Abstract:
:Reconstruction of infected median sternotomy wounds using muscle and omental flaps has been shown to result in significantly reduced morbidity, mortality, and length of hospital stay. Despite these benefits, very little is known about the potential long-term sequelae of such procedures. The purpose of this study was therefore to evaluate the ultimate functional outcome in such patients. One-hundred and thirty-three consecutive patients underwent debridement and flap reconstruction of their infected median sternotomy wounds over an 8-year period. Eighty patients were available for follow-up and responded to a questionnaire. Forty-eight patients consented to a physical examination. The length of follow-up ranged from 15 to 108 months (average 48 months). Healed wounds were obtained in 99 percent of patients. Fifty-one percent of patients noted persistent pain or discomfort, particularly in the chest and shoulder. Forty-four percent noted areas of numbness/paresthesias, mainly on the chest. Thirty-four patients (42.5 percent) noted symptoms of sternal instability; of those consenting to an examination, 45 percent were confirmed to have instability. Twenty-six patients (32.5 percent) claimed postoperative weakness (shoulder/abdomen). Significant shoulder weakness was not demonstrated; however, abdominal weakness was substantial. Thirty-six percent of patients reported an inability to perform the same preoperative activities that were of importance to them (sports, housework, etc.). Of those patients eligible to return to work, 52 percent did not. Patients younger than age 60 had a somewhat higher chance of not returning to work. Scars were noted to be good to excellent in 75 percent, but contour abnormalities of the chest and abdomen were found in 85 percent.(ABSTRACT TRUNCATED AT 250 WORDS)
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Ringelman PR,Vander Kolk CA,Cameron D,Baumgartner WA,Manson PNsubject
Has Abstractpub_date
1994-05-01 00:00:00pages
1208-14; discussion 1215-6issue
6eissn
0032-1052issn
1529-4242journal_volume
93pub_type
杂志文章abstract::The Le Fort I osteotomy is a versatile operation for correction of developmental, congenital, and posttraumatic deformities of the lower midface. One of the challenges of the osteotomy is pterygomaxillary separation, with the potential for unfavorable fractures to the orbit/skull base or vascular injury. A modified te...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006751
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:"Disruptive physician" is a term appearing more frequently in many hospital bylaws. It has significant negative implications that can lead to loss of privileges for plastic surgeons. METHODS:Exploring the various definitions of disruptive physician reveals palpable differences between those of the Joint Com...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31819348bd
更新日期:2009-01-01 00:00:00
abstract::The purpose of this study was to identify important sociodemographic factors affecting the utilization of immediate and early delayed postmastectomy breast reconstruction in the United States. Using the Surveillance, Epidemiology, and End Results (SEER) program, all cases of mastectomy-treated breast cancer that were ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000041438.50018.02
更新日期:2003-02-01 00:00:00
abstract:LEARNING OBJECTIVES:Learning Objectives: After reading this article, the participant should be able to: 1. Examine a nasal defect to determine its true dimension and outline and plan the appropriate timing of reconstruction. 2. Develop a surgical plan to restore normal dimension, volume, symmetry, and outline. 3. Deter...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182827bb3
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Although much has been published with regard to the columella assessed on the frontal and lateral views, a paucity of literature exists regarding the basal view of the columella. The objective of this study was to evaluate the spectrum of columella deformities and devise a working classification system based...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000022
更新日期:2014-04-01 00:00:00
abstract::Several authors have cited renal disease as a risk factor for free flap failure. The authors performed a retrospective analysis of all patients who underwent free tissue transfer with concomitant renal disease, including acute renal failure, end-stage renal disease, chronic renal insufficiency, and functional kidney t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000122214.55090.16
更新日期:2004-06-01 00:00:00
abstract::The U.S. Food and Drug Administration silicone gel breast implant moratorium occurred 25 years ago. The immediate and long-term consequences of the moratorium are reviewed and assessed. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000004284
更新日期:2018-05-01 00:00:00
abstract::Composite tissue defects may involve skin, mucosa, muscle, and bone together or in combinations of two or three of these tissues. Defects involving bone and skin are frequently encountered. Osteocutaneous flaps may be used to reconstruct these composite tissue defects. Sometimes, it is not possible to obtain a vascula...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000101062.00227.4F
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Sagittal craniosynostosis typically presents shortly after birth, with a scaphocephalic head shape, and is addressed surgically for functional and aesthetic concerns. This study highlights the authors' experience with a challenging patient population: those with phenotypically mild, missed, and late-developi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003602
更新日期:2017-09-01 00:00:00
abstract::The anatomy of the cervical and marginal mandibular branches of the facial nerve is reviewed. In the senior author's practice, "pseudoparalysis of the marginal mandibular nerve" due to cervical branch injury occurred in 34 of 2002 superficial musculoaponeurotic system-platysma face lifts (1.7 percent) and was associat...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000061004.74788.33
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Current rodent models of wound healing and scarring are flawed because of rapid wound contraction and inconspicuous scarring after healing, which is not closely parallel to the physiologic process in humans. This study aimed to establish a novel model of wound healing and scarring in rats. METHODS:Excisiona...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005274
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Cranial skeletogenic mesenchyme is derived from two distinct embryonic sources: mesoderm and cranial neural crest. Previous studies have focused on molecular and cellular differences of juvenile and adult osteoblasts. METHODS:To further understand the features of mouse-derived juvenile osteoblasts, the auth...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000279491.48283.51
