Abstract:
:Traumatic amputation of the lip is a rare yet devastating event affecting both form and function. Considering the available methods for reconstruction, replantation may offer a reasonable solution. We sought to characterize the variables associated with lip replantation and to assess the outcome in a retrospective review of 13 lip replantations performed in 12 institutions utilizing a form database and clinical and photographic analysis. Lip replantation was successful in all 13 patients; partial flap loss occurred in one patient owing to iatrogenic injury. Follow-up averaged 3.1 years. Average patient age at the time of injury was 21.1 years. There were six male and seven female patients. Injuries in two patients were the result of a human bite, the remaining injuries resulted from dog bites. One patient had significant associated injuries. Average length of hospital stay was 11.9 days. Ten patients suffered amputations of the upper lip, and three suffered amputations of the lower lip. Average defect size was 10.6 cm2. Operative time averaged 5.7 hours (range 2.5 to 12 hours). Warm ischemia time averaged 2.9 hours, and cold ischemia time averaged 2.7 hours. Donor and recipient veins were often scarce; all patients had at least one arterial anastomosis, whereas no vein was available in 7 of 13 patients; vein grafts were required in one patient. Leech therapy was employed in 11 of 13 patients. Anticoagulant therapy was administered in the majority of patients. Systemic heparin was utilized in 10 of 13 patients, low molecular weight dextran was used in 7 of 13 patients, and aspirin was given to 7 of 13 patients. One bleeding complication was incurred. An average of 6.2 units of packed red blood cells was administered to 12 of 13 patients (adjusted to 250 cc/unit). Antispasmodic therapy was employed in six of eight patients intraoperatively and in two of eight patients postoperatively. Intraoperative complications included difficulty identifying veins in 7 of 13 patients, arterial spasm in 1 of 13 patients, and vessel diameter < 0.5 mm in 4 patients. Postoperatively, one patient suffered vein thrombosis requiring anastomotic revision. Broad spectrum antibiotics were administered to all patients, and there were no infections. Nearly one-third (4 of 13) patients suffered prolonged edema lasting > 4 months. Color match of the replanted lip segment was rated excellent in all cases. Hypertrophic scarring occurred in 6 of 13 patients. A total of 12 revision procedures was performed in six patients. Interestingly, leech therapy resulted in permanent visible scarring as a result of the leech bite in 6 of 11 patients treated. Ten patients demonstrated active orbicularis muscle contraction in the replanted lip segment. Stomal continence was present in all lips. Sensibility return in the replanted lip segment was quite good with 12 of 13 patients demonstrating at least protective moving two-point sensibility (> or = 10 mm). Partial replant necrosis in one patient resulted in significant scar and contraction that compromised the aesthetic appearance. Overall, however, all patients were uniformly pleased with their final results. This clinical study is one of the largest of its kind on lip replantation. Although this represents a multi-institutional experience, the data are remarkably consistent. Re-establishment of venous outflow seems to be the most problematic technical challenge. By incorporating the adjuncts of anticoagulation, leech therapy, and antispasmodics, a successful outcome can be expected despite the paucity of vessels and small vessel size. The risks of blood transfusion, lengthy operative time, and hospital stay must be weighed against the functional benefits.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Walton RL,Beahm EK,Brown RE,Upton J,Reinke K,Fudem G,Banis J,Davidson J,Dabb R,Kalimuthu R,Kitzmiller WJ,Gottlieb LJ,Buncke HJdoi
10.1097/00006534-199808000-00009subject
Has Abstractpub_date
1998-08-01 00:00:00pages
358-68issue
2eissn
0032-1052issn
1529-4242journal_volume
102pub_type
杂志文章abstract::The objective of this study was to determine whether the type of capsulectomy, anterior or total, affects the recurrence of capsular contracture around subglandular silicone-gel breast implants. A retrospective analysis was performed of patients who underwent either anterior or total capsulectomy for Baker grade 3 or ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200009040-00006
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:With health reform increasingly focused on readmission rates as an indicator of quality of care, providers have a duty to identify patients at risk of readmission. The authors assessed the incidence and risk factors for readmission following immediate breast reconstruction. METHODS:Patients who underwent im...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000319
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Microsurgical procedures, although equipment- and labor-intensive, allow efficient treatment of selected soft-tissue, bone, and peripheral nerve defects. The precise surgical skills required and the high equipment and institutional costs have been deterrents to initiating programs in developing countries. Th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000254544.65054.95
更新日期:2007-04-01 00:00:00
abstract::A new approach for tissue creation using synthetic biocompatible and biodegradable polymers as templates onto which cells are seeded is presented. This report concerns the generation of homogeneous plates of stable mature cartilage in vivo. The delivery of chondrocytes on synthetic polymers configured to provide a lar...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199111000-00001
