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 those patients who require omental flap reconstruction of poststernotomy mediastinitis. METHODS:A retrospective review was performed on consecutive patients undergoing omentum flap transposition for poststernotomy mediastinitis from 1990-2005 at Emory University Hospitals. Data points queried included patient demographics, risk factors, type of reconstruction, and outcome. Patient survival was determined at 60 days and 1, 3, and 5 years postomentum reconstruction using the Social Security Death Index. These data points were compared with age- and risk-matched patients from our institution, treated during the same time period with muscle flaps alone. RESULTS:Fifty-two patients had omental flap reconstruction, with an average age of 61 years (range: 35 to 78). The average follow-up was 5.1 years (range: 1 day to 15 years). Methicillin-resistant Staphylococcus aureus (MRSA) was the most common organism identified at time of omental transfer (56%). The omentum was used either for primary reconstruction, n = 35/52 (67%), or as a salvage procedure following failed muscle flap coverage, n = 17/52 (33%). Complications included donor site 27%, flap related 23%, and general 71% of patients. Those patients undergoing salvage reconstruction had a proportionally greater 60-day mortality (24%) and complication rate. The overall mortality was higher in those patients who required an omental flap transfer when compared with 52 muscle-flap controls (42% versus 18% at 3 years). DISCUSSION:The greater omentum is still an invaluable tool in the management of mediastinal wound infections when other options have failed or are insufficient. Although reliable and well indicated, the omental flap appears to be a marker for increased mortality, especially when used as a salvage procedure. This association is not directly related to the omental flap but rather to the complexity of the clinical situation leading up to its use. Patients who require omental flap coverage should be counseled and treated appropriately.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Ghazi BH,Carlson GW,Losken Adoi
10.1097/SAP.0b013e318054718esubject
Has Abstractpub_date
2008-02-01 00:00:00pages
169-73issue
2eissn
0148-7043issn
1536-3708pii
00000637-200802000-00012journal_volume
60pub_type
杂志文章abstract:BACKGROUND:Management of posttraumatic large soft tissue defects and bone loss remains a therapeutic and surgical challenge for orthopedic surgeons. We assessed the use of a neurocutaneous flap and the Ilizarov technique in the reconstruction of severe composite defects in the tibia. METHODS:We retrospectively reviewe...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000921
更新日期:2017-05-01 00:00:00
abstract::The last 30 years has seen a shift in surgical treatment of breast diseases to less invasive, more conservative treatment options. The mammotome equipment was originally introduced as a diagnostic tool, but advances in technology have extended its role to therapeutic procedures. The mammotome device (8-gauge) is inser...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000095441.40759.1f
更新日期:2004-02-01 00:00:00
abstract::The indications for and limitations of cryosurgery for various types of hemangiomas on the body surface or in the intraoral region are reported based on our clinical experience. In our opinion, cryosurgery is not the method of choice in the management of hemangiomas but is useful under certain conditions, as with a lo...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198006000-00005
更新日期:1980-06-01 00:00:00
abstract::Blepharoptosis surgery is one of the most common oculoplastic procedures, and the aim is to clear the visual axis. Many surgical techniques for the correction of ptosis have been described and performed, but the operative approach is based on the extent of eyelid excursion, the amount of levator function, and the degr...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181de838a
更新日期:2011-03-01 00:00:00
abstract::Sodium warfarin is one of the most commonly used oral anticoagulants. It is not without complications. A case is presented of a 56-year-old woman on well-regulated sodium warfarin therapy who suffered unexplained necrosis and gangrene of the breast. She underwent total mastectomy for debridement because of the extensi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198508000-00012
更新日期:1985-08-01 00:00:00
abstract::Controversy as to benefits, risks, and long-term durability of the subcutaneous rhytidectomy as compared with the composite and the subcutaneous musculoaponeurotic system (SMAS) rhytidectomy procedures has persisted over the last several years. Conventional surgical wisdom holds that deep-tissue support would provide ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199511000-00001
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:In this study, we evaluated the role of antitumor necrosis factor-alpha (TNF-α) therapy in the decrease of adipocyte apoptosis and weight preservation of fat grafts in the rat model. METHODS:A total of 64 rats were randomly divided into 2 groups, with 32 rats in each group. Autologous fat tissue w...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31821deb1b
更新日期:2012-05-01 00:00:00
abstract::Oxidative stress secondary to ischemia can cause physiopathologic changes that adversely affect wound healing. In this experimental study, we hypothesized that the topical use of esterified glutathione, a well-known antioxidant, can minimize the effects of oxidative stress by an increase in intracellular glutathione a...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000241681.57965.35
更新日期:2007-04-01 00:00:00
abstract::The experiences of the author while an Officer in the South African Medical Corps are related. During the battle of Britain he was attached to the R.A.M.C. and observed the work of pioneers in modern military plastic surgery. On his return to South Africa, he set up the Brenthurst Military Red Cross Hospital for Plast...
