Abstract:
BACKGROUND:Clinical infection remains a significant problem in implant-based breast reconstruction and is a physical and emotional strain to the breast reconstruction patient. Bacterial strikethrough of draping and gown material is a likely source of infection. Strategies to reduce infection in implant-based breast reconstruction are essential to improve patient outcomes. OBJECTIVE:The aim of this study is to determine if a disposable draping system is superior to reusable draping materials in the prevention of implant-based breast reconstruction infection. METHODS:This single-institution, prospective, randomized, single-blinded, IRB-approved study enrolled women with breast cancer who were eligible for implant-based breast reconstruction. The primary endpoint was clinical infection by postoperative day 30. Secondary endpoints included all other complications encountered throughout the follow-up period and culture data. Demographic data recorded included patient age, body mass index, diabetes, smoking, chemotherapy, radiation, and follow-up. Procedural data recorded included procedure type, procedure length, estimated blood loss, use of acellular dermal matrix, use of muscle flap, and inpatient versus outpatient setting. RESULTS:From March 2010 through January 2012, 107 women were randomized and 102 completed the study. Five patients were determined not to be candidates for reconstruction after randomization. There were 43 patients in the Reusable Group and 59 patients in the Disposable Group. There were no significant differences in patient demographic data, procedural data, or the type of procedure performed between groups. In the Reusable Group, there were 5 infections (12%) within 30 days compared to 0 (0%) infections in the Disposable Group (P = 0.012). There was no significant difference in secondary complications. There was a trend for positive wound cultures (11% vs. 3%, P = 0.10) and positive drape cultures (17% vs.4%, P = 0.08) in patients with clinical infection. There were no differences in the number of colony-forming units or positive cultures between groups. CONCLUSIONS:Disposable draping material is superior to a reusable draping system in the prevention of clinical infection within the immediate postoperative period. This study did not demonstrate a clear link between intraoperative culture data and the development of clinical infection. A completely disposable gown and draping system is recommended during implant-based breast reconstruction.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Showalter BM,Crantford JC,Russell GB,Marks MW,DeFranzo AJ,Thompson JT,Pestana IA,David LRdoi
10.1097/SAP.0000000000000086subject
Has Abstractpub_date
2014-01-01 00:00:00pages
S165-9issue
6eissn
0148-7043issn
1536-3708journal_volume
72pub_type
杂志文章,随机对照试验abstract:BACKGROUND:This study of stage III (locally advanced) breast cancer patients evaluated the survival improvement conferred by immediate breast reconstruction by transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction after modified radical mastectomy (MRM) in comparison with MRM alone. METHODS:This retr...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000251
更新日期:2014-09-01 00:00:00
abstract:PURPOSE:Today, medical education emphasizes clinical applications of anatomic knowledge. In 2014, we instituted Clinically Applied Anatomy (CAA) within first-year Human Gross Anatomy at our university. The course was designed and overseen by academic plastic surgery. We hypothesized CAA would positively impact students...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002216
更新日期:2020-05-01 00:00:00
abstract::In previous studies, we were able to demonstrate baseline non-augmented cadaveric silicon tissue values as well as silicone-augmented breast capsular tissue silicon levels from various geographic locations in the United States. One of the limitations of these previous studies was the potential for intracapsular variat...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199612000-00004
更新日期:1996-12-01 00:00:00
abstract::Lymphaticovenular anastomosis has become one of the treatment options for lymphedema. Among several types of anastomosis, side-to-end anastomosis in which a window is made on the wall of a lymphatic vessel is considered to be the most effective, because it creates bidirectional bypasses through 1 anastomosis. However,...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318276d99a
更新日期:2014-08-01 00:00:00
abstract::Seventeen whole-breast tissue specimens of mammary cystic disease were prepared using Marcum's whole-mounting technique. Histological studies were performed on from 10 to 19 slides of tissue containing the suspected pathological foci. Cysts in the cleared breast tissues were numerous, and cyst walls were covered by si...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197911000-00005
更新日期:1979-11-01 00:00:00
abstract::Activator protein 1 (AP-1) is thought to play an important role in the expression of genes expressed in response to ischemia-reperfusion injury. In this report, the activation of AP-1 in rat skeletal muscle during reperfusion after a 4-hour ischemic period was studied. AP-1 activation displayed a biphasic pattern, sho...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200212000-00016