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:This study was proposed to evaluate the facial contour and electrophysiologic changes of the masseter and temporalis muscles before and after botulinum toxin A injection in the wide lower face (square face). METHODS:The botulinum toxin A injections were performed on 10 patients for the treatment of square f...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000271068.71399.ae
更新日期:2007-09-01 00:00:00
abstract::Over a 3-year period, 50 patients with strawberry hemangiomas and 7 patients with postinvolutional redness or telangiectasia were treated with the SPTL-1 laser (Candela Corporation, Wayland, Mass.). The SPTL-1 laser emits pulsed light at a wavelength of 585 nm with a pulse duration of 450 ms. Lesions with a superficia...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199502000-00010
更新日期:1995-02-01 00:00:00
abstract::An experimental animal study was undertaken to evaluate the potential use of HTR polymer as a craniomaxillofacial reconstructive material. Its properties of marked hydrophilicity, a negative surface charge, and extensive porosity combined with a calcium graft coating suggested favorable osteoconductive properties. Fou...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199012000-00006
更新日期:1990-12-01 00:00:00
abstract::Treatment of nasal deformity and obstruction requires analysis, planning, and precise execution of rhinoplasty techniques. When performed well, rhinoplasty is a powerful tool for achieving appealing nasal morphology and optimizing function. This article aims to highlight an open approach to septorhinoplasty using a nu...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006687
更新日期:2020-04-01 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:BACKGROUND:The nasolabial flap is a pedicled flap with a wide description and application for use in lateral nasal wall, ala, columella, and intraoral reconstruction. It is a versatile flap that is well tolerated by the patient, with very acceptable donor-site scars. The soft and spongy nature of the flap, with its pro...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318182370b
更新日期:2008-09-01 00:00:00
abstract::The anatomic boundaries and vascular supply of the subgaleal fascia have been described previously. The thin and malleable subgaleal fascia was selected for difficult reconstructive problems in seven patients. This flap has been based on either the supraorbital or the superficial temporal vascular leash. The subgaleal...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199104000-00003
更新日期:1991-04-01 00:00:00
abstract::Recent experimental work has suggested that increased lip pressure and scar contraction following lip repair with wide soft-tissue undermining may, in part, contribute to midfacial growth inhibition. The present study was designed to test this hypothesis through the application of pharmacologic agents reported to mini...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199107000-00021
更新日期:1991-07-01 00:00:00
abstract::A concise protocol for the rehabilitation of the upper extremity after replantation is presented with special emphasis in the early mobilization of the hand. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/00006534-200203000-00027
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Despite a growing literature on patient satisfaction in breast reconstruction, few studies have compared perforator flaps with the more commonly practiced methods. The authors compared four reconstructive techniques and identified factors influencing patient satisfaction. METHODS:All patients undergoing pos...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181cb6351
更新日期:2010-06-01 00:00:00
abstract::The authors have previously described a model of in vivo tissue generation based on an implanted, microsurgically created vessel loop in a plastic chamber (volume, 0.45 ml) containing a poly(DL-lactic-co-glycolic acid) (PLGA) scaffold. Tissue grew spontaneously in association with an intense angiogenic sprouting from ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000046034.02158.EB
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Health care reforms aimed at bundling payments attempt to contain costs. Uncovering variation in spending provides one strategy for decreasing expenditure. This study aims to investigate interhospital cost variation for thumb replantation. METHODS:A retrospective cross-sectional analysis of patients undergo...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006022
更新日期:2019-10-01 00:00:00
abstract::A noncontact three-dimensional measuring system (liquid crystal range finder system) is described. Three-dimensional facial surface data (more than 30,000 points) could be obtained in 1 second, and the resolution was approximately 0.4 mm. The reliability and repeatability of the results were validated with a calibrati...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199811000-00046
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:Bariatric surgery, particularly the Roux-en-Y gastric bypass, is currently the most effective method of sustainable weight loss for the morbidly obese patient population. Unfortunately, the nutritional adequacy of the postoperative diet has frequently been overlooked, and in the months to years that follow, ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e31817d6023
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate the incidence of symptomatic and asymptomatic deep venous thrombosis in patients undergoing harvest of a free flap from the lower extremity who were receiving standard chemoprophylaxis while hospitalized. METHODS:A retrospective review of 65 consecutive patients ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002399
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Optimal central body contouring may be achieved with a combination of circumferential liposuction and excisional techniques for patients with diffuse lipodystrophy or generalized skin laxity or after massive weight loss. The central body lift has evolved to improve the contour of the trunk and proximal lower...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000234652.49061.28
更新日期:2006-08-01 00:00:00
abstract::Closure of plantar defects with local rotation flaps was studied in 10 patients with 11 plantar defects. Ages ranged from 15 to 66 years, and the average defect was 3.0 X 3.6 cm. Two patients were diabetics. Etiology was variable and included trauma, tumors, and breakdown in patients with anesthetic plantar surfaces. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198611000-00012
更新日期:1986-11-01 00:00:00
abstract::Split-thickness nail bed grafting is the accepted method of treatment for injuries involving loss of nail bed tissue. The nail bed of the great toe may be used without donor-site morbidity, and nail bed grafting may be combined with other procedures for fingertip reconstruction. A case of fingertip avulsion injury wit...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198803000-00023
更新日期:1988-03-01 00:00:00