Abstract:
BACKGROUND:The purpose of this study is to examine the effect of various risk factors on complications in patients undergoing pedicled transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction. METHODS:A retrospective review of 224 pedicled TRAMs in 200 patients over a 10-year period was carried out. Patients were divided into subgroups based on smoking history, weight, radiation status, and pedicle type. Complication rates were calculated and logistic regression analysis was used to identify risk factors. RESULTS:Logistic regression identified active smoking as a statistically significant risk factor for developing multiple (2 or more) flap complications (P = 0.0061) and TRAM infection (P = 0.0255), while former smoking was a risk factor for multiple flap complications (P = 0.01) and TRAM-delayed wound healing (P = 0.0433). Obesity (body mass index > or =30) was found to be a statistically significant risk factor for overall (1 or more) donor-site complications (P = 0.0281), overall flap complications (P = 0.0375), multiple flap complications (P = 0.0002), TRAM-delayed wound healing (P = 0.0334), and minor flap necrosis (P = 0.0075). CONCLUSIONS:This study identified that active or former smoking and obesity contribute to a significant complication rate, while overweight body habitus, use of double-pedicled flaps, and pre-TRAM radiation do not. This second decade "look-back" on pedicled TRAM flap breast reconstruction emphasizes the need for appropriate patient selection to achieve successful results with pedicled TRAM breast reconstruction.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Ducic I,Spear SL,Cuoco F,Hannan Cdoi
10.1097/01.sap.0000184463.90172.04subject
Has Abstractpub_date
2005-12-01 00:00:00pages
559-64issue
6eissn
0148-7043issn
1536-3708pii
00000637-200512000-00001journal_volume
55pub_type
杂志文章abstract::A histologically benign tumor of the temporal bone became a life-threatening neoplasm. Previous surgical procedures and a course of radiotherapy failed to arrest the growth of the neoplasm. Our therapeutic objectives were fourfold: (1) ventilation of tumor histology; (2) total tumor removal without an increase of the ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198302000-00010
更新日期:1983-02-01 00:00:00
abstract::Tattooing is increasingly common in Western society. The aim of the study was to create an overview of the surgical options when a tattoo is present in the operative site and to present an algorithm for the surgical plan.A literature-based study was conducted, using the Pubmed database. The following search terms have...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0b013e3181b1429f
更新日期:2010-01-01 00:00:00
abstract::A technique of correction of Stahl's ear is presented and is compared with other techniques reported in the literature. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000067728.84041.96
更新日期:2004-01-01 00:00:00
abstract::This study has demonstrated that microcrystalline collagen is useful for controlling hemorrhage from an area where microvascular anastomoses are being performed, and that microcrystalline collagen does not adversely affect patency rates of microvascular repairs even when applied directly to the anastomosis itself. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198212000-00004
更新日期:1982-12-01 00:00:00
abstract::Webs and contracture, whether congenital or the result of trauma or surgical excision, have been resurfaced with local tissue utilizing the principle of multiple Y-V advancement flaps. Initially the procedure was used in releasing broad scar contracture following a burn wound of the torso, and for congenital soft tis...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197905000-00013
更新日期:1979-05-01 00:00:00
abstract:BACKGROUND:Ketorolac tromethamine (Toradol) is an effective a nonsteroidal anti-inflammatory drug and a powerful analgesic for patients undergoing breast surgery. However, the potential for postoperative bleeding has not yet been explored specifically in women undergoing implant-based breast reconstruction. There is co...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001409
更新日期:2018-05-01 00:00:00
abstract::Treatment of patients with infected median sternotomy wounds includes debridement and closure using vascularized tissue, most often the pectoralis major muscle. However, occasionally, surgeons use other flaps to close sternotomy wounds. The purpose of this study is to review 1 center's experience with infected median ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000099710.38299.a3
更新日期:2004-04-01 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
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更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Tissue-expander (TE) placement followed by implant exchange is currently the most popular method of breast reconstruction. There is a relative paucity of data demonstrating patient factors that predict complications specifically by stage of surgery. The present study attempts to determine what complications ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000109
更新日期:2015-09-01 00:00:00
abstract::This study was performed to determine the degree of shrinkage over time in nipple projection after reconstruction. Nipple-areolar reconstruction was performed using the modified Anton-Hartrampf technique, and pigmentation was achieved with tattooing. This study looked at 28 consecutive patients with nipple reconstruct...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199911000-00001
更新日期:1999-11-01 00:00:00
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journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318281aece
更新日期:2013-09-01 00:00:00
abstract::Improvements were made by us in several distally based pedicled flaps of the nutrient vessels of the saphenous nerve with lower rotation points. However, these flaps are still insufficient for trauma complicated by bone defects. Accordingly, we conducted a systematic study of the anatomic theory on distally based pedi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318188b958
更新日期:2009-07-01 00:00:00
abstract::A rare congenital anomaly of the face has been encountered and reported: lateral nasal proboscis. It is characterized by a trunk-like tube arising from an eyelid and is coupled with hypoplasia of the nose, abnormal orbit and maxilla, and ophthalmic anomalies. The pathogenesis and treatment of this disorder are discuss...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1986-03-01 00:00:00
abstract::Dermatofibrosarcoma protuberans is an unusual soft-tissue tumor with a propensity for local recurrence and occasional metastatic spread. Given its indolent course, it may be mistaken for atypical scarring or a keloid growth. Most lesions are trunkal or on the proximal extremities with digital lesions being extremely r...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-199010000-00009
更新日期:1990-10-01 00:00:00
abstract::The medial sural(MEDIAL GASTROCNEMIUS) perforator flap has previously been described as a free flap distinguished by the potential for a large yet thin cutaneous flap that incorporates the calf skin territory. Its medial sural vascular pedicle can be tailored to allow reach extending from the popliteal fossa to the su...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
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更新日期:2004-11-01 00:00:00
abstract::The development of sophisticated bariatric surgery techniques has led to an increasing number of patients demanding a complexity of body contouring procedures that can be achieved either with a step-by-step approach or by combining dermolipectomy in various regions. The aim of this study was to test the hypothesis tha...
