Abstract:
PURPOSE:Periarterial sympathectomy is a treatment option for patients with systemic sclerosis (SSc) suffering from digital vasculopathy. Despite potential benefits of ulcer healing, pain improvement, and amputation prevention, this operation appears to be infrequently performed. The aims of our study are as follows: (1) to assess national digital sympathectomy rates in patients with SSc and (2) to improve our understanding of referring physicians' perceptions of operative management and access to hand surgeons. Our hypothesis is that rheumatologists' practices largely influence their referral patterns for digital sympathectomy. METHODS:To determine the rates and demographics of hospitalized patients with SSc who had undergone digital sympathectomy, we queried the Nationwide Inpatient Sample from 2006 to 2010. Additionally, we mailed a self-administered survey to a national sample of 500 board-certified rheumatologists to elicit their practice patterns and perceptions of digital sympathectomy. Using logistic regression, we analyzed potential predictor variables associated with rheumatologists performing the following: (1) routinely counseling patients about digital sympathectomy and (2) expressing the desire to refer these patients for operative evaluation. RESULTS:Of 348,539 hospitalizations associated with a diagnosis of SSc, only 0.2% were for digital sympathectomy. Our questionnaire revealed that only 50% of rheumatologists routinely counseled, whereas 67% expressed the desire to refer. Factors associated with increased rheumatologists' interest in surgical management for patients with SSc included positive perception of the operation's efficacy, comfort with postoperative management, and interdisciplinary relationship with a hand surgeon. DISCUSSION:Critical components to increasing appropriate utilization of digital sympathectomy include enhancing rheumatologists' understanding of the operation, comfort with postoperative management, and promoting strong, interdisciplinary relationships with hand surgeons. Increasing education and awareness, as well as establishing a solid referral network of hand surgeons may thereby improve patient access to digital sympathectomy.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Chiou G,Crowe C,Suarez P,Chung L,Curtin C,Chang Jdoi
10.1097/SAP.0000000000000614subject
Has Abstractpub_date
2015-12-01 00:00:00pages
637-43issue
6eissn
0148-7043issn
1536-3708journal_volume
75pub_type
杂志文章abstract::A new surgical repair of enterocutaneous fistula associated with abdominal wound defects is presented. The authors turned over the fasciocutaneous flap from the surrounding skin and sutured the intestinal lumen directly to the cutaneous side of the flap. The method is a risk-free extraperitoneal approach that can be p...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200205000-00019
更新日期:2002-05-01 00:00:00
abstract::There is an ongoing demand for surgeons to demonstrate that they can operate well, maintain their performance, and deliver acceptable results. Currently, surgeons are assessed by a series of subjective and peer-reviewed interviews, but at no stage is the objective assessment of surgical competence measured. The author...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000037271.26659.f4
更新日期:2003-03-01 00:00:00
abstract::The pain felt during botulinum toxin type-A injections and the troubled and distressed treatment it induces is common and well known for the patient and the doctor applying the treatment. This problem is further intensified on the patients who have needle phobia. The effect of ice application on the treatment zone bef...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.sap.0000139563.51598.75
更新日期:2004-12-01 00:00:00
abstract::Reconstruction of complex tissue deficiencies in which each missing component is in a different spatial relationship to each other can be particularly challenging, especially in patients with limited recipient vessels. The chimera flap design is uniquely suited to reconstruct these deformities. Chimera flaps have been...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0b013e318193499f
更新日期:2009-10-01 00:00:00
abstract::Sensory assessment of the skin is essential to document the function of the sensory fibers of the tested nerves. The Semmes-Weinstein monofilaments, disk-criminator, electrodiagnostic testing, and Pressure-Specified Sensory Device (PSSD) have been currently used to assess sensory function of peripheral nerves. None of...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0000000000000855
更新日期:2016-08-01 00:00:00
abstract::Circumcision is a commonly performed minor surgical procedure; however, it may lead to serious complications if performed by poorly trained health care providers. In this case report, a subglanular stricture causing a mushroom-like deformity resulting from circumcision is presented. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000024754.83430.05
更新日期:2003-02-01 00:00:00
abstract::Pedicled flaps and microsurgical free tissue transfers are increasingly being used for reconstruction in the elderly and poorer risk patient. The use of systemically administered vasoactive agents to date has been avoided because of the fear that systemic levels of these agents perioperatively (particularly the vasopr...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199711000-00013
更新日期:1997-11-01 00:00:00
abstract::Glomus tumors develop from a thermoregulatory unit called the glomus body which is found in high density within the digits of both the hands and feet. To note, even though less frequently, these tumors can present in extradigital locations. Usually it presents as a small, 1-cm bluish nodule. Glomangioma (multiple glom...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000222729.59856.e1
更新日期:2006-10-01 00:00:00
abstract::The author presents a brief discussion of the causes, extent, and prevention of primarily automobile-related soft tissue maxillofacial injuries. This is followed by a practical approach to their management. Personal preferences relative to armamentarium and techniques that have withstood the test of time are given, to...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198611000-00007
更新日期:1986-11-01 00:00:00
