Abstract:
BACKGROUND:Tissue-expander (TE) placement followed by implant exchange is currently the most popular method of breast reconstruction. There is a relative paucity of data demonstrating patient factors that predict complications specifically by stage of surgery. The present study attempts to determine what complications are most likely to occur at each stage and how the risk factors for complications vary by stage of reconstruction. METHODS:A retrospective chart review was performed on all 1275 patients who had TEs placed by the 2 senior authors between 2004 and 2013. Complication rates were determined at each stage of reconstruction, and these rates were further compared between patients who had pre-stage I radiation, post-stage I radiation, and no radiation exposure. Multivariate logistic regression was used to identify independent predictors of complications at each stage of reconstruction. RESULTS:A total of 1639 consecutive TEs were placed by the senior authors during the study period. The overall rate for experiencing a complication at any stage of surgery was 17%. Complications occurred at uniformly higher rates during stage I for all complications (92% stage I vs 7% stage II vs 1% stage III, P < 0.001). Predictors of stage I complications included increased body mass index [odds ratio (OR), 1.04; 95% confidence interval (CI), 1.01-1.07], current smoking status (OR, 3.0; 95% CI, 1.7-4.8), and higher intraoperative percent fill (OR, 3.3; 95% CI, 1.7-6.3). Post-stage I radiation was the only independent risk factor for a stage II complication (OR, 4.5; 95% CI, 1.4-15.2). CONCLUSIONS:Complications occur at higher rates after stage I than after stage II, and as expected, stage III complications are exceedingly rare. Risk factors for stage I complications are different from risk factors for stage II complications. Body mass index and smoking are associated with complications at stage I, but do not predict complications at stage II surgery. The stratification of risk factors by stage of surgery will help surgeons and patients better manage both risk and expectations.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Lovecchio F,Jordan SW,Lim S,Fine NA,Kim JYdoi
10.1097/SAP.0000000000000109subject
Has Abstractpub_date
2015-09-01 00:00:00pages
275-80issue
3eissn
0148-7043issn
1536-3708journal_volume
75pub_type
杂志文章abstract::Idiopathic avascular necrosis of the scaphoid, or Preiser disease, is a rare condition. Both the etiology and the pathology are still not well understood. We here present 2 cases with this disease and discuss the recommended treatment according to the stage of disease progression and by reference to previous studies i...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0b013e31827fafa1
更新日期:2014-11-01 00:00:00
abstract::Vascularized muscle flaps for treatment of mediastinitis and sternal wound dehiscence have become standard treatment practice, but triple-muscle flap reconstruction is reserved for the more complex wounds. The incisional approach for reoperation in such patients is controversial. We report an extremely ill infant, bor...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199805000-00015
更新日期:1998-05-01 00:00:00
abstract::Historically, biologic materials found in nature have been used for a wide variety of medicinal purposes, although their widespread use may be limited due to challenges in obtaining and properly preparing the material for safe clinical use. Amniotic membrane has long been recognized to possess unique properties favora...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0000000000000983
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Quality of life and functional improvement have emerged as important goals for patients with oncologic disease. For patients with head and neck cancer, free anterolateral thigh (ALT) flaps serve as reliable reconstruction and provide functional restoration. Nevertheless, factors affecting the resumption of o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002652
更新日期:2021-02-01 00:00:00
abstract::Adipose-derived stem cells (ADSCs) are a promising new therapeutic modality for several diseases and have been applied to various clinical fields because of their multidifferentiation potential and capacity for growth-factor secretion. Recently, 2 in vivo studies showed ADSCs to have potential applications in lymphede...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000084
更新日期:2015-06-01 00:00:00
abstract::A subjective description of a technique of immediate reconstruction of cutaneous defects due to laceration is presented. Extension of the use and range of the Z-plasty is emphasized and its benefits and limitations are discussed. The reconstructive surgeon is challenged to consider wider and more frequent use of these...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197809000-00003
更新日期:1978-09-01 00:00:00
abstract:BACKGROUND:Management of posttraumatic large soft tissue defects and bone loss remains a therapeutic and surgical challenge for orthopedic surgeons. We assessed the use of a neurocutaneous flap and the Ilizarov technique in the reconstruction of severe composite defects in the tibia. METHODS:We retrospectively reviewe...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000921
更新日期:2017-05-01 00:00:00
abstract:INTRODUCTION:Abdominal wall integrity may be compromised after abdominal flap harvest for breast reconstruction, leading to bulging or herniation due to weakening of the abdominal wall and dissection through the rectus muscle. Mesh can be used to reinforce the abdominal wall to reduce the risk of hernia formation posto...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001468
更新日期:2018-05-01 00:00:00
abstract::The almost single disadvantage of polyurethane film dressings, an uncontrolled leakage, is probably as often described as its numerous advantages for split-thickness skin graft donor sites. We solved this problem by perforating the polyurethane film, which permits a controlled leakage into a secondary absorbent dressi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31818790b4
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:Forward-looking infrared (FLIR) thermography technology uses a handheld camera that measures skin infrared emissivity, captures photographs, and can be analyzed through specialized software. Forward-looking infrared images can be used to analyze and correlate burn wound temperature with burn depth, burn progr...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001363
更新日期:2018-04-01 00:00:00
abstract::We report 2 cases of patients with thumb polydactyly that were difficult to classify into either Wassel type VI with a remarkable hypoplastic metacarpal or Wassel type VII (triphalangeal thumb). The radial digit was functional but hypoplastic, and the ulnar digit presented a dominant appearance but no active motion. T...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31821b6ced
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:For thin women with little subcutaneous fat and micromastia, they could not obtain ideal results by choosing autologous fat breast augmentation or prosthesis-only breast augmentation. To address these problems, we combined autologous fat and prosthesis for breast augmentation, and the clinical results were sa...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002093
