Abstract:
:Expeditious yet efficacious removal of skin tumors is a common responsibility for the plastic surgeon. The need to minimize potential risks for mortality or morbidity from undue or excessive surgical resections and to control costs by avoiding unnecessary procedures behooves us to make a precise clinical diagnosis preceding any decision even for such "minor" surgery. Just how accurate these decisions can be expected to be for a typical surgical practice was scrutinized by means of this prospective 4-year study involving the resection of 2058 skin lesions. Each lesion was initially assigned a clinical diagnosis after a brief gross examination and then compared with the pathology report, which was always considered to be the correct answer. Within these parameters, only 65 percent of all tumors were identified correctly preoperatively. Two-thirds of all lesions were benign. Three-quarters of benign lesions were as assumed, and 92 percent of all presumed benign lesions were benign even if incorrectly identified initially, whereas fortunately only 3 percent proved to be malignant. On the other hand, only three-fifths of malignant lesions were identified correctly clinically, yet only 11 percent were benign, implying that most such lesions properly deserved excision anyway. Therefore, approximately 90 percent of all lesions whether benign or malignant were removed appropriately without compromising the patient, but to expect a clinical acumen of 100 percent in this setting may not be realistic. The accuracy of the surgeon in identifying lesions as probably benign was certainly high enough that cost-containment mechanisms designed to deny authorization for their removal probably would be justifiable and difficult to appeal. Any suspicious or equivocal lesions still will require mandatory intervention despite such constraints, because often only histologic examination will allow a definitive diagnosis.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Hallock GG,Lutz DAdoi
10.1097/00006534-199804050-00014subject
Has Abstractpub_date
1998-04-01 00:00:00pages
1255-61issue
5eissn
0032-1052issn
1529-4242journal_volume
101pub_type
杂志文章abstract::The 47-kDa heat shock protein (HSP47) is a molecular chaperone specifically targeting the processing and quality control of collagen molecules. This study was performed to investigate whether antisense therapy preventing HSP47 expression might affect the scar formation occurring during wound healing of skin. In wound ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000054844.41243.F2
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Molecular mechanisms that direct the extent of the foreign body reaction to implanted biological meshes and their subsequent incorporation are poorly understood. The purpose of this study was to compare the influence of non-cross-linked human dermis (AlloDerm) with that of cross-linked porcine dermis (Permac...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182818a3d
更新日期:2013-04-01 00:00:00
abstract::Although prominent ears are the most common congenital deformity in the head and neck region, only approximately 8 percent of patients who present for treatment of this deformity will have some family history of the abnormality. More than 200 techniques have been described for correction of this deformity, indicating ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200109150-00038
更新日期:2001-09-15 00:00:00
abstract:UNLABELLED:Contracture of the antecubital fossa is a common occurrence following thermal burn injury to the upper extremity. Scarring of the superficial tissues can be treated with a variety of surgical methods to provide release and coverage. However, complex scarring of the elbow, which involves the deeper structures...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182450c0c
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Information about silicone gel implant longevity is sparse. Magnetic resonance imaging studies have superseded explantation studies in the search for data on their long-term integrity. Unfortunately, the majority of studies are based predominantly on second-generation implant cohorts. Although magnetic reson...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000279374.99503.89
更新日期:2007-10-01 00:00:00
abstract::Split-thickness skin grafts remain central to the strategy of burn wound treatment. The dressing used to cover the donor wound site has a significant effect on healing parameters. The purpose of this study was to compare split-thickness skin graft donor site reepithelialization under Xeroform and Jelonet dressings. A ...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/01.PRS.0000070408.33700.C7
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Theories regarding the cause of craniosynostosis that are more than 15 years old cite the role that tensional forces play in the normal and abnormal development of the cranial suture. These theories highlight the effect of stress bands originating from the skull base to the vertex, guiding sutural developmen...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000270284.69632.6b
更新日期:2007-09-01 00:00:00
abstract::A modification of Tennison's operation for closure of a cleft lip is presented. The modification entails the use of X-shaped incision lines and a piece of lead rather than a wire. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197612000-00002
更新日期:1976-12-01 00:00:00
abstract:BACKGROUND:Treatment of keloid scars poses a significant challenge. Assessment of treatment response and research in this area depend on the availability of objective, accurate, and reproducible outcome measures. At present, scars are assessed using subjective grading systems, or with cumbersome investigations such as ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000252505.52821.76
更新日期:2007-02-01 00:00:00
abstract::The cause of cleft lip remains speculative. The nature and extent of pathophysiologic changes in cleft lip muscle are controversial. This study was undertaken to better understand the developmental processes at work. There were two groups of patients. In group 1, 40 fresh tissue specimens were taken from 22 patients w...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200109010-00002
更新日期:2001-09-01 00:00:00
abstract::Maternal cigarette smoking during pregnancy as a risk factor for having a child with cleft lip/palate has been suggested by several epidemiologic studies. However, most of these studies contained small sample sizes, and a clear association between these two factors could not be established. The U.S. Natality database ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/00006534-200002000-00001
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Today's criterion standards for measuring functional recovery after nerve trauma in experimental studies are the muscle mass ratio and the isometric tetanic force; both tests are invasive and require a sacrificial procedure. The authors propose ultrasound as a noninvasive method to determine muscle atrophy, ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000001681
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Single-stage reconstruction of the nasal tip using frontonasal flaps yields variable results. Variations in flap design were used to optimize outcome. METHODS:Consecutive nasal tip reconstructions using frontonasal flaps performed by the author during a 6-year period were studied retrospectively. Patients w...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002785
