Abstract:
:This paper describes the wound management and treatment of 12 consecutive patients with severe radiation damage to the hands. Three of these were secondary to therapeutic radiation for squamous cell carcinoma in one and synovial sarcoma in two, and nine were healthy professional people exposed to radiation in the work-place. All lesions were characteristic radiation burns with ulcerative necrotic changes of the skin and subcutaneous tissues. One patient had a lesion on the dorsum of the hand, three patients had lesions on the palm of the hand, and eight patients had lesions in the fingers of the hand. Reconstructive surgery was carried out by debridement to what was felt to be healthy margins, followed by cross-finger flaps or thenar flaps to fingertips in three, radial forearm flaps in three, free flaps from the first web space in three, neurovascular island flaps from the fourth finger in two, a free scapular flap in one, a free inguinal flap with vascularized iliac crest in one, and a wraparound flap from the great toe in one. Two patients required two procedures; thus 14 flaps were done in 12 patients. Follow-up ranged from 2 to 12 months, with a mean of 6 months. All the patients have maintained a healed wound with adequate hand function, except for one patient, who had a recurrent synovial sarcoma in the midportion of the hand, requiring amputation. We conclude that management of radiation-induced injuries to the hand should be done with aggressive debridement and immediate coverage with well-vascularized flaps, either regional or free-tissue transfers. This will result in adequate wound healing and the most rapid, effective return of function with rapid institution of therapeutic modalities.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Milanov NO,Shilov BL,Tjulenev AVdoi
10.1097/00006534-199308000-00015subject
Has Abstractpub_date
1993-08-01 00:00:00pages
294-300issue
2eissn
0032-1052issn
1529-4242journal_volume
92pub_type
杂志文章abstract::The purpose of this paper is an assessment of clinically evident systemic health problems associated with failed silicone gel breast implants. A computer search of the medical records of 2033 patients receiving implants in the years 1962-1992 revealed that between 1970 and 1992, 200 women 14 to 75 years of age underwe...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199408000-00012
更新日期:1994-08-01 00:00:00
abstract::An 18-year-old girl had a cyst excised from the left buttock in 1988. The cyst was diagnosed to be a cutaneous ciliated cyst, since histologic examination using special stains demonstrated its lining to be similar to fallopian tube epithelium. Only 20 such cases have been published to date, and this report is probably...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:
更新日期:1990-08-01 00:00:00
abstract::The role of the plastic surgeon in the diagnosis and management of congenital anomalies is often a complicated one that involves the integration of input from numerous specialists into the evaluation process. Diastematomyelia is a serious neurosurgical problem that often presents with cutaneous findings in a neurologi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1995-07-01 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::We have presented an unusual case of basal cell carcinoma that presented in a 76-year-old black woman. This is an atypical case in that it occurred in a black patient, and the incidence of basal cell carcinoma is low in black people. The lesion was located in the groin, which is an uncommon location for basal cell car...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199610000-00022
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:An acellular dermal matrix will typically incorporate, in time, with the overlying mastectomy skin flap. This remodeling process may be adversely impacted in patients who require chemotherapy and radiation, which influence neovascularization and cellular proliferation. METHODS:Multiple biopsy specimens were...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000807
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Photoaging is generally treated by ablative procedures that injure the epidermis and basal membrane and lead to fibrosis of the papillary dermis. Damaging the epidermis significantly can cause potential adverse effects such as dyspigmentation. It was recently shown in clinical trials that percutaneous collag...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318188245e
更新日期:2008-11-01 00:00:00
abstract::Design and preoperative planning of microsurgical flaps are fundamental steps for successful surgery. Currently, computed tomographic angiography is considered the gold standard, and new technologies such as thermography could complement its usefulness. The aim of this study was to determine the concordance between th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004126
更新日期:2018-03-01 00:00:00
abstract::Free-tissue transfer has facilitated and refined the reconstructive surgeon's ability to repair or reconstruct acquired or congenital defects in children. Although parallels exist between indications for free-tissue transfer in adults and children, the technical challenges and surgical skill required in pediatric pati...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181bf83f1
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:The long-term implications of components separation for the lateral oblique and rectus muscles remain unknown. The authors hypothesized that recreation of the tendinous insertion of the linea alba through components separation results in expansion of the rectus muscle with potential atrophy of the external o...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182589d79
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Since their introduction to clinical medicine in 1989, botulinum toxin injections have been used for many indications. First used for nonsurgical management of strabismus, botulinum toxin injections are now widely used in plastic and reconstructive surgery for aesthetic indications; however, nonaesthetic ind...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000006908
更新日期:2020-07-01 00:00:00
abstract::This study was designed to examine whether hypotelorism associated with trigonocephaly might be self-correcting. Only patients who required surgical treatment and had undergone preoperative and postoperative anthropometric measurements were included. In no case was any attempt made to correct the hypotelorism surgical...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199603000-00001
更新日期:1996-03-01 00:00:00
abstract::In 25 random patients undergoing rhytidectomy, we did unilateral subplatysmal-fascial dissections of the superficial musculoaponeurotic system (SMAS) of the face and neck--with redistribution of the tension of this system and fixation by suturing. Late evaluation of these patients by 3 observers showed no detectable d...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197712000-00002
更新日期:1977-12-01 00:00:00
