Abstract:
:The response of tissue to trauma is difficult to define. The zone of injury is an area surrounding a wound that, though traumatized, may not appear nonviable at initial debridement. Because of this, a policy of repeated debridements has been followed to monitor tissues for viability before final tissue coverage. Appreciation of the zone of injury has led to a controversy in the literature about how to define and approach the management of traumatic injuries requiring free-tissue coverage. This review examines the current literature with regard to the definition of the zone of injury, and seeks to establish a consensus statement about the application of free flaps to traumatized wounds. We have investigated the literature supporting the use of free flaps relying on proximally or distally based recipient vessels. Critical appraisal of this literature includes study design, determination of the power of the study, subject classification, inclusion and exclusion criteria, follow-up, and outcomes (free flap success). There has been little attempt in the literature to fully and objectively define the zone of injury. All studies to date have been observational alone. Although it would be impossible to rid a definition of the zone of injury of subjectivity entirely, a more objective, reproducible definition is vitally needed. Without a clear definition of what the zone of injury is, there can only be anecdotal, technique reports of the placement of free flap anastomoses. In this time of rising costs and lower reimbursements, this is one area that could provide vital information to improve care for patients, lessen costs, and further medical knowledge.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Loos MS,Freeman BG,Lorenzetti Adoi
10.1097/SAP.0b013e3181d50e3esubject
Has Abstractpub_date
2010-12-01 00:00:00pages
573-7issue
6eissn
0148-7043issn
1536-3708journal_volume
65pub_type
杂志文章,评审abstract::A new homodigital neurovascular island flap for fingertip reconstruction, called a volar digital island flap, is described. The flap is perfused from the proper digital artery through the transverse palmar branch, and is drained through the tiny venules and capillaries contained in the perivascular soft tissue. Betwee...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200109000-00008
更新日期:2001-09-01 00:00:00
abstract::Forty-one hemimandible allografts were transplanted in young rabbits immunosuppressed with cyclosporine. The majority of the grafts demonstrated normal wound healing, and growth of hair, bone, and teeth. The mandibular body and the premolars showed significant growth in length. The allografted mandibles functioned suf...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199102000-00006
更新日期:1991-02-01 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:Life-threatening facial hemorrhage in Maxillofacial Surgery (MFS) has an approximate incidence of 1% in the trauma patient and in elective surgery. The treatment of acute life-threatening hemorrhage in MFS to prevent hypovolemic shock or airway obstruction forms the basis of emergency care and necessitates t...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0b013e31824a2171
更新日期:2012-10-01 00:00:00
abstract::Dupuytren's contracture, a benign condition characterized by fibrosis of the palmar and digital fascia, may be a debilitating condition that limits daily function. Several techniques exist for managing symptomatic contractures of the hand related to Dupuytren's. These techniques include the more invasive open fascioto...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0000000000001607
更新日期:2018-12-01 00:00:00
abstract::Lipofibromatosis is a slow-growing, childhood soft-tissue neoplasm that is often confused with other conditions. We report a patient with lipofibromatosis causing extremity enlargement at birth. The lesion initially was thought to be a vascular anomaly or lipedema on clinical and MRI examination. When involving the lo...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181a13df6
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:There is no consensus with regard to antibiotic prophylaxis usage in clean and clean-contaminated plastic and reconstructive surgery. This meta-analysis sought to assess the efficacy and safety of antibiotic prophylaxis and to determine appropriate duration of prophylaxis. METHODS:An English language litera...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1097/01.SAP.0000440955.93769.8c
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Despite advances in reconstruction techniques, pressure sores continue to present a challenge to the plastic surgeon. The parasacral perforator flap is a reliable flap that preserves the entire contralateral side as a future donor site. On the ipsilateral side, the gluteal muscle itself is preserved and all ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000024
更新日期:2015-07-01 00:00:00
abstract::A random-pattern cutaneous flap with its base at the highly vascularized dorsal web space has been designed to decrease donor site deformity and to increase securely flap mobilization in contractures involving more than 1 adjacent proximal phalanx base. Rectangular flaps facing each other on the lateral sides of adjac...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000141941.62650.59
更新日期:2005-01-01 00:00:00
abstract::The authors describe the ability of the gracilis muscle to provide multiple tissue components- skin, muscle, nerve, and tendonin the reconstruction of a complex dorsal foot wound resulting from a sarcoma resection. The deficits of skin, deep peroneal nerve, anterior tibialis tendon, and dorsal extensor retinaculum wer...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200103000-00023
更新日期:2001-03-01 00:00:00
abstract::Reconstruction of complex tissue deficiencies in which each missing component is in a different spatial relationship to each other can be particularly challenging, especially in patients with limited recipient vessels. The chimera flap design is uniquely suited to reconstruct these deformities. Chimera flaps have been...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0b013e318193499f
更新日期:2009-10-01 00:00:00
abstract::This reconstructive microsurgery course will run yearly and was borne and popularized from its infant meeting the year before, primarily focused on perforator flaps. It is a 2-day course updating residents/registrars to attending physicians/consultants about the most topical advancements in microvascular reconstructiv...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000824
更新日期:2017-01-01 00:00:00
abstract::Seroma formation at the donor site of the transverse rectus abdominis myocutaneous flap was evaluated in 48 patients who underwent breast reconstruction with either quilting sutures and suction drains (QS+DN group) or quilting sutures alone (QS group) or suction drains alone (DN group). Clinical and ultrasound examina...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SAP.0b013e3182610b11
