Abstract:
:After 30 years of clinical use, the 1992 Food and Drug Administration moratorium on silicone gel breast implants (SGBIs) resulted from a paucity of scientific data concerning their safety. The frequency of rupture and reoperative procedures was not known, nor were reliable data available for changes in the physical properties of shells and the composition of gels that might lead to SGBI failure. For this reason the authors conducted large-cohort meta-analyses of failure data for SGBIs based on numerous literature reports and also investigated systematically shell and gel properties from explanted SGBIs. They report their failure analysis data for more than 9,770 SGBIs (an update of an earlier study of more than 8,000 implants) as well an examination of the properties of shells and gels for 74 explanted SGBIs that ranged in age from 2 to 19 years (mean implanted age, 9.9 years). The explants tested were from several different manufacturers. For the modest-size explant cohort that was tested, 31 of 74 implants (42%) were found to be ruptured (some extensively). Even many intact shells were so weakened that only 51 shells had sufficient strength to enable preparation of samples for testing of mechanical properties and for analysis of composition by solvent extraction. Shells were found to contain 15 to 25% of extractable silicone. Exhaustive extraction of gels showed that they actually contained very little crosslinked silicone--85 to 95% being extractable soluble silicone fluid. Tensile and tear strengths of explanted silicone elastomer shells were lower than unimplanted prostheses and were generally well below reported manufacturers' values. This updated large-cohort failure analysis continues to show that shell rupture is related directly to implant duration (e.g., from analysis of variance statistics, 26% failure at 3.9 years, 47% at 10.3 years, 69% at 17.8 years; < or = 0.001). However, for the relatively small series of explants for which physical property data are reported, no significant correlation was observed between implant duration and the degradation of implant strength. It therefore appears most reasonable to conclude that after early weakening of shells as a result of swelling of the shell elastomer by diffusion of silicone oil from the gel, SGBI failure can occur in a time-dependent manner as a result of continuing implant motion and cyclic stresses that are exacerbated by stress concentration at thin areas, defects, and folds in the shells.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Marotta JS,Goldberg EP,Habal MB,Amery DP,Martin PJ,Urbaniak DJ,Widenhouse CWdoi
10.1097/00000637-200209000-00001subject
Has Abstractpub_date
2002-09-01 00:00:00pages
227-42; discussion 242-7issue
3eissn
0148-7043issn
1536-3708pii
00000637-200209000-00001journal_volume
49pub_type
杂志文章,meta分析abstract::This study evaluated the outcomes of extensor indicis proprius (EIP) transfer based on varying degrees of thumb extension after EIP transfer and elongation of the EIP. A total of 24 cases with extensor pollicis longus (EPL) ruptures who underwent EIP to EPL transfer were analyzed prospectively. The EIP transfer was pe...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SAP.0000000000000593
更新日期:2015-12-01 00:00:00
abstract::Lip augmentation is a well tolerated procedure that can lead to a more youthful appearance. Autologous tissue offers the safest and most long lasting results. Recently, a new source of autologous tissue, breast implant capsule, was described in the performance of permanent lip augmentation. Long term data in thirteen ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199803000-00012
更新日期:1998-03-01 00:00:00
abstract::Children with metopic synostosis have a well-described clinical picture of trigonocephaly, often with hypotelorbitism. The craniofacial disorder itself is well recognized; however, objective prognostic factors for predicting the risk of reoperation are not well known. In 39 children with metopic synostosis, measuremen...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000058498.64113.11
更新日期:2003-08-01 00:00:00
abstract::Many techniques for cleft lip repair have been reported, but these techniques do not consider the contour lines of the upper lip and, in fact, destroy them. The upper lip has complicated contour lines including the vermilion free margin, vermilion border, upper lip horizontal groove (upper lip groove), philtrum (dimpl...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199109000-00008
更新日期:1991-09-01 00:00:00
abstract::Breast cancer treatment has dramatically changed over the past century. Since Halsted's first description of radical mastectomy in 1882, breast reconstruction has evolved slowly from being considered as a useless or even dangerous procedure by surgeons to the possibility nowadays of reconstructing almost any kind of d...