更新日期:2002-12-01 00:00:00
abstract::Surgical correction of chronic mallet finger caused by terminal tendon disruption was carried out in 22 patients. The distal stump of the tendon was fixed to the base of the distal phalanx with a Mitek micro arc bone anchor. In all patients the mallet finger deformity was corrected. There were 15 patients with excelle...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000151464.03967.a2
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Human acellular dermal matrices (HADMs) are used in a variety of settings. AlloMax is a new HADM currently being used for breast reconstruction and hernia repair. We compared the in vivo tissue integration of AlloMax to AlloDerm, a well-studied HADM, in rats. METHODS:We implanted AlloDerm and AlloMax patche...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31827a2d00
更新日期:2014-09-01 00:00:00
abstract::Prostaglandin E1 (PGE1) is a kind of prostaglandin that produces vasodilation of the peripheral vessels and platelet disaggregation, similar to prostacyclin (PGI2). The effects of PGE1 administered intraarterially or intravenously on peripheral vascular disease have been reported by many authors. In this investigation...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198707000-00008
更新日期:1987-07-01 00:00:00
abstract::Forelimb buds of rat embryos at day 13 of gestation were cut and cultured in Dulbecco's modified Eagle medium. In the absence of serum, the epidermis did not cover the wound surface. In the presence of fetal calf serum or ultroser G, a serum substitute, epidermal wound closure appeared in a concentration-dependent man...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198912000-00002
更新日期:1989-12-01 00:00:00
abstract::A 40-year-old man presented with near-complete mid and lower facial destruction from a shotgun blast to the face. His midface was reconstructed with a serratus anterior muscle composite flap employing rib for nasal reconstruction and scapular tip for palate. Surfacing was done with split-thickness skin grafts. A tempo...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199703000-00018
更新日期:1997-03-01 00:00:00
abstract::The pericranial membrane is of great interest in corrective and reconstructive procedures of the craniofacial region. A close look at its ultrastructure reveals that the outer layer is made up of loose areolar tissue and fibroblasts, and the inner layer of osteoblasts. A network of vessels near the inner layer account...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1981-02-01 00:00:00
abstract::We examined regeneration of Meissner corpuscles in palm skin grafts. In only one of the specimens (split-thickness skin graft from the sole of the foot), numerous regenerated Meissner corpuscles were found in the dermal papilla. This suggests that the nerve pattern of the graft depends on reinnervation from the recipi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198906000-00001
更新日期:1989-06-01 00:00:00
abstract:BACKGROUND:Precise flap planning and perforator selection are paramount for successful perforator flap surgery. Portable color-flow ultrasound (PCFU) is a convenient, low-cost, easily accessible imaging modality that is pivotal in the planning of perforator flaps where anatomic variability is the rule. METHODS:Perfora...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002203
更新日期:2020-06-01 00:00:00
abstract::Intravascular coagulation is the final common pathway of failure in replanted digits and "free" tissue transfers. To address this clinical problem, a model based upon intimal damage and stasis in the rat femoral vein was developed. The ability of local, intraarterially administered Thrombolysin to achieve "local" clot...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198107000-00006
更新日期:1981-07-01 00:00:00
abstract::We have successfully applied a reverse flow island flap of extensor digitorum brevis muscle for coverage of tissue defects in the distal portion of the foot dorsum in 2 patients. This flap covered the metatarsophalangeal area well with cadaver limb dissection and seems useful to cover the defect in the distal foot dor...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199207000-00015
更新日期:1992-07-01 00:00:00
abstract::Acquired defects involving exposed bone in the central forehead can be challenging to reconstruct. We present a simple technique in which two superiorly based flaps of galea frontalis and skin are transposed medially, like the shutter of a camera. Full-thickness grafts are used to close the donor site. This is a remar...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199604000-00019
更新日期:1996-04-01 00:00:00
abstract::In the small percentage of deep wound infections complicating total hip arthroplasty and recalcitrant to conventional forms of treatment, muscle flaps with or without a cutaneous unit can offer a satisfactory solution. Seven patients (4 male, 3 female) with failed total hip arthroplasty and multimicrobial infection we...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198312000-00006
