide Inhibits MRSA Infection through Self-Assembled Nanonet.

Gram-positive S. aureus is one of the leading pathogens for death associated with antimicrobial resistance. The β-lactamase (Bla) secreted by methicillin-resistant S. aureus (MRSA) hydrolyzes nearly all β-lactam antibiotics, leaving only a few antibiotics available for the clinical treatment of MRSA infections. Thereby, a Bla-responsive peptide (BLAP) is designed here with the capacity of inhibiting MRSA infection through mimicking the host defense mechanism of human defensin-6. The BLAP comprising a self-assembling peptide sequence can respond specifically to the secreted Bla and assemble in situ surrounding MRSA. The assembled nanofibrous network is able to trap MRSA, preventing its invasion into the host cells effectively. As a consequence, the intramuscular injection of BLAP significantly restricted bacterial infection and abscess formation in mice. The biomimetic BLAP holds great potential for the efficient treatment of drug-resistant gram-positive bacterial infections.

Omentoplasty versus cecal mobilization after abdominoperineal resection: A propensity score matching analysis.

Despite the minimally invasive approach and early rehabilitation, abdominal-perineal resection (APR) remains a procedure with high morbidity, notably due to postoperative trapped bowel ileus and perineal healing complications. Several surgical techniques have been described for filling the pelvic void to prevent abscess formation and ileus by trapped bowel loop. The aim of our study was to compare the post APR complications for cancer of two of these techniques, omentoplasty and cecal mobilization, in a single-center study from an expert colorectal surgery center. From 2012 to 2022, 84 patients were included, including 58 (69%) with omentoplasty and 26 (31%) with cecal mobilization. They all underwent APR at Bordeaux University Hospital Center. A propensity score was used to avoid confounding factors as far as possible. Patient and procedure characteristics were initially comparable. The 30-day complication rate was significantly higher in the cecal mobilization group (53.8% vs. 5.2% p < 0.01), as was the rate of pelvic abscess (34.6% vs. 0% p < 0.001). These findings suggest that, when feasible, omentoplasty should be considered the preferred method for pelvic reconstruction following APR.

The clinical efficacy of Lou's Wentong method in the treatment of lactational mastitis: A retrospective self-control study with 158 cases

BackgroundAs a common breast disease in lactating women, lactational mastitis is clinically manifested as painful breast lumps and systemic symptoms. To a certain extent, this disease may affect the physical and mental health of lactating women and even the breastfeeding of infants. ObjectiveThis study was conducted to evaluate the clinical efficacy of Lou's Wentong Method in the comprehensive treatment of lactational mastitis and its effects on relevant symptoms. MethodsA total of 158 patients who were diagnosed with lactational mastitis in The First Affiliated Hospital of Zhejiang Chinese Medical University from January 2022 to January 2024 were included in this study to conduct a retrospective analysis. The treatment method comprised oral administration of traditional Chinese medicine prescriptions guided by the concept of “Wentong zhi yong” (warming and dispersing therapy for treating abscesses), puncture and pus extraction for patients with abscess formation, and milk drainage for patients with milk stagnation. The clinical symptoms of these patients were collected according to the seven indexes in Lou's quantitative scorecard for evaluating the condition of canker sores before and after treatment. Additionally, the improvement of each symptom after treatment, the total effective rate of the clinical treatment, and the total symptom evaluation score before and after treatment were also analyzed. ResultsIt was demonstrated that there were significant differences in the overall distribution of different severity symptoms (skin erythema, breast pain, number of lumps, size of lumps, breast abscesses, and body temperature) at three time points (P < 0.01). The evaluation of these symptoms at different time points revealed that all symptoms were effectively mitigated over time. Meanwhile, the efficacy was assessed according to the efficacy index to evaluate the efficacy of Lou's Wentong Method in the comprehensive treatment of lactational mastitis. The results corroborated the pronounced efficacy of Lou's Wentong Method in treating lactational mastitis, exhibiting statistical significance (P < 0.01). ConclusionLou's Wentong Method has significant therapeutic effects in the comprehensive treatment of lactational mastitis. Furthermore, this method is conducive to alleviating the clinical symptoms of these patients as soon as possible and can reduce the pain of patients, thus promoting their recovery.

Perineal Hidradenitis Suppurativa: two Case Studies and a Review of the Literature

Severe Hidradenitis Suppurativa (HS), characterised by chronic abscess and sinus tract formation, causes significant reduction in patient physical and psychological quality of life. Completion of surgical excision and reconstruction is the only definitive treatment for HS refractory to medical management such as topical or oral antibiotics or disease-modifying biological agents. Staged skin grafting with BTM and vacuum assisted closure dressings is a novel technique that has shown efficacy in closing wounds left by extensive surgical excision of severe HS. We present two case studies demonstrating the effectiveness of this technique for management of groin and perineal HS while minimising wound contracture and preserving range of movement for improved quality of life.