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 opposite either a hyperplastic or moderate sized but ptotic breast. Also, the likely need for a prosthesis can result in encapsulation and firmness. Expanding the latissimus flap has been suggested as a means of improving its aesthetic and reconstructive results. Indications for choosing an expanded flap in 10 patients included: (1) a need for autogenous tissue reconstruction of irradiated breast and chest wall tissues; (2) cutaneous coverage requirements that exceeded the availability of donor site skin; (3) the presence of a hyperplastic or ptotic contralateral breast that the patient preferred to match rather than alter; and (4) unavailability of an alternative flap such as a TRAM and unsuitability of an implant or expander without a flap. Results of this study in 10 patients requiring breast and chest wall reconstruction demonstrate that flap dimensions increased by approximately a factor of 1.5 after expansion. The latissimus flap was pre-expanded on the back before transfer in two patients when skin and soft tissues were inadequate, or was expanded post-transfer in eight patients for both immediate and delayed breast reconstruction. Eight patients underwent a total of two operations, including two who had nipple areolar reconstruction. Earlier in the series, two other patients had nipple areolar reconstruction performed as a third procedure. Mean follow-up was 15.1 months. Complications consisted of partial dehiscence of the donor site wound in one patient after transfer of an expanded flap measuring 16 x 28 cm; three patients developed symptomatic seromas requiring drainage. All patients had soft, nonpalpable implants and no distortion of the flap's shape. The application of tissue expansion techniques yields latissimus flaps that are notable for their capacious dimensions, thinned tissues, and improved pliability. Advantages include an avoidance of reduction or mastopexy procedures in patients with large, ptotic breasts and uncomplicated wound healing in those with a history of prior irradiation. Not all latissimus flaps need to be expanded, but some can be significantly improved when specific indications are present. Most importantly, expanded latissimus flaps appear to resist the early formation of periprosthetic encapsulation.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Slavin SAdoi
10.1097/00006534-199404000-00024subject
Has Abstractpub_date
1994-04-01 00:00:00pages
811-24issue
4eissn
0032-1052issn
1529-4242journal_volume
93pub_type
杂志文章abstract:BACKGROUND:After excess skin and fat are removed, a body-lift suture advances skin and suspends ptotic breasts, the mons pubis, and buttocks. For women, the lift includes sculpturing adiposity. While some excess fat may need removal, muscular men should receive a deliberate effort to achieve generalized tight skin clos...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000933
更新日期:2015-02-01 00:00:00
abstract::The use of mesh materials for reinforcement of the abdominal wall has revolutionized the approaches to hernia repair. Whether it's a permanent, synthetic mesh, a biologically derived collagen graft, or a synthetic, bioresorbable construct, data demonstrate improved outcomes with respect to recurrence with their use. N...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000004857
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:The orbital blowout fracture is a common facial injury, but full consensus has not been reached regarding its optimal management. The authors retrospectively explored consecutive cases of blowout fractures and proposed new recommendations for treatment. METHODS:Two hundred eight newly registered patients we...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181addbbd
更新日期:2009-08-01 00:00:00
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:This study evaluated patients who underwent primary breast surgery within a single group practice from 1994 to 2009. Reoperations were divided by reoperation reason into total reoperations and implant-specific reoperations. The authors hypothesized that the implant-specific reoperation rate will provide the ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318205f41b
更新日期:2011-03-01 00:00:00
abstract::Clinical application of composite tissue allograft transplants opened discussion on the restoration of facial deformities by allotransplantation. The authors introduce a hemifacial allograft transplant model to investigate the rationale for the development of functional tolerance across the major histocompatibility co...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000142414.92308.ab
更新日期:2004-12-01 00:00:00
abstract::Since the advent of three-dimensional (3D) printing in the 1980s, it is now possible to produce physical objects from digital files and create 3D objects by adding one layer at a time following a predetermined pattern. Due to the continued development of inexpensive and easy- to- use 3D printers and bioprinting, this ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000150
更新日期:2016-01-21 00:00:00
abstract::Three groups of dogs were studied to compare the bone formation obtained with traditional bone grafting techniques, and that obtained with revascularized periosteum or revascularized bone grafts--all in unstressed bone. Revascularized periosteum did not produce a significant amount of bone in this unstressed model. At...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197909000-00013
更新日期:1979-09-01 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:BACKGROUND:Although in modern medicine, patients' preferences are important, these have never been defined for characteristics of Dupuytren treatment. This study determines these patients' preferences using a discrete choice experiment. METHODS:A multicenter discrete choice experiment study was conducted among patient...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/PRS.0000000000001878
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:The compromised airway in Robin sequence demands prompt operative intervention. Tongue-lip adhesion is one alternative; however, the outcome of this technique is variable. The purpose of this study was to identify variables that preoperatively predict the success of adhesion in Robin sequence patients with l...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318217420d
更新日期:2011-07-01 00:00:00
abstract::A major difficulty in understanding rare craniofacial clefts arises from the fact that previous reports have focused on a single case or have grouped together different types of rare clefts. Less than 50 Tessier no. 4 clefts have been reported. This paper examines our experience with eight patients treated primarily o...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199006000-00001
更新日期:1990-06-01 00:00:00
abstract::Microvascular transfer of the omentum has several unique advantages for the reconstruction and revascularization of extremity wounds. The omentum provides well-vascularized, malleable tissue for reconstruction of extensive soft-tissue defects and has a long vascular pedicle (35 to 40 cm) with sizable vessels, which re...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000056874.31920.7D