更新日期:2016-12-01 00:00:00
abstract::Tissue engineering and dermal substitution are currently prominent topics of wound-healing research. However, no extensive clinical trials with objective evaluation criteria have been published so far that support the clinical effectiveness of dermal equivalents in the long term. The dermal substitute that is discusse...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00006534-200112000-00014
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Capsular contracture remains a major problem following prosthetic breast implantation, especially in patients undergoing irradiation. Recent studies suggest that such radiation injuries are a cascading process of cytokine activation, with transforming growth factor (TGF)-β acting as the "master switch." Beca...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182131bea
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:In autologous breast reconstruction after mastectomy, fat necrosis is a rather common complication that may lead to secondary corrective surgery. The understanding of fat necrosis until now has been limited because previous studies were based exclusively on physical examination and used diverse definitions. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181bf7e03
更新日期:2009-12-01 00:00:00
abstract::Recent controversy encountered with silicone breast implants has increased the use of autogenous tissue for breast reconstruction following mastectomy. Surveillance of patients who have undergone autogenous tissue reconstruction is important in the evaluation of recurrent or new cancer. Magnetic resonance imaging (MRI...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199501000-00010
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:This study aims to assess the health-related quality-of-life benefit following auricular reconstruction using autologous costal cartilage in children. In addition, key aspects of the surgical reconstruction are assessed. METHODS:After auricular reconstruction, patients completed two questionnaires. The firs...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182402ca7
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Abdominally based free tissue transfer (FTT) and latissimus dorsi and immediate fat transfer (LIFT) procedures are both fully autologous options for breast reconstruction. The former is specialized and requires comfort with microsurgical technique, whereas LIFT combines a common set of techniques familiar to...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000007027
更新日期:2020-08-01 00:00:00
abstract::We retrospectively reviewed 119 consecutive patients who underwent cleft palate repair at the Mayo Clinic to determine the incidence of postoperative fistula formation, to assess possible contributing factors, and to review the methods of surgical management. Fistulas of the secondary palate were included, but nasal-a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract::Hair transfer from split-thickness skin grafts harvested from the scalp is not a widely reported problem. The authors present their experience with hair transfer from scalp autografts in a pediatric burn population, with particular emphasis on hair transfer to the face. They retrospectively reviewed 3307 acute and rec...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199811000-00009
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:Previous studies have proposed that the frontal branch of the superficial temporal artery could be used to determine the course of the temporal branch of the facial nerve; however, these studies have not documented this relationship. The objective of this study was to thoroughly examine the courses of the fr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000174001.95115.9e
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:The omentum, nourished by the gastroepiploic vessels, has gained popularity as an option for vascularized lymph node transfer. The anatomy of the gastroepiploic vessels, omentum, and lymph nodes has not been investigated. The purpose of this article is to describe the right gastroepiploic artery and related ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004772
更新日期:2018-10-01 00:00:00
abstract::Perfusion of rat groin flaps after 10 and 11 hours of complete ischemia with superoxide dismutase, an oxygen free-radical scavenger, significantly improved the survival of these flaps. This finding provides further evidence for the important role that oxygen-derived free radicals play in ischemic injury. The study als...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198604000-00022
更新日期:1986-04-01 00:00:00
abstract::Previous work on critical ischemia time suggested (1) a greater susceptibility of myocutaneous flaps over skin flaps to the ischemia reperfusion injury and (2) that duration of ischemia may affect the survival area of a flap. Using a pig model, 55 animals were operated on and the critical ischemia times and survival p...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND:The use of platelet-rich plasma has emerged as one of the most desired nonsurgical treatments for facial rejuvenation and hair restoration. It has grown to encompass a wide variety of applications within the field of plastic surgery, including its use in combination with microneedling, laser, and fat-graftin...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000007509
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:In 2002, the author implemented a new two-stage approach, "delayed-immediate breast reconstruction," for patients who desire breast reconstruction and who are at an increased risk for conditions necessitating postmastectomy radiotherapy. There is increasing acceptance of this approach in clinical practice. T...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181c82d58
更新日期:2010-02-01 00:00:00
abstract::Complications after a median sternotomy incision, which is used currently in most cardiac and mediastinal surgical procedures, although infrequent, are serious. If sternal dehiscence follows median sternotomy, infection extends to vital underlying structures, exposing the anterior part of the heart and ascending aorta...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198511000-00008
更新日期:1985-11-01 00:00:00
abstract::The purpose of this study was to assess the progressive changes of nasal symmetry, growth, and relapse after presurgical nasoalveolar molding and primary cheiloplasty in unilateral complete cleft lip/palate infants. Twenty-five consecutive complete unilateral cleft lip/palate infants were included. All the infants und...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000133027.04252.7a
更新日期:2004-09-15 00:00:00
abstract::Despite advances in breast implant surgery, capsular contracture remains a challenging sequela of reconstructive and cosmetic breast implant surgery. Although there are established modalities for treatment, most recently, acellular dermal matrix products have been suggested to have a role in preventing or diminishing ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e318262df58
更新日期:2012-11-01 00:00:00