abstract::The incidence of free-flap failure is reported at 4 to 5 percent. Often, these failures are attributed to postoperative venous thrombosis with salvage rates reported at 42 percent. The use of thrombolytics has been effective in laboratory protocols; however, there have been only case reports to substantiate their use ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199811000-00021
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:The frontalis is a representative target muscle for botulinum neurotoxin type A injections aimed at treating horizontal wrinkles in the forehead region. However, a lack of information regarding the shape and thickness of the frontalis may lead to unexpected side effects. METHODS:This study dissected hemifac...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005202
更新日期:2019-02-01 00:00:00
abstract::Fibrin glue was applied at the anastomotic site of the vein graft that was placed in rat femoral artery defects by the telescoping anastomotic technique at both proximal and distal anastomoses. All 35 vein grafts thus placed were patent, yielding a statistically higher patency rate than those placed in the same femora...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199511000-00026
更新日期:1995-11-01 00:00:00
abstract::Thirteen patients who had undergone ablative surgery for advanced squamous cell carcinoma in which more than half of the tongue had been resected underwent reconstruction in which the cutaneous nerve of a free flap was anastomosed to the stump of the transected lingual nerve. Eight of the patients underwent reconstruc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199910000-00010
更新日期:1999-10-01 00:00:00
abstract::Two adjunctive or primary surgical procedures, partial resection and electrofulguration, are popular today for reducing offending inferior turbinates. Both are relatively successful. However, there seems to be a growing consensus that judicious partial resection of the inferior turbinates is associated with a higher l...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198806000-00010
更新日期:1988-06-01 00:00:00
abstract::Since the development of smooth silicone breast implants in 1962, more than 1 million women throughout the world have opted for breast augmentation surgery. Although initially successful, smooth implants are prone to develop surrounding scar capsules that may harden and contract, resulting in discomfort, weakening of ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199712000-00014
更新日期:1997-12-01 00:00:00
abstract::Severe crush to the hand is associated with a poor prognosis. The authors investigated the hypothesis that compartment syndrome complicates such injuries. From 1996 to 2000, the authors retrospectively identified 11 patients who, after sustaining a closed crush injury, developed acute hand compartment syndrome. Diagno...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000025183.78057.9B
更新日期:2002-10-01 00:00:00
abstract::Both the safety and efficacy of the treatment of isolated craniofacial dysostosis (plagiocephaly) in infancy have been demonstrated. Opinions remain divided, however, as to the optimal type of procedure to be undertaken. In an attempt to answer this question, we have retrospectively evaluated a study population of 48 ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199005000-00003
更新日期:1990-05-01 00:00:00
abstract::Although the latissimus dorsi myocutaneous flap is a safe and reliable technique for breast reconstruction, its versatility is limited when large cutaneous units are needed to resurface a heavily irradiated or scarred breast and chest wall. The thick back skin, in particular, may be unsuitable for reconstruction oppos...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199404000-00024
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:When selecting flaps for coverage of pressure ulcers of the sacrum and perineal region in paraplegic patients, long-term high recurrence rates should be considered. Therefore, the authors developed an infragluteal perforator flap to avoid "burning bridges" for future reconstruction. METHODS:Infragluteal per...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000239533.39497.a9
更新日期:2006-11-01 00:00:00
abstract::Surgery is accepted as one of the most demanding professions that create both physical and mental strain on the performers. Therefore, the authors aimed to elucidate the mental burden of surgeons, which is dedicated to operative stress. They also tested the hypotheses that participating in surgery creates mental stres...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000133166.50279.7c
更新日期:2004-09-15 00:00:00
abstract:BACKGROUND:Neurofibromatosis type 1 is a genetic and ubiquitous disease, with an estimated incidence of one in 3000 live births. Neurofibromas, defined as various benign tumors, are hallmarks of the disease. Facial plexiform or diffuse neurofibromas usually occur unilaterally and can induce facial hemihypertrophy. Surg...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181d180e9
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:The aims of the current study were to (1) measure trends in the type of mastectomy performed, (2) evaluate sociodemographic/hospital characteristics of patients undergoing contralateral prophylactic mastectomy versus unilateral mastectomies, and (3) analyze reconstruction rates and method used following diff...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31827cf576
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:In the spring of 2000, the U.S. Food and Drug Administration issued a ban on the use of Betadine (povidone-iodine; Purdue Frederick, Stamford, Conn.) in association with saline breast implants, because data seemed to indicate a higher rate of implant deflation in association with Betadine. Betadine has been ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000251088.51675.a8
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:The role of mandibular distraction osteogenesis for reconstructing mandibular defects following radiation therapy depends on the quality of attenuated bone healing in the regenerate. This study investigated the regenerate properties after radiation therapy using yield and breaking load. The authors hypothesi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318191c5d2
更新日期:2009-02-01 00:00:00
abstract::A case of total reconstruction of skull and scalp in a patient with a large defect from aplasia cutis congenita is reported. Tissue expansion was successfully employed on two occasions: first to construct a well-vascularized space to sustain multiple rib grafts for cranial reconstruction and then to develop adequate q...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198604000-00026
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:Craniofacial injuries secondary to earthquake-related trauma are uncommonly reported and can pose a significant reconstructive challenge. The objective of this study is to report and analyze earthquake-related craniofacial injury reconstruction and the disaster relief capabilities of a U.S. Navy hospital shi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181f5272d
更新日期:2010-12-01 00:00:00