journal_title:Annals of plastic surgery
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更新日期:2003-10-01 00:00:00
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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::The authors describe a case of microvascular ear replantation with repair of the artery only and medicinal leech therapy that survived for 14 days but ultimately failed as a result of the absence of development of venous channels between the replant and the recipient bed. A 35-year-old man presented with complete avul...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200104000-00016
更新日期:2001-04-01 00:00:00
abstract::Burn units and experienced burn nurses are valuable, expensive resources that are underutilized when the burn census is low. Burn facilities can be used to treat other conditions or injuries to provide optimum wound management or to provide overflow intensive care unit beds. We studied via a questionnaire survey the a...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198911000-00008
更新日期:1989-11-01 00:00:00
abstract::The pain felt during botulinum toxin type-A injections and the troubled and distressed treatment it induces is common and well known for the patient and the doctor applying the treatment. This problem is further intensified on the patients who have needle phobia. The effect of ice application on the treatment zone bef...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2004-12-01 00:00:00
abstract::Aggressive thinning of the muscle from the pedicle of a gastrocnemius musculocutaneous flap can change the nature of that pedicle radically. Instead of being bulky and causing contour deformity, the pedicle is reduced to a vascular leash that has virtually no effect on contour at all. Radical thinning of this type was...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198910000-00018
更新日期:1989-10-01 00:00:00
abstract::Finding an appropriate soft-tissue grafting material to close a wound located over the distal phalanx of the thumb, especially the pulp region, can be a difficult task. A sensate first dorsal metacarpal artery flap, mobilized from the dorsum of the adjacent index finger and used as an island pedicle skin flap, can be ...
journal_title:Annals of plastic surgery
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更新日期:2004-11-01 00:00:00
abstract::One of the most common complications of double eyelid operations is asymmetry. To reduce asymmetry, we fixed the dermis to the tarsal plate at the same level as the skin incision, and objectively evaluated the symmetry of the height using photogrammetry.Of 30 patients who had double eyelid operations by the intratarsa...
journal_title:Annals of plastic surgery
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更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:This study aimed to present the results of a series of forequarter amputations (FQAs) and to evaluate the reconstructive methods used. SUMMARY BACKGROUND DATA:Although FQA has become a rare procedure in the era of limb-sparing treatment of extremity malignancies, it is a useful option when resection of a sho...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002204
更新日期:2020-06-01 00:00:00
abstract::Recombinant human growth hormone, a very potent anabolic hormone, plays a significant role in growth regulation, bone metabolism, and wound healing. This study evaluates its effect on random flap survival. Rats were randomly divided into 2 groups. A dorsal random flap, cephalically based, was used. One group received ...
journal_title:Annals of plastic surgery
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doi:10.1097/SAP.0b013e318193498c
更新日期:2009-11-01 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
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更新日期:2013-11-01 00:00:00
abstract::A randomized, prospective, double-blind study designed to compare the effectiveness of the use of cloxacillin with the result of nontreatment in patients undergoing surgical intervention of axillary hyperhidrosis was conducted from August 1987 to October 1987 at the Veterans General Hospital, Taipei, Taiwan. Forty-two...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000637-198905000-00009
更新日期:1989-05-01 00:00:00
abstract:PURPOSE:Limb salvage in bone sarcomas requires resection and joint and soft-tissue reconstruction. Suboptimal coverage can lead to prosthesis infection, subsequent hardware exposure, or loss with eventual amputation. In the pediatric sarcoma population, it is essential to not only have viable soft-tissue coverage but o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
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更新日期:2012-11-01 00:00:00
abstract::The Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) procedure entails performing a lymphovenous bypass (LVB) at the time of axillary lymph node dissection to reduce lymphedema risk. The two most common fluorophores utilized in LVB are blue dye and indocyanine green. We developed a novel application of flu...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001034
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:The volar advancement flap of the thumb described by Moberg has been used for pulp defects up to 1 to 1.5 cm since its mobility is quite limited due to the stiff nature and fibrous connections of the regional skin with underlying structures. There have been several attempts to increase the mobility of this u...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318216e6b1
更新日期:2012-02-01 00:00:00