journal_title:Annals of plastic surgery
pub_type: 历史文章,杂志文章,评审
doi:10.1097/SAP.0000000000001312
更新日期:2018-04-01 00:00:00
abstract::Traditional gastrocnemius flap harvest requires a long skin incision, starting from the popliteal fossa to the mid leg. The authors designed three instruments to facilitate harvest of this flap through a small incision without the help of an endoscope in 10 patients. All 10 gastrocnemius muscle flaps survived with a 1...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200108000-00005
更新日期:2001-08-01 00:00:00
abstract::Carpal tunnel decompression (CTD) is the most commonly performed surgical procedure within a hand unit. We have analyzed data on outcomes after carpal decompression performed by both open and closed techniques to assess whether outcomes differed between the 2 procedures. Data were jointly gathered from 2 units. The ai...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000267
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Lower eyelid malposition is the most common complication after lower eyelid blepharoplasty. Although the traditional techniques were effective for correcting lower eyelid malposition, they had potential disadvantages, including additional trauma, additional scar, and long recovery period. OBJECTIVE:To evalu...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318248b65f
更新日期:2013-07-01 00:00:00
abstract::Glomus tumors develop from a thermoregulatory unit called the glomus body which is found in high density within the digits of both the hands and feet. To note, even though less frequently, these tumors can present in extradigital locations. Usually it presents as a small, 1-cm bluish nodule. Glomangioma (multiple glom...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000222729.59856.e1
更新日期:2006-10-01 00:00:00
abstract::Human bites of the face are common in Port Harcourt, Nigeria. Twenty-four such patients with tissue losses seen over a period of two years (1983-1985) at the University of Port Harcourt Teaching Hospital were studied. Women in their third decade of life seem to be most at risk; the lips and ears are most frequently bi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198810000-00005
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:Massive defects of the abdominal wall are commonly repaired with the component separation technique (CST) when insufficient tissue exists to close the defect primarily. Although the utility of CST has been documented in cases of large ventral hernias in adults, its application to congenital and acquired defe...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000652
更新日期:2016-11-01 00:00:00
abstract:INTRODUCTION:Communication failures between multidisciplinary teams can impact efficiency, performance, and morale. Academic operating rooms (ORs) often have surgical, anesthesia, and nursing teams, each teaching multiple trainees. Incorrectly identifying name and "rank" (postgraduate year [PGY]) of resident trainees c...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001092
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:National plastic surgery society web sites are an important source of information for patients, family members, and healthcare professionals. There are currently no standardized recommendations for the information provided on web sites. The aim of this study was to assess the information available on each na...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002447
更新日期:2020-08-01 00:00:00
abstract::A new surgical technique for upper lip augmentation is presented. In this technique, 2 vertically parallel V-shaped incisions placed in a "V in V" fashion are used. Remarkable augmentation of the lip is provided by V-to-Y closure of the incisions. Over 7 years, this new technique, namely, V-Y in V-Y procedure, was use...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000205774.40210.58
更新日期:2006-06-01 00:00:00
abstract:INTRODUCTION:Use of the omentum for poststernotomy mediastinitis is typically viewed as a last resort. Formal debridement and muscle flap coverage is sufficient most of the time; however, there are situations when the omental flap is more appropriate. The purpose of this series is to critically evaluate the outcome in ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318054718e
更新日期:2008-02-01 00:00:00
abstract::The purpose of our retrospective study was to evaluate the outcomes of scaphoid fracture nonunion treated with a pronator quadratus pedicled vascularized bone graft and a headless compression screw with regard to early wrist and thumb mobilization. From January 2008 to June 2011, 27 patients (20 men and 7 women; mean ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000025
更新日期:2015-06-01 00:00:00
abstract::Diagnosing osteomyelitis in patients with pressure ulcers is complicated by overlying soft-tissue inflammation and reactive bone formation. We set out to evaluate the efficacy of indium scanning in the diagnosis of chronic osteomyelitis in spinal-cord-injury patients with grade IV pressure ulcers. The goal was to esti...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000164467.97551.ed