更新日期:1983-12-01 00:00:00
abstract:PURPOSE:Limb salvage in bone sarcomas requires resection and joint and soft-tissue reconstruction. Suboptimal coverage can lead to prosthesis infection, subsequent hardware exposure, or loss with eventual amputation. In the pediatric sarcoma population, it is essential to not only have viable soft-tissue coverage but o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3182223d5b
更新日期:2012-11-01 00:00:00
abstract::Current recipient vessels for microvascular breast reconstruction include the internal mammary and the thoracodorsal systems. This review will focus on the advantages of the internal mammary artery and vein and reasons for their preference. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0b013e31821daac3
更新日期:2012-05-01 00:00:00
abstract::Peripheral nerve repair remains one of the most difficult problems in hand surgery; the results of conventional epineurial and fascicular suture repair are a major limitation to the rehabilitation of the patient. The aim of this study was to evaluate a tubulization technique of nerve repair by wrapping a membrane of h...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198906000-00002
更新日期:1989-06-01 00:00:00
abstract::The authors review 175 basal cell carcinomas of the face, treated primarily by surgery. The overall cure rate was 97%. Among these cases, 53 were treated by excision and immediate local flap reconstruction. Analysis of results in the latter group encourages the use of this method for virgin, untreated tumors provided ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract::Le Fort defined the classic weak points of facial fractures. Fractures of the midface and mandible are believed to require management with standard rigid fixation. Recent work has allowed mini- and microplating of multiple fracture fragments into more manageable larger segments for reduction and subsequent plating wit...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-199505000-00001
更新日期:1995-05-01 00:00:00
abstract::The authors present their successful experience with an attractive alternative to the latissimus dorsi and gracilis muscle flaps for lower extremity reconstruction--the free rectus abdominis muscle flap. The muscle flap has a dual blood supply, but the longer pedicle length and larger vessel diameter of the inferior e...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198311000-00003
更新日期:1983-11-01 00:00:00
abstract::A Silastic tissue expander inserted subpectorally at the time of modified radical mastectomy has provided early development of the reconstructive envelope, thereby simplifying matching of the contralateral breast. Significant emotional support for the woman faced with imminent loss of her breast has been repeatedly ob...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198511000-00007
更新日期:1985-11-01 00:00:00
abstract::Cryopreservation has the potential to improve availability of donor parts for composite tissue allotransplantation and may reduce their antigenicity. This study investigates whether the component tissues of composite flaps remain viable after cryopreservation. Forty-one epigastric flaps were harvested from Lewis rats....
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000245114.96202.62
更新日期:2007-06-01 00:00:00
abstract::Seven male patients and 8 total ears underwent composite excision for neoplasm of the auricular helix. Defect size ranged from 2.5 to 4.5 cm exceeding the conventional limit of l.5 cm for wedge excision with primary closure. An incision at the root of the helix released the superior auricular muscle and a portion of t...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181a395fb
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:The epicanthal fold (Mongolian fold) in Asians reduces the aesthetic results of eyelid surgery, and thus, medial epicanthoplasty is commonly performed in combination with a double fold operation or blepharoptosis correction. Epicanthoplasty is one of the most popular cosmetic operations conducted in Asia, bu...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31826eabbc
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Hematomas after tissue expander immediate breast reconstruction (TE-IBR) pose a significant challenge during the recovery period. In this study, we aim to evaluate whether hematoma formation leads to subsequent complications and how management can impact final reconstructive goals. METHODS:A single-institut...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002343
更新日期:2020-07-01 00:00:00
abstract::Pleural space problems after lung resection and persistent air leaks are among the commonest challenges posed to thoracic surgeons. Surgical repair of air leaks are indicated when conventional tube thoracostomy has failed to solve the problem. We would like to propose the novel application of the combined latissimus d...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31818a6609
更新日期:2009-08-01 00:00:00