Background: Seroma formation is the most frequent postoperative complication after breast cancer surgery. We carried out a study to investigate the effect of various demographic, clinical and therapeutic variables on seroma formation. Patients and methods: A retrospective cross sectional study of patients who underwent surgical therapy for breast cancer with either modified radical mastectomy (MRM) or breast preservation (BP) was carried out. The demographic data and clinical information were extracted from case records. Seroma formation was studied in relation to age, type of surgery, tumor size, nodal involvement, preoperative chemotherapy, surgical instrument (electrocautery or scalpel), use of pressure garment, and duration of drainage. The multiple logistic regression analysis was performed to estimate odds ratios. Results: A total of 158 patients with breast cancer were studied. The mean age of the patients was 46.3 years (SD ± 11.9). Seventy-three percent underwent modified radical mastectomy and the remaining 27% received breast preservation surgery. Seroma occurred in 35% of patients. In multivariate logistic regression analysis an association of postoperative seroma formation was noted with modified radical mastectomy (OR = 2.83, 95% CI 1.01–7.90, P = 0.04). No other factor studied was found to significantly effect the seroma formation after breast cancer surgery. Conclusion: The findings suggest that the type of surgery is a predicting factor for seroma formation in breast cancer patients.

Background and Objectives: Low-level laser therapy (LLLT) has been shown to promote chronic wound healing in conditions of reduced microcirculation. In this preliminary study, we report the results of using LLLT to heal foot ulcers in patients with diabetes mellitus. Materials and Methods: Twenty-three patients with a diabetic foot wound for at least 3 months were included in this double-blind randomized clinical trial. Patients were randomized to receive placebo treatment ( n = 10) or LLLT ( n = 13) (685 nm, energy density 10 J/cm ² ) in addition to conventional therapy. Patients were followed for 20 weeks. Ulcer size reduction and the number of patients with complete healing were compared between the LLLT and placebo groups. Results: There were no significant differences in baseline characteristics of patients and foot ulcers receiving LLLT and placebo treatment. At week 4, the size of ulcers decreased significantly in the LLLT group ( p = 0.04). After 20 weeks, in the LLLT group, eight patients had complete healing and in the placebo group only three patients experienced complete wound healing. The mean time of complete healing in LLLT patients (11 weeks) was less than that in placebo patients (14 weeks) though the difference was not statistically significant. Conclusions: The study provides evidence that LLLT can accelerate the healing process of chronic diabetic foot ulcers, and it can be presumed that LLLT may shorten the time period needed to achieve complete healing.

Background This study aims to evaluate the attending surgeons' and residents' attitudes towards error disclosure and factors that can potentially affect these tendencies in major academic hospitals affiliated with Tehran University of Medical Sciences (TUMS). Methods and material In a cross-sectional study, self-administered questionnaires were delivered to all attending surgeons and second to fourth year surgical residents of TUMS during October and November 2009. The questionnaire contained two clinical scenarios and questions regarding physicians' attitudes towards disclosing medical error and their actual practice in the case of their last error. Of the 63 distributed questionnaires, 53 (84.1%) were completed and returned. Results Participants were less likely to disclose minor (39.6%; 21/53) than major (49.1%; 29/53) medical errors. Participants believed that their most important concerns for not disclosing errors were fear of a malpractice lawsuit (71.7%, n=38), losing patients' trust (62.3%, n=33), and emotional reactions of the patients and their relatives (56.6%, n=30). Although most physicians indicated they would disclose errors in minor and major scenarios, only 16.7% (n=8) had disclosed their last medical errors to their patients, two of which had resulted in patients taking legal action. Conclusion There was an obvious gap between surgeons' intentions and actual practices concerning disclosure of medical error. Education in medical error management to professionally support error disclosure might help reduce the gap.