Abstract:
:Resection of malignancies of the upper face and skull base may result in complex bone and soft tissue defects. To better define the optimal management of these defects, we conducted a retrospective review of 75 consecutive patients who underwent closure of 76 craniofacial defects after malignant tumor excision from 1966 to 1990. Wound complications requiring further surgery occurred in 30% of the defects (23 of 76). Wound complications at anterior, temporal, or combined sites were correlated with each method of reconstruction (scalp flap or split thickness skin graft, pedicled myocutaneous flap, and free flap). The presence of a large combined defect involving both frontal and temporal areas was the only significant risk factor for development of a wound complication requiring secondary surgery. These data suggest that anterior or temporal craniofacial defects may be closed with either scalp flaps and split thickness skin grafts or pedicled myocutaneous flaps with reasonable wound complication rates of 16% to 22%. Large combined defects have high wound complication rates (90%) when local tissue is used; therefore, other methods of closure such as free tissue transfer should be strongly considered in these patients.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Wornom IL 3rd,Neifeld JP,Mehrhof AI Jr,Young HF,Chinchilli VMdoi
10.1016/0002-9610(91)90160-fsubject
Has Abstractpub_date
1991-10-01 00:00:00pages
408-11issue
4eissn
0002-9610issn
1879-1883pii
0002-9610(91)90160-Fjournal_volume
162pub_type
杂志文章abstract::A simplified technique for insertion of a peritoneovenous shunt is described. By using a "peel-away" sheath at both ends of the shunt, the insertion is much quicker and less traumatic to the patient. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(06)80078-4
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:The objective of this study was to characterize variations in packed red blood cell (PRBC) transfusion practices in critically ill patients and to identify which factors influence such practices. We hypothesized that significant variation in transfusion triggers exists among acute care surgeons. METHODS:A s...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.08.024
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Radioguided surgery can also be used for the simultaneous guidance to a nonpalpable primary tumor and sentinel lymph nodes. METHODS:Retrospective review of a prospective database. The surgeon used a gamma probe for guidance to an iodine-125 labeled titanium seed at the primary lesion and technetium-99 label...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00716-4
更新日期:2001-10-01 00:00:00
abstract::In this study, we sought to identify changes in the picture of a selected surgical condition during an interval of time that has brought about radical departures from previously established policies and programs. As a direct consequence, the patients take a more circuitous route to the surgeon. A significant number of...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90549-7
更新日期:1989-03-01 00:00:00
abstract:BACKGROUND:blood loss during liver resection and the need for perioperative blood transfusions have negative impact on perioperative morbidity, mortality, and long-term outcomes. METHODS:a randomized controlled trial was performed on patients undergoing liver resection comparing hemihepatic vascular inflow occlusion, ...
journal_title:American journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2009.09.029
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:This study evaluated a simulated pages curriculum that was developed to assess communication and clinical decision making in medical students and interns. METHODS:A curriculum consisting of 14 simulated pages was administered across 5 institutions to 150 senior medical students. A 3-case subset was administ...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2014.01.014
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:The adipocyte hormone leptin has been shown to increase migration and angiogenesis in epithelial cells. Therefore, we hypothesized that leptin would induce prostate cancer cell migration and growth factor expression in vitro. METHODS:Prostate cancer cell lines DU145 and PC-3 (androgen-resistant) were treate...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.07.031
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Management of the open abdomen with polyglactin 910 mesh followed by split-thickness skin grafts allows safe, early closure of abdominal wounds. This technique can be modified to manage enteroatmospheric fistulae. Staged ventral hernia is performed in a less inflamed surgical field. METHODS:A retrospective ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.07.040
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Increased surgical workforce diversity diminishes health disparities. METHODS:Researchers recruited and nonrandomly enrolled participants into intervention and comparison groups for a quasi-experimental study of the impact of a seminar course on student exposure to diverse mentorship and service through sur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.07.031
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Incision and drainage of perianal sepsis has appreciable success in the immunocompetent population, but outcomes after incision and drainage in the immunosuppressed population are unknown. METHODS:13,666 patients (n = 930 immunosuppressed) undergoing incision and drainage of perianal sepsis between 2011 and...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.01.036
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:This study aimed to assess the transferability of basic laparoscopic skills between a virtual reality simulator (MIST-VR) and a video trainer box (D-Box). METHODS:Forty-six medical students were randomized into 2 groups, training on MIST-VR or D-Box. After training with one modality, a crossover assessment ...
