Abstract:
:The repair of complex chest wall defects presents a challenging problem for the reconstructive surgeon. Although the majority of such defects could be repaired with the use of local and regional musculocutaneous flaps, more complicated cases require increasingly sophisticated reconstructive techniques. This study reviews the experience at a single cancer center with chest wall reconstruction over a decade. A retrospective review was undertaken for each patient who underwent chest wall reconstruction from 1992 to 2002. Patient demographics and variables, including pathologic diagnosis, extent of resection, size of defect, method of reconstruction, and outcome were evaluated. There was a total of 113 patients, 88 females and 25 males. The average age was 58 years (range, 19-88 years). The most common diagnoses were breast cancer and sarcoma. The average area of the chest wall defect after resection was 266 cm. One hundred fifty-seven musculocutaneous or muscle flaps were performed for reconstruction of the chest wall. Eleven percent of patients underwent reconstruction with autologous free tissue transfer. One hundred six patients underwent a single operation. Seven patients required a second operation for salvage of a complication. In 19 cases (15%), more than 1 flap was used simultaneously to complete the reconstruction. Eighty-four percent of the patients achieved stable chest wall reconstruction with no complications. Seven patients (4%) had partial (>10%) flap loss. The most common remaining postoperative complications were delayed wound healing (3% of patients), infection (2.5%), and hematoma (2.5%). Immediate chest wall reconstruction is safe, reliable, and can most often be accomplished with 1 operation. A variety of flaps, both single and in combination, could be used to achieve definitive coverage of the chest wall after extirpative surgery. The reconstructive choice is dependent on factors such as size of the defect, location on the chest wall, arc of rotation of the flap, and availability of recipient vessels. Based on this single institutional experience over a decade, an algorithm to chest wall reconstruction is provided.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Chang RR,Mehrara BJ,Hu QY,Disa JJ,Cordeiro PGdoi
10.1097/01.sap.0000122653.09641.f8subject
Has Abstractpub_date
2004-05-01 00:00:00pages
471-9; discussion 479issue
5eissn
0148-7043issn
1536-3708pii
00000637-200405000-00013journal_volume
52pub_type
杂志文章abstract::Intraoperative navigation is a tool that provides surgeons with real-time, interactive access to their patient's diagnostic imaging studies while in the operating room. This modality allows for anatomic localization and facilitates intraoperative planning and diagnosis. The application of intraoperative navigation to ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31822a3ec3
更新日期:2012-09-01 00:00:00
abstract::Over the past century, many advancements have been made in peripheral nerve repair, yet these reconstructions still remain a challenge. Although sutures have historically been used for neurorrhaphy, they sometimes fail to provide optimal outcomes. As a result, multiple adhesive compounds are currently being investigat...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002408
更新日期:2021-01-01 00:00:00
abstract::Seventy-five patients with melanoma were surveyed for recent history of major stress, coping styles, and psychiatric disturbance. Recurrence of disease was strongly related to biological variables (stage and Breslow depths) but not to psychological measures. Major life stress was not related to stage, Breslow, Clark l...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199201000-00007
更新日期:1992-01-01 00:00:00
abstract::Plastic surgeons with a practice that includes breast augmentation, breast reduction, and breast reconstruction should have a working knowledge of both genetic and environmental breast cancer risk factors and of risk stratification of these patients. Specific tests to determine genetic susceptibility to certain cancer...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200045050-00017
更新日期:2000-11-01 00:00:00
abstract::Dynamic reconstruction of the abdominal wall using a free reinnervated rectus femoris muscle and an island tensor fascia lata transfer was performed for a large herniation with loss of the bilateral rectus abdominis muscles of the abdominal wall. The tensor fascia lata transfer was used to close an inner side of the a...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1999-08-01 00:00:00
abstract::As the data in the literature concerning the vascularization of the pectoralis minor were conflicting, we conducted a new anatomic study on cadavers preliminary to clinical application of a pedicle flap for clavicular coverage in 3 patients. Twenty flaps were dissected, yielding numerous anatomic variations. In all ca...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318195381d
更新日期:2009-10-01 00:00:00
abstract::Incisional hernias develop in 2% to 11% of patients who undergo laparotomy. Prosthetic mesh repair provides more strength, tension-free closure, and decreased recurrence rates as compared to primary tissue repairs. Complications-fistula formation, adhesions, skin erosion, and seroma/abscess formation-however, include ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318212f380
更新日期:2012-02-01 00:00:00
abstract:INTRODUCTION:The reconstruction of the postburn contracture area is always a challenge in the field of plastic surgery. Moreover, the joints are very sensitive to trauma and immobilization, showing a susceptibility to stiffness. The aim of this article is to emphasize the use of "Namaste flap"-modification of subcutane...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002076
更新日期:2019-12-01 00:00:00
abstract::Endothelin-1, a peptide isolated from vascular endothelial cells, facilitates the constriction of vascular smooth muscle and various pharmacological actions including vasodilation, the proliferation of smooth muscle cells and fibroblasts, and the stimulation of arachidonic acid metabolism. In this study, plasma, urine...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199609000-00012
更新日期:1996-09-01 00:00:00
abstract::Repair of unilateral cleft lip is a challenging procedure with no single technique satisfactory for all types of unilateral cleft deformity. This study compares retrospectively five techniques of unilateral cleft lip repair in 72 children (45 boys, 27 girls). Twenty-two children had a Millard rotation-advancement repa...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199812000-00002
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:Obstetric brachial plexus palsy is caused by traction during birth. Most patients regain useful function with spontaneous recovery. In some cases, cross reinnervation occurs between the biceps and triceps muscles. In these cases, smooth active motion of the elbow joint is impaired by simultaneous biceps and ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002075
更新日期:2019-10-01 00:00:00