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:There is no quantitative evidence supporting one unilateral cleft lip (UCL) repair technique over the other with regard to scarring. We sought to evaluate the difference between the extended Mohler and Millard techniques, using 3 scar assessment scales. METHODS:Postoperative frontal and basal photographs of...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001991
更新日期:2019-12-01 00:00:00
abstract::A Silastic tissue expander inserted subpectorally at the time of modified radical mastectomy has provided early development of the reconstructive envelope, thereby simplifying matching of the contralateral breast. Significant emotional support for the woman faced with imminent loss of her breast has been repeatedly ob...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198511000-00007
更新日期:1985-11-01 00:00:00
abstract::Many treatment modalities of ingrown toenail are reported in the literature, often associated with unacceptably high recurrence rate. The authors present their technique, which aims at reducing the convexity of the nail fold. After complete removal of the nail plate and accurate debridement of the granulomatous tissue...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000095436.08812.67
更新日期:2004-06-01 00:00:00
abstract::A clinical study was designed in which 20 women who were to undergo bilateral McKissock reduction mammaplasties were requested to use a precut silicone elastomer sheet over the scars of one breast, starting at the time of suture removal. The patients were instructed to use the silicone sheet for 12 hours each day for ...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000637-199610000-00001
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Data regarding donor-site morbidity, postoperative clinical course, and functional outcome after hemisoleus muscle flap reconstruction are rare. The aim of this study was to determine the clinical and functional outcome of distally based medial hemisoleus flaps used for the reconstruction of defects in the l...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001539
更新日期:2018-10-01 00:00:00
abstract::Local fascial flaps independently are a versatile option, reliable when properly designed, and technically simple to execute especially when compared to microsurgical tissue transfers. Although free flaps continue to be the method of choice to repair major distal extremity defects, for smaller wounds it could be prefe...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199704000-00014
更新日期:1997-04-01 00:00:00
abstract::In this article the author describes 2 cases of a distally based perforator medial plantar flap that were transferred successfully from the nonweight-bearing instep region to the weight-bearing plantar forefoot (defects, 8 x 5 cm and 6 x 5 cm respectively). This flap is nourished solely by perforators of the medial pl...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000112287.56354.f8
更新日期:2004-10-01 00:00:00
abstract::Millions of patients are treated annually in the United States with either acute or chronic wounds, costing billions of dollars. This is a retrospective study designed to quantify the directed education that medical students receive in their 4 years of training on 3 wound-related topics: physiology of tissue injury, p...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31802dd43b
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:With the continued application of fat grafting in plastic surgery, many studies have focused on various factors to improve maintenance of the fat graft volume, such as platelet-rich plasma, adipose-derived stromal/stem cells, and the stromal vascular fraction (SVF). In addition, many review ar...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001589
更新日期:2018-09-01 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:INTRODUCTION:The modified Meek micrografting technique has been used in the treatment of severely burned patients and a number of articles have examined the use of the modified Meek technique in adults and in mixed-age groups. However, there is a paucity of research pertaining to the outcome in the pediatric age group....
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001565
更新日期:2018-09-01 00:00:00
abstract::A bayonet-shaped airway allowing free respiration and undisturbed deglutition was reconstructed in 2 young women who had undergone tracheotomy and radiotherapy for thyroid carcinoma. The laryngeal vestibule, glottis, and subglottis had been destroyed, and the air passages were closed. An external gutter and an anterio...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198605000-00010
更新日期:1986-05-01 00:00:00
abstract::When exposing the orbit, the transconjunctival approach is regarded to have limited surgical exposure. The aim of this study is to demonstrate the versatile usability of extended transconjunctival approach, which can be extended medially and laterally, in reconstruction of medial orbital wall, floor, and even the late...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181855d27
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Lacerations to the extensor mechanism are usually diagnosed clinically. Ultrasound (US) has been a growing diagnostic tool for tendon injuries since the 1990s. To date, there has been no publication establishing the accuracy and reliability of US in the evaluation of extensor mechanism lacerations in the han...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000524
更新日期:2016-02-01 00:00:00
abstract::Although most commonly seen with dental extractions, inferior alveolar nerve injury is occasionally seen with orthognathic surgery and facial trauma. Nerve grafting can be performed by lateral corticotomy without the use of maxillomandibular fixation. A case is reported with this technique and recovery of sensibility ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199408000-00019
更新日期:1994-08-01 00:00:00
abstract::Ectopia cordis is defined as a congenital malposition of the heart outside of the thoracic cavity. It is a rare condition, and complete ectopia cordis can be a fatal condition. Successful surgical reconstruction of this defect has been reported but is uncommon. The general approach to reconstructing the chest wall inv...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181c5a7ff
更新日期:2010-08-01 00:00:00
abstract::The gastrocnemius muscle flap has gained wide acceptance as a reconstructive technique for management of wounds of the knee and proximal tibia. The use of the muscle as a pedicle flap to the distal and middle femur has not been well quantified, and the proximal rotation arc has been underestimated. We report the use o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199504000-00014
更新日期:1995-04-01 00:00:00