journal_title:American journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2009.05.016
更新日期:2010-06-01 00:00:00
abstract::The intramandibular sliding myoosseous graft provides a new technique for reestablishment of mandibular continuity. It is well suited for immediate or remote reconstruction of midline or unilateral defects. Close attention to constructing smooth, confluent bone margins reduces the probability of mucosal fenestration. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(85)90156-4
更新日期:1985-10-01 00:00:00
abstract::A prospective study of 390 indwelling central venous catheters placed by way of the subclavian route identified bacteremia and tracheostomy as the only significant variables associated with the colonization of the catheters by pathogenic microorganisms. Catheter-related sepsis was likely in only 3 of 33 episodes of pr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90085-0
更新日期:1979-06-01 00:00:00
abstract:BACKGROUND:Lymphoepithelial cyst of the pancreas is a rare but distinctive cystic lesion lined by a mature, keratinizing squamous epithelium and surrounded by lymphoid tissue. METHODS:To gain more insights into this entity, we describe 5 examples of lymphoepithelial cyst of the pancreas (2 of which were briefly descri...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80247-5
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVE:We aimed to identify potential variables predictive of a resident achieving faculty future entrustment as a way to enhance attending surgeons' planning of teaching in the operating room leading to improved resident operative autonomy in practice. METHODS:We reviewed 273 resident performance evaluations from ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2021.01.020
更新日期:2021-01-19 00:00:00
abstract::A prospective clinical trial was designed to evaluate the efficacy of postoperative jejunostomy feedings using high (44 percent) and low (15 percent) branched-chain amino acid elemental diet formulations compared with no jejunostomy feedings in a homogeneous surgical population. Twenty-eight patients undergoing radica...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9610(87)90815-4
更新日期:1987-02-01 00:00:00
abstract:BACKGROUND:We performed an evaluation of antimicrobial guidelines for patients with surgical sepsis. METHODS:The purpose of this study was to validate current empiric antibiotic recommendations in our sepsis protocol based on the suspected site of infection. The primary objective was to assess the appropriateness of e...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.09.001
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Currently, there is no consensus in the literature regarding which patients with calf vein thrombi are at high risk for proximal propagation. This study examined patients with isolated calf vein thrombi with serial duplex scans in order to identify risk factors that would predict outcome. PATIENTS AND METHO...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80261-x
更新日期:1995-08-01 00:00:00
abstract::Much literature supports the value of performance-based tests for obtaining an overall assessment of clinical skills; however, these tests can also identify specific deficits in medical curriculum and student learning. This study, conducted over a period of 2.5 years, used standardized patients to identify deficiencie...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80072-8
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Hemorrhage during hepatectomy remains the major cause of morbidity and mortality associated with this surgery. Traditionally, a Pringle technique is employed to reduce vascular inflow during parenchymal transection. METHODS:This paper describes a simple method to achieve unilateral vascular control during h...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00697-3
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:This study was undertaken to evaluate the accuracy of touch preparation (touch prep) in the evaluation of sentinel lymph nodes (SLNs). METHODS:We performed a retrospective review of 402 breast cancer patients who underwent SLN biopsy. RESULTS:A SLN was identified in 381 patients. Of 61 patients with a true...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.06.020
更新日期:2010-06-01 00:00:00
abstract:INTRODUCTION:The few series of synchronous lung cancers have included small cell and carcinoid tumors. We wished to determine the prognosis for patients with synchronous non-small cell lung cancer (NSCLC). METHODS:A database of 3034 lung cancer patients was reviewed for synchronous NSCLC. Survival was determined by Ka...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00019-0
更新日期:1996-05-01 00:00:00
abstract::Herein, we have described the surgical management of 23 patients with chronic intestinal ischemia. The patients presented most commonly with postprandial pain and weight loss. Diagnosis was confirmed by angiography, including lateral aortography. Surgery included bypass with Dacron being the most common graft material...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90301-5
更新日期:1984-07-01 00:00:00
abstract::The reported incidence of hypotension after carotid reconstruction ranges from 21 to 50 percent. To evaluate baroreceptor dysfunction, 283 carotid reconstructions were studied. During 181 consecutive reconstructions, a transcutaneous Teflon catheter was positioned intraoperatively at the carotid bifurcation for postop...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90196-x
更新日期:1984-06-01 00:00:00
abstract::Pulmonary metastases are the primary cause of death due to bone and soft tissue sarcomas. We have previously shown that an aggressive approach and a new technique of multiple pulmonary metastasectomies have resulted in improved survival for patients with pulmonary metastases. In this follow-up study, an expanded datab...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81150-x
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Laparoscopic parastomal hernia repair can be technically challenging. We herein present a simplified technique of laparoscopic parastomal hernia repair. METHODS:This technique entails fixation of the rolled mesh to the anterior abdominal wall before unfolding it, each side of the mesh is unfolded and fixed ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.06.034
更新日期:2008-09-01 00:00:00
abstract::A review has been made of the records of 208 patients operated on for complications of diverticulitis of the colon. One hundred forty patients had emergency operations and 68, elective operations. Resection and anastomosis, with or without temporary diverting colostomy, practiced in the majority of emergency cases in ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90605-2
更新日期:1987-03-01 00:00:00
abstract::Various reports have demonstrated that the intraoperative utilization of the choledochoscope has significantly reduced the incidence of unsuspected retained common duct stones from approximately 10 percent to 0 to 2 percent. Our series revealed a 4 percent incidence of retained stones before choledochoscopy was utiliz...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90406-3
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND:Traumatic vascular injuries are infrequent but can be devastating. This study characterized their incidence and the need for vascular surgeons in their repair. Outcomes for patients repaired by vascular and trauma surgeons were compared. METHODS:Patients age ≥14, needing operations for acute traumatic vascu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.11.011
更新日期:2016-03-01 00:00:00
abstract::Typhlitis is a neutropenic enterocolitis of varying severity. Its incidence is increasing, particularly in patients with acute myelogenous leukemia undergoing high dose cytosine arabinoside chemotherapy. The onset is heralded by prodromal fever, watery or bloody diarrhea, abdominal distension, and nausea during the ph...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90547-7
更新日期:1986-05-01 00:00:00