abstract:INTRODUCTION:Van der Woude syndrome (VWS), an autosomal dominant condition associated with clefts of the lip and/or palate and lower lip pits, is caused by mutations in interferon regulatory factor 6 gene. It is reported to be the most common syndromic cleft worldwide. This case series presents the phenotypic character...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002605
更新日期:2020-12-16 00:00:00
abstract::From 1979 to 1983, 14 patients were treated at the University of Maryland Hospital for injuries sustained as a result of the injection of crushed pentazocine tablets partially dissolved in water into the arterial system of the upper extremity. Eight patients received intraarterial reserpine within 15 hours of the inju...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198701000-00010
更新日期:1987-01-01 00:00:00
abstract::Only 38 cases of blunt traumatic rupture of the anterior abdominal wall musculature have been described in the literature to date. We describe a patient who sustained a complete transection of the right and a partial disruption of the left rectus abdominis muscle as well as multiple associated injuries secondary to bl...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198407000-00012
更新日期:1984-07-01 00:00:00
abstract::The gold standard for mandibular defect reconstruction is the fibular free flap. Nevertheless, the pedicled osteomuscular dorsal scapular flap as a reconstructive tool offers promise for mandibular defect reconstruction and could be the first choice in certain circumstances. Its use in resource-limited settings offers...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318230992e
更新日期:2013-01-01 00:00:00
abstract::Hair transplantation involves the transplantation of hair, beard, eyebrows, eyelashes, and pubic hair. Based on our experience, the aesthetic result of hair transplantation mainly relies on 4 indicators, including selection of the donor site, direction and angle of grafted hairs, density, and survival rate of implante...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000778
更新日期:2016-02-01 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::The ability to perform abdominal cosmetic surgery in the ambulatory setting provides a more comfortable environment for the patient, ease of scheduling for the physician, and decreased costs. Avoiding the use of general anesthesia allows for quicker recovery, shorter length of hospital stay, and decreased rate of post...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200105000-00005
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:The primary shortcoming of the osteocutaneous radial forearm flap (ORFF) in head and neck reconstruction is the high incidence of fracture at the donor site. Although several prophylactic measures are reported, combined plating with iliac crest bone graft (ICBG) of the donor site has not been previously desc...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31827a2fe4
更新日期:2014-09-01 00:00:00
abstract::In 1994, Suzuki et al proposed the pins-and-rubbers traction system, a new dynamic distraction technique for difficult complex intra-articular fractures of the digits of the hand. From February 1999 to April 2003, we used the Suzuki frame for 15 complex fractures of the proximal interphalangeal joint of the fingers. T...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000244975.89885.c7
更新日期:2007-05-01 00:00:00
abstract::Construction of male genitalia in biological female transsexual patients is problematic. We report 3 transsexuals with scrotal construction by tissue expansion of the labia majora. In each patient, tissue expanders were inserted into the labia majora several months before free flap phalloplasty. In 2 patients, the tis...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199310000-00016
更新日期:1993-10-01 00:00:00
abstract::The reconstruction of scalp defects presents a clinical challenge. Free tissue transfer has played an increasingly important role in the reconstruction of complex scalp defects. In many cases, patient medical comorbidities along with the length of the operative procedures incurs significant patient risk. Artificial de...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318180c913
更新日期:2009-06-01 00:00:00
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journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200045010-00011
更新日期:2000-07-01 00:00:00
abstract::Forelimb buds of rat embryos at day 13 of gestation were cut and cultured in Dulbecco's modified Eagle medium. In the absence of serum, the epidermis did not cover the wound surface. In the presence of fetal calf serum or ultroser G, a serum substitute, epidermal wound closure appeared in a concentration-dependent man...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198912000-00002
更新日期:1989-12-01 00:00:00
abstract::Intraosseous ganglia are occasionally found affecting the carpal bones of the hand and should be considered in the differential diagnosis of chronic wrist pain. They have characteristic radiographic findings of a cyst with a thin sclerotic rim. This case report illustrates an unusual presentation of a cyst in the luna...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200204000-00018
更新日期:2002-04-01 00:00:00
abstract::It has been reported that breastfeeding problems occur in women who have breast implants. The breastfeeding success of women who had augmentation with saline implants and subsequently had a live birth (n = 107) was compared with that of women of similar age who had hypoplastic breasts and had children before their con...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181c925e4
更新日期:2010-05-01 00:00:00
abstract::One of our patients had been recovering from prolonged illness for about eight months following extensive deep burns of the lower limbs, along with other complications, when he had a sudden attack of acute dyspnea with orthopnea. The cause of this condition was diagnosed as secondary hypodynamic cardiomyopathy. We fou...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198710000-00014
更新日期:1987-10-01 00:00:00
abstract::Peripheral nerve gap injuries continue to present a clinical challenge to today's surgeons. One method of surgical repair, implantation of acellular allografts, has been developed with the aim of bridging the gap with a cadaveric graft after removal of its cellular components, thereby accelerating axonal regeneration ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001464
更新日期:2018-08-01 00:00:00
abstract::From an anatomical standpoint, the support of the inferior two thirds of the nose is ensured by the cartilaginous septum. Usually, the reconstruction of total loss of the quadrangular cartilage is performed with some success by means of camouflage procedures such as L-shaped struts or cantilever grafts. In this articl...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199506000-00010
更新日期:1995-06-01 00:00:00
abstract::Infected femoral shaft fractures and femoral nonunions are difficult to manage. In the presence of associated segmental bony defects, limb length discrepancy, or complex deformities, Ilizarov techniques seem to be the ideal choice for management. We would like to describe small case series of 3 patients managed using ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3182a795f0
更新日期:2013-11-01 00:00:00