更新日期:2019-10-01 00:00:00
abstract::The authors describe a helical crus reconstruction technique using a postauricular chondrocutaneous flap vascularized by the postauricular vessels. They used this procedure on 7 patients who had developed a large defect on the helical crus following surgery. In each patient the flap design was adjusted to fit the form...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199901000-00011
更新日期:1999-01-01 00:00:00
abstract::Pre- and postauricular skin was harvested from 25 facelift patients to study fibroblast replicative ability (RA). In tissue cultures, considerable heterogeneity was found in the ability of facial skin fibroblasts to replicate, both from patient to patient, and in the relationship of preauricular and postauricular skin...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199802000-00005
更新日期:1998-02-01 00:00:00
abstract::Traumatic hemipelvectomy is an uncommon and devastating injury with few patients alive when they reach the hospital. There are only 19 reported survivors of this injury. This group includes 17 males and 2 females. All had severe, associated injuries. The mechanism of injury involved motorcycle, automobile, pedestrian/...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-199108000-00011
更新日期:1991-08-01 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::Children with metopic synostosis have a well-described clinical picture of trigonocephaly, often with hypotelorbitism. The craniofacial disorder itself is well recognized; however, objective prognostic factors for predicting the risk of reoperation are not well known. In 39 children with metopic synostosis, measuremen...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000058498.64113.11
更新日期:2003-08-01 00:00:00
abstract::The purpose of this investigation was (1) to determine the incidence of basal cell carcinoma (BCC) recurrence in patients who had microscopic evidence of residual tumor at the margin of resection and (2) to identify morphological characteristics that predispose to recurrence. Twenty-nine patients with margin-positive ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199703000-00008
更新日期:1997-03-01 00:00:00
abstract::Keloid disease is known to have variable clinical behavior in response to therapy and there is no clinicopathologic classification that predicts such varied behavior. The aim of this study was to study the effect of excision margins and other histopathologic characteristics on keloid prognosis.Seventy-five multiethnic...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31819b6c3a
更新日期:2010-01-01 00:00:00
abstract::Roentgenograms of 26 bone grafts from 21 patients ranging in age from 8 to 64 were reviewed to study the osseous regeneration of the donor area. They were followed from six to seventy-two months--most about twenty-four months. Complete regeneration occurred only in patients under 30 and did not occur in those over 30 ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198305000-00007
更新日期:1983-05-01 00:00:00
abstract::Twenty-five feet (18 patients) plus 2 traumatically amputated feet were used for angiographic analysis of the first metatarsal arteries. The author classified the first (dorsal and plantar) metatarsal arteries into three types: the first dorsal metatarsal artery, dominant type (seen in 17 feet), the first plantar meta...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198107000-00002
更新日期:1981-07-01 00:00:00
abstract:INTRODUCTION:The aim of any reconstruction is to provide a robust and cosmetically pleasing result that does not significantly alter function. We describe our experience of using the V-Y principle in advancement flaps designed around a distinct perforator to reconstruct soft tissue defects of the upper limb. The shortc...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002138
更新日期:2020-05-01 00:00:00
abstract:PURPOSE:The reconstruction of complicated defects with 3-dimensional deficits remains challenging. The reconstruction of these defects requires not only coverage of surface but also appropriate obliteration of dead space, and muscle-chimeric perforator flaps can be a valuable option. Here, we present our experience wit...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3182a6363c
更新日期:2015-05-01 00:00:00
abstract::Ischemia/reperfusion injury (IRI) after free tissue transfer of the small intestine results in transmural tissue damage. This study examined the effects of IRI on the jejunum. Wistar rats served either as controls (N=10) or underwent clamping of the infrarenal aorta for 1 hour followed by 1 hour of reperfusion (N=10)....
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199806000-00008
更新日期:1998-06-01 00:00:00
abstract::Primary intraosseous venous malformations affecting the zygoma are rare vascular lesions, with only 35 cases reported in the surgical literature. Despite the establishment of the binary classification system, which serves to distinguish vascular tumors from malformations, inappropriate use of the term "hemangioma" to ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3182605690
更新日期:2014-03-01 00:00:00
abstract::A patient with malignant fibrous histiocytoma of the dorsum of the hand, managed with irradiation and wide local excision, is presented. Biopsy technique, the rationale for preoperative irradiation, and the details of extensor tendon reconstruction are discussed. Tendon grafts, rather than transfers, were used to reco...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199811000-00016
更新日期:1998-11-01 00:00:00
abstract::The use of lidocaine as a local anesthetic has been limited to 7 mg/kg. The authors question whether amounts of lidocaine greater than the recommended dosage may be safely used in the patient undergoing lipoplasty of the torso and knees. Six patients were used as a sample and a wetting solution of 750 mg or 1,000 mg o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198904000-00004
更新日期:1989-04-01 00:00:00
abstract::A simple, practical alternative to the traditional method of excising small cutaneous lesions is described. It has the advantages of decreased length of final closure and flexibility in determining the orientation of final incisions in areas where it may be difficult to accurately determine skin tension lines. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract:OBJECTIVE:To study the techniques of cranial flap fixation (suture, stainless steel wire, and rivetlike titanium clamp) on biomechanics. METHODS:Twenty-four cadaver craniotomy flaps were reattached with either suture, stainless steel wire, or rivetlike titanium clamp. Cranial flap fixation was timed and measured for t...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000239352.89088.26
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:It is generally believed that increasing obesity is a predictor of postoperative complications after abdominal contouring procedures such as abdominoplasty and panniculectomy. The purpose of this study is to review the complication rate for abdominal contouring in the level 3 obesity category (body mass inde...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3182012580
更新日期:2011-05-01 00:00:00