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:International adoptees with cleft lip and palate (CLP) are a growing population in the United States. They represent a clinical challenge, presenting at various ages and stages of cleft repair. METHODS:A retrospective review of patients seen at the CLP Program at the Children's Hospital of Philadelphia (CHO...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000863
更新日期:2016-10-01 00:00:00
abstract::Pedicled flaps and microsurgical free tissue transfers are increasingly being used for reconstruction in the elderly and poorer risk patient. The use of systemically administered vasoactive agents to date has been avoided because of the fear that systemic levels of these agents perioperatively (particularly the vasopr...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199711000-00013
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:Current trends in the management of medial orbital wall fractures are toward the development of transconjunctival incisions and the use of endoscopic-assisted methods. Different authors have suggested variations of the medial transconjunctival approach. METHODS:(1) In 30 fresh cadaver orbits, the classic tr...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000531
更新日期:2016-03-01 00:00:00
abstract::Long-term follow-up of free flaps used for skull coverage in this experience has revealed that serious sequela are more likely after muscle-only free flaps. Over the past 2 decades, 8 muscle and 6 composite free flaps have been used in 12 patients. Debulking was the only secondary procedure necessary in 1 composite fl...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000123024.80566.8c
更新日期:2004-05-01 00:00:00
abstract::To investigate a 3-dimensional (3D) model of human brachial plexus including its topography of sensory and motor fascicles with the assistance of the computer technology, 2 brachial plexus were serially horizontally sliced. Each slice was stained by Karnovsky-Roots acetylcholinesterase histochemical method. The staine...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31822f677e
更新日期:2011-12-01 00:00:00
abstract::During the past 10 years, there have been extensive developments in both "island" muscle and musculocutaneous flaps and in "free" microvascular transfers. Competition still exists between these two schools of surgical methodology, even though both methods are known to be complementary and have comparable success rates...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-198710000-00012
更新日期:1987-10-01 00:00:00
abstract::We report 2 cases of patients with thumb polydactyly that were difficult to classify into either Wassel type VI with a remarkable hypoplastic metacarpal or Wassel type VII (triphalangeal thumb). The radial digit was functional but hypoplastic, and the ulnar digit presented a dominant appearance but no active motion. T...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31821b6ced
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Infantile hemangioma (IH) is a common, benign tumor occurring in up to 10% of white infants. Propranolol has emerged as a front-line therapy for IH. The retrospective study examined the response of propranolol therapy on hemangioma size. METHODS:Twenty-seven children (4 to 20 weeks old) with IH were enrolle...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000521
更新日期:2016-03-01 00:00:00
abstract:INTRODUCTION:Common upper body findings after massive weight loss (MWL) include breast ptosis, projection loss, flattening, inframammary fold descent, and back rolls. Although implants address volume loss, manifestations of circumferential excess (ie, back rolls) are ignored. We review our experience with extended late...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000413
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Most head and neck melanomas occur on the face, with the cheek being the most frequently affected site. So far, small numbers of researches on cheek melanomas have yielded insufficient and controversial results. In this trial, we aimed to define the histopathological and clinical features specific to cheek m...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001695
更新日期:2019-04-01 00:00:00
abstract::Textured silicone expanders are alleged to be less painful in the filling process, to have less capsular contracture, and to stay in position better than smooth silicone expanders. To test these three hypotheses, 6 patients undergoing bilateral simultaneous expander implant placement for breast reconstruction after ma...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000637-199403000-00001
更新日期:1994-03-01 00:00:00
abstract::An effective and practical method of oxygen administration during cosmetic facial surgery under local anesthesia is described. A large volume of oxygen is delivered directly to the nasopharynx, and partial upper airway obstruction caused by the tongue falling into the pharynx is resolved, yet the apparatus does not in...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198606000-00014
更新日期:1986-06-01 00:00:00
abstract::The most common cause of nasal obstruction is chronic enlargement of the inferior turbinate bones. The variety of medical and surgical treatments available for this condition bears testimony to their frequent ineffectiveness and the frustration of the physician or surgeon caring for these patients. Removal or destruct...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197909000-00009
更新日期:1979-09-01 00:00:00