更新日期:1991-11-01 00:00:00
abstract::A venous skin graft for the treatment of skin defects in a finger is described. This procedure involves taking a flap from the forearm together with the subcutaneous vein and anastomosing both ends of this vein to the digital artery and vein, respectively. Thirteen difficult finger wounds were resurfaced with such a v...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198702000-00016
更新日期:1987-02-01 00:00:00
abstract:BACKGROUND:Reconstruction of large full-thickness defects of the upper eyelids is challenging because of their complex anatomy and specialized functions. The authors present and discuss a new, simple surgical technique for upper eyelid reconstruction. This is a single-stage procedure and has produced satisfactory to ex...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000297649.71049.ae
更新日期:2008-02-01 00:00:00
abstract::Prophylactic bilateral mastectomy is an option for women who are at an increased risk of developing breast cancer. Prophylactic mastectomy is often performed with immediate reconstruction (i.e., at the same time and under the same anesthetic as the mastectomy). Satisfaction with reconstruction has been described previ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000131877.52740.0e
更新日期:2004-08-01 00:00:00
abstract::The purpose of this study was to investigate the significance of fiber type and the effects of the duration of ischemia on metabolic and contractile function of skeletal muscle. Under anesthesia, the distal tendons of the fast twitch extensor digitorum longus (EDL) and slow twitch soleus (SOL) muscles of the right hin...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199701000-00025
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Although many plastic surgeons perform autologous fat grafting (lipofilling) for breast reconstruction after oncologic surgery, it has not been established whether postoncologic lipofilling increases the risk of breast cancer recurrence. The authors assessed the risk of locoregional and systemic recurrence i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000475741.32563.50
更新日期:2016-02-01 00:00:00
abstract::A method is presented for the closure of a circular defect without altering its shape. It employs semicircular rotational flaps and Z-plasties. Its use in 178 patients with malignant skin neoplasms is presented. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198412000-00015
更新日期:1984-12-01 00:00:00
abstract::Logical correction of aging contour changes of the face is based on understanding its structure and the processes involved in the aging appearance. Aging changes are seen at all tissue levels between the skin and bone although the relative contribution of each component to the overall change of facial appearance has y...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000001752
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Long-term neuropsychological and cognitive outcomes in patients with nonsyndromic craniosynostosis have proven difficult to evaluate objectively because of methodologic problems with published studies based on their small and biased samples of patients, wide age ranges, and testing with unacceptable psychome...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005515
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to compare clinical outcomes and 1-year postsurgical stability with three different techniques of Le Fort III midface advancement. METHODS:The records of 212 syndromic craniosynostosis patients were reviewed from the period 1973 to 2006. A total of 60 patients satisfied the inc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181e6051e
更新日期:2010-09-01 00:00:00
abstract::Distraction osteogenesis has become an accepted method of treatment for patients requiring reconstruction of hypoplastic mandibles. We present a quantitative analysis of volumetric changes after distraction osteogenesis in a series of 10 patients. Group I (n = 5 patients, 3 unilateral craniofacial microsomia, 1 Golden...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199704001-00005
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:Preservation of the scroll area is essential when performing rhinoplasty to achieve a good functional outcome. This is of particular concern with tip-plasty procedures. The objectives of this study were (1) to describe a novel tip-plasty procedure consisting of sliding the cephalic portion of the alar cartil...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005991
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Vascular malformations are congenital anomalies of the vascular system. Intralesional bleomycin injections are commonly used to treat vascular malformations. However, pulmonary fibrosis could potentially be a severe complication, known from systemic bleomycin therapy for malignancies. In this study, the auth...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1097/PRS.0000000000001924
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:The use of a porous high-density polyethylene implant for ear reconstruction is gradually gaining acceptance because it allows for a pleasing ear reconstruction in young children before they enter school. In response to this growing interest, the authors decided to write an article clarifying in detail all t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004088