journal_title:Annals of plastic surgery
pub_type: 历史文章,杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract:BACKGROUND:The debate on how to create ideal facial proportions--once the remit of artists and sculptors--has been reignited during the past 5 decades, with the emergence of aesthetic facial surgery. Classic ideals exist, but few individuals actually satisfy these criteria. Aesthetic ideals are culturally and temporall...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31823f3ca1
更新日期:2012-04-01 00:00:00
abstract::We present a modified version of the cervical collar that can be used immediately postoperatively and accommodates bulky bolster dressings. Its benefits include immediate neck hyperextension and immobilization and parallel monitoring of a skin graft or free flap. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198506000-00009
更新日期:1985-06-01 00:00:00
abstract::A technique for reconstruction of the bilateral cleft lip nose is described. The literature for bilateral cleft lip nasal repair and the use of autogenous cartilage grafts is reviewed. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197905000-00003
更新日期:1979-05-01 00:00:00
abstract::Burn wound sepsis can be due to exogenous or endogenous bacteria. When rare organisms cause infection, exogenous sources are implicated. This sets into motion hospital infection control team searches, which are both exhausting and harassing to patients and staff. This study examines the skin bacteria present at admiss...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198907000-00007
更新日期:1989-07-01 00:00:00
abstract::To evaluate objectively the outcome of the Abbe flap procedure, an anthropometric ratio--the lip index--is introduced. The lip index is the ratio of the labiale superius-tragion to the labiale inferius-tragion. It represents the protrusion of the upper lip in relation to the lower lip. It has been assessed in preopera...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199808000-00009
更新日期:1998-08-01 00:00:00
abstract::Sixteen years ago the result of an operation that was performed on a 5-year-old boy with Romberg's disease was described in this journal. Nineteen years have passed since the first operation, and the authors now report the long-term follow-up. The volume of the transferred free groin flaps was maintained. Although the...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199812000-00012
更新日期:1998-12-01 00:00:00
abstract::Granulomatous mastitis is an inflammatory breast condition of unknown etiology. Management remains controversial and treatment algorithms are lacking from the literature. Few resources exist that discuss breast reconstruction following extirpation. This descriptive case series reviews the clinicopathologic features of...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181a20cae
更新日期:2010-01-01 00:00:00
abstract::A patient with multiple keratoacanthomas association with a well-differentiated squamous cell carcinoma is presented. Incomplete excision of a keratoacanthoma deprives the pathologist of his main criteria in differentiating this lesion from a squamous cell carcinoma. Wide excision appears to be the treatment of choic...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197908000-00015
更新日期:1979-08-01 00:00:00
abstract::The use of external devices for cranial suspension or immobilization may facilitate the transfer of skin grafts or flaps needed for scalp coverage. Skull tongs are readily available in any trauma center. Following composite tissue transfer to the skull, skull tongs can prevent compromise of the microanastomoses or the...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198901000-00015
更新日期:1989-01-01 00:00:00
abstract::Autologous fat is an excellent soft-tissue filler, given its abundance and ease of harvest. Nevertheless, the technique is accompanied by postoperative complications such as fat necrosis, calcification, and sclerotic nodules. These problems directly influence surgical efficacy. Computed tomography or magnetic resonanc...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318189a98a
更新日期:2009-08-01 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:ABSTRACT:Repair for the soft tissue defects of hand has been a major challenge of hand or reconstructive surgery. A lot of flaps are used, free or pedicle flap, but there are no comprehensive description of these flaps. In this article, we retrospectively reviewed the repair technique of the fingertip defect, palmar or...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002645
更新日期:2020-12-15 00:00:00
abstract::There are only a few reports that investigate the measurement of functional penile length and compare the methods used for this purpose. The aim of this study was to determine the correlation between the measurement techniques and to determine an appropriate method that correlates the erect state most closely. Measure...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200204000-00008
更新日期:2002-04-01 00:00:00
abstract:INTRODUCTION:Breast cancer in women under 40 years of age is rare, accounting for approximately 5% of cases. The disease tends to be more aggressive in younger women. Younger age has been shown to be an independent predictive of breast reconstruction after total mastectomy. Treatment by total mastectomy and reconstruct...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318216b648
更新日期:2011-05-01 00:00:00
abstract::There is an ongoing demand for surgeons to demonstrate that they can operate well, maintain their performance, and deliver acceptable results. Currently, surgeons are assessed by a series of subjective and peer-reviewed interviews, but at no stage is the objective assessment of surgical competence measured. The author...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000037271.26659.f4
更新日期:2003-03-01 00:00:00
abstract::An osteomyelitic defect of the posterior superior iliac spine was filled with a rectus abdominis island pedicle flap passed beneath the transversalis fascia and through the preperitoneal and retroperitoneal spaces. This maneuver extends the arc of rotation of this flap to the posterior rim of the pelvis and increases ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198906000-00012
更新日期:1989-06-01 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
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181b022e3
更新日期:2010-03-01 00:00:00
abstract::We present a case of a nail defect, which was reconstructed by free composite nail combined with the palmar pocket method without vascular anastomoses. A 40-year-old man lost his nail of the right middle finger by trauma 1 year ago. A total nail composite graft, composed of germinal and sterile matrices, and proximal ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000164731.99795.fe
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:This study of stage III (locally advanced) breast cancer patients evaluated the survival improvement conferred by immediate breast reconstruction by transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction after modified radical mastectomy (MRM) in comparison with MRM alone. METHODS:This retr...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000251
更新日期:2014-09-01 00:00:00
abstract::There has recently been an increase in the usage of the Internet as a source of patient information. It is very difficult for laypersons to establish the accuracy and validity of these medical websites. Although many website assessment tools exist, most of these are not practical.A combination of consumer- and clinici...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000216244.81900.3b
更新日期:2006-09-01 00:00:00
abstract:PURPOSE:This study aims to determine the relationship between race and ischemic complications in women undergoing breast reconstruction with pedicled TRAM (pTRAM) and perforator flaps (DIEP). PATIENTS AND METHODS:A retrospective, cross-sectional study of women who underwent breast reconstruction utilizing either pTRAM...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000102
更新日期:2014-01-01 00:00:00