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Oronasal fistulas are a frequent complication after cleft palate surgery. Numerous repair methods have been described, but wound-healing problems occur often. The authors investigated, for the first time, the suitability of multilayered amniotic membrane allograft for fistula repair in a laboratory experimen...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182910b50
更新日期:2013-07-01 00:00:00
abstract::The purpose of this survey was to evaluate the current trends in the care of facial trauma. Data were obtained through the responses of a survey mailed to all those members and candidates listed in the 1989 American Society of Plastic and Reconstructive Surgeons Directory. A total of 2777 questionnaires were sent, wit...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199210000-00003
更新日期:1992-10-01 00:00:00
abstract::As the inclusion criteria for breast conservation therapy have continued to evolve to include lower quadrant tumors, very large breasts, and central tumors, the potential for significant disfigurement after breast conservation therapy has also increased. This has led some centers to develop coordinated oncology-plasti...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000046491.87997.40
更新日期:2003-03-01 00:00:00
abstract::Lymphangioma circumscriptum of the penis and scrotum is an unusual entity that may be indistinguishable from genital warts. After confirmation of the diagnosis, a treatment plan consisting of wide excision should be outlined. To lower the chance of recurrence, not only the affected skin but all the subjacent subcutane...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199901000-00028
更新日期:1999-01-01 00:00:00
abstract::This study was designed to clarify the vascularization of the inner anterior abdominal wall with respect to the novel transversus and rectus abdominis musculoperitoneal (TRAMP) flap, which was introduced recently for vaginal reconstruction. A series of human cadavers was injected with a lead oxide-gelatine mixture by ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199703000-00016
更新日期:1997-03-01 00:00:00
abstract::Microsurgeons suspect that cigarette smoking reduces the survival of free vascularized flaps and replantations, but this has never been proven. This experimental study investigates the effect of smoking on free-flap survival. A fasciocutaneous epigastric flap was used in 30 rats as a free flap and in 30 rats as a pedi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199601000-00015
更新日期:1996-01-01 00:00:00
abstract::Obesity and specimen weight have both been associated with a higher incidence of complications for patients undergoing reduction mammaplasty. However, obesity has been arbitrarily and inconsistently defined, and the degree of obesity has not been considered in these previous studies. Because insurance companies are in...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200010000-00006
更新日期:2000-10-01 00:00:00
abstract::One-hundred forty-eight operative procedures for flexion contractures of the finger(s) following burn injury in children have been studied in detail with follow-up from 6 months to 8 years. Intramedullary K-wires, used for 53 procedures where a graft was done, were associated with a significantly worse long-term resul...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198108000-00016
更新日期:1981-08-01 00:00:00
abstract:BACKGROUND:Nipple-preserving mastectomy and immediate reconstruction has further improved the aesthetic outcome of skin-sparing mastectomy. To investigate the effect of the type of reconstruction technique on aesthetic outcome, three different methods of reconstruction were compared using four evaluation modalities. M...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000251999.52374.09
更新日期:2007-03-01 00:00:00
abstract::A highly unusual method of reconstruction was used to advantage following a massive pectoral chest-wall tumor resection that entailed unavoidable section of the subclavian and axillary vessels and the cords of the brachial plexus, irretrievably encased by tumor in the axilla. Since leaving the defunctionalized upper l...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract::The reverse flow island sural flap is presented as an alternative to flaps currently used for reconstruction of small and medium substance losses in the distal third of the leg, ankle, and heel. This is a random type of flap, based on the reverse flow of the superficial sural artery, which mainly depends on the anatom...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200202000-00027
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:Practitioners in other surgical specialties have increasingly advanced their volume of reconstructive procedures traditionally served by plastic surgeons. Because there has not been a previous specialty training comparison, the average operative reconstructive volume of graduating plastic surgery residents w...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,收录出版
doi:10.1097/PRS.0b013e3182402f17
更新日期:2012-03-01 00:00:00
abstract::To date, a paucity of information is available on the optimal management of obstructive sleep apnea in Down syndrome, which may have particularly important implications in this already vulnerable patient population. The objective of this study was to evaluate prospectively the results of a new surgical approach for th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199703000-00004
更新日期:1997-03-01 00:00:00
abstract::Free submandibular salivary gland transfer was investigated as a surgical method for the treatment of severe keratoconjunctivitis sicca. In an animal model, we examined the tolerance of warm ischemia of the submandibular gland. After temporary interruption of the blood supply (1 to 6 hours), the morphologic changes in...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract:LEARNING OBJECTIVES:After reading this article, the participant should be able to: 1. Clinically describe various cutaneous neoplasms. 2. Identify the corresponding histopathologic findings. 3. Discuss the optimal treatment approach for each entity. SUMMARY:Cutaneous neoplasms are broadly viewed as benign, premalignan...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e3181d6e89a
更新日期:2010-05-01 00:00:00
abstract::Breast reconstructions performed with latissimus dorsi and transverse rectus abdominis myocutaneous (TRAM) flaps in 82 patients with a history of previous chest-wall irradiation were compared with similar reconstructions in 202 nonirradiated patients to determine whether prior irradiation was associated with more freq...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::A case is presented in which a filleted flap from the unreplantable forearm was used successfully to cover the upper arm amputation stump after 55 hours of cold ischemia. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198607000-00014
更新日期:1986-07-01 00:00:00