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Several randomized controlled trials comparing platelet-rich plasma to standard wound care for chronic wounds have been published. Previous articles have revealed that the role of platelet-rich plasma in promoting chronic wound healing is uncertain. This quantitative meta-analysis was conducted to evaluate w...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,meta分析
doi:10.1097/PRS.0000000000006281
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Options for bilateral autologous breast reconstruction in thin women are limited. The aim of this study was to introduce a novel approach to increase abdominal flap volume with the stacked hemiabdominal extended perforator (SHAEP) flap. The authors describe the surgical technique and analyze their results. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005058
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Along with technical advancements in perforator flap surgery, great interest has been recently focused on the accuracy of preoperative perforator location through the assessment of the donor-site vascular network. The goal of the present study was to investigate the usefulness of contrast-enhanced ultrasound...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182729e9e
更新日期:2013-01-01 00:00:00
abstract::Deformities of the adjacent facial bones are common with large vascular tumors. Most hemangiomas will resolve spontaneously, but the incidence of resolution appears to be quite low when the adjacent bones are affected. In these, we have used high dosage corticosteroid therapy in the early cases, particularly those inv...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197903000-00003
更新日期:1979-03-01 00:00:00
abstract::Injuries to the proximal interphalangeal joint are commonly encountered by the hand surgeon. Proper diagnosis and treatment are vital for optimal outcomes. Proper treatment of these injuries requires a working knowledge of the anatomy of the joint and an appreciation for principles for reduction, stabilization, and ea...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182a48d65
更新日期:2013-11-01 00:00:00
abstract::The aim of the present study was to evaluate the alterations of symptoms and tactile sensibility of the breast after reduction mammaplasty. In a prospective study, 10 women were operated on using the inferior pedicle technique. The patients were examined and interviewed preoperatively and at 2 weeks and 3 and 12 month...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000037749.88018.21
更新日期:2003-01-01 00:00:00
abstract::A primary gastrocnemius transposition flap is a useful technique for prosthetic coverage following extensive soft-tissue and bone resection for sarcomas of the knee joint. The gastrocnemius transposition flap is also a useful secondary procedure to treat local complications following attempted limb-sparing surgery. Th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198405000-00004
更新日期:1984-05-01 00:00:00
abstract::A shallow buccal sulcus deformity following bilateral cleft lip repair is not rare. A variety of techniques are described for the secondary reconstruction of a deficient sulcus. Most of these are associated with a variable amount of contraction with subsequent obliteration of the sulcus. In this article, an inverted U...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200112000-00004
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:The aim of this study was to describe the relationship between the deep peroneal nerve and the dorsalis pedis artery to help ensure a safer surgical approach in flap surgery. METHODS:The dissection of 36 cadaver lower limbs was undertaken to describe the relationship of the deep peroneal nerve to the dorsal...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000270310.39084.2d
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Upper airway narrowing has been a concern of mandibular setback. The aims of this study were (1) to evaluate the effect of bimaxillary rotational setback surgery on upper airway structure in patients with skeletal class III deformities, and (2) to compare the preoperative and postoperative upper airways of c...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000913
更新日期:2015-02-01 00:00:00
abstract::As part of forehead rejuvenation and surgical treatment of migraine headaches, the mass of the corrugator supercilii, the procerus, and the depressor supercilii muscles is replaced with fat for optimal aesthetic contouring of this region and to help prevent recurrence of the glabellar lines. The authors propose a new ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000128825.62390.73
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Microbotox consists of the injection of microdroplets of botulinum toxin into the dermis to improve the different lower face and neck aging components. No clinical trial has evaluated its effect on the different face and neck components and no study has compared it to the "Nefertiti lift" procedure. METHODS...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/PRS.0000000000004695
更新日期:2018-09-01 00:00:00
abstract::Primary melanomas of the skin of the breast are uncommon lesions. Fifty-four patients were surgically treated for this lesion during a 13-year period, accounting for 3.8 percent of a total of 1431 patients with cutaneous melanoma. Nineteen patients were female and 35 were male. Most recently, in patients with high-ris...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198709000-00011
更新日期:1987-09-01 00:00:00