abstract::Melanoma excision requires wide margins, leaving large defects. Surgical dogma has taught that definitive reconstruction of melanoma defects be performed after permanent pathology results, with skin grafts favored. However, this results in an open wound and the need for a second operation. The advantages of immediate ...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SAP.0000000000000166
更新日期:2014-05-01 00:00:00
abstract::A patient affected by a voluminous synovial sarcoma of mediastinum received radical surgery, resulting in injury of both phrenic nerves. Because of the cancer location, reconstruction of the left phrenic nerve was not possible, so to prevent the patient's ventilator dependence, the right phrenic nerve was reconstructe...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002543
更新日期:2020-11-01 00:00:00
abstract::The Parkland formula is currently the most widely used protocol to guide fluid resuscitation of acute burns and has been adapted for pediatric use. We describe 3 novel graphic devices (a nomogram, slide rule, and disc calculator) based on this formula, which have significant advantages over existing graphic and electr...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3182586d4e
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:We evaluated changes in lip height and length by position in cleft lip nasal deformity patients who underwent treatment with Millard technique. METHODS:A retrospective review of the medical records and an anthropometric analysis of photographs were performed in 209 cases of cleft lip nasal deformity. In the...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002487
更新日期:2020-07-27 00:00:00
abstract:BACKGROUND:Attempts to salvage upper and lower extremities have performed more frequently in recent decades, although there are clear cases that cannot be salvaged. The purpose of this retrospective study was to present our experience in using free calcaneus osteocutaneous fillet flap for preserving below-knee amputati...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001775
更新日期:2019-08-01 00:00:00
abstract::Since 1993, a total of 41 free osteofasciocutaneous fibular flaps with an extended skin island (average dimensions, 16.9 cm long [range, 12-22 cm] x 10.7 cm wide [range, -16 cm], or 180.8 cm [range, 112-352 cm ]) have been used in by the authors in various clinical applications. To evaluate donor site morbidity, the 4...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200208000-00005
更新日期:2002-08-01 00:00:00
abstract::Piezoelectric sensors have been shown to respond reproducibly to changes in tissue mechanical properties surrounding an implant over a 4-month period. The vibrational amplitude at a frequency corresponding to the radial resonance shows a statistically significant change over time. The initial period of inflammation is...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000189620.45708.5f
更新日期:2006-01-01 00:00:00
abstract::Using an enzyme-linked immunosorbent assay, we investigated the amount of cell surface fibronectin and the amount released to the culture medium in human skin fibroblasts during successive cultivation. Cell surface fibronectin did not show a remarkable change in quantity through early and midpassage, but it decreased ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198503000-00010
更新日期:1985-03-01 00:00:00
abstract:UNLABELLED:One of the main steps in perforator flap surgery is to identify the dominant perforator. Using multidetector row computed tomography (MDCT) for the preoperative planning of deep inferior epigastric artery perforator (DIEAP) flap surgery, we identified a perforator with a large caliber, an excellent location ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318285873e
更新日期:2014-12-01 00:00:00
abstract::Island flaps supplied by the intermuscular cutaneous perforator (IMCP) from a deep vessel, such as the peroneal flap pedicled by IMCP from the peroneal vessel or the anterior tibial flap supplied by IMCP from the anterior tibial vessel, are reported to be useful in reconstructive procedures for soft-tissue defects of ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199004000-00004
更新日期:1990-04-01 00:00:00
abstract::A 66-year-old woman with an abdominal wound caused by infected synthetic mesh had failed to heal in spite of many surgical attempts to close the wound. A sealed transparent vinyl chamber was glued to the periphery of the wound and antibiotics in high concentrations (up to 2,500 times the minimum inhibitory concentrati...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199601000-00016
更新日期:1996-01-01 00:00:00
abstract::Seventy-five patients with melanoma were surveyed for recent history of major stress, coping styles, and psychiatric disturbance. Recurrence of disease was strongly related to biological variables (stage and Breslow depths) but not to psychological measures. Major life stress was not related to stage, Breslow, Clark l...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199201000-00007
更新日期:1992-01-01 00:00:00
abstract::Free posterior tibial perforator-based flaps, fed by a perforator from the posterior tibial artery, were applied in 2 patients. The advantages of this flap are that they are reliable, relatively large and thin flaps, making it possible to use an innervated flap without sacrificing the posterior tibial artery. This fla...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199103000-00012
更新日期:1991-03-01 00:00:00
abstract::Twelve cases of squamous cell carcinoma arising in scars of the skin are analyzed. Correlation of tumor aggressiveness, tumor differentiation, intensity of small lymphocyte infiltration, and nature of adjacent collagen tissue to tumor stroma was investigated. All tumors were predominantly well differentiated. Nine pat...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198601000-00004
更新日期:1986-01-01 00:00:00
abstract::Benign hypertrophy of the masseter muscle is an uncommon entity important in the differential diagnosis of head and neck masses, particularly a unilateral mass located in the cheek. Ten cases of benign masseteric hypertrophy are reviewed, current surgical treatment is described, and the pertinent literature is summari...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198406000-00007
更新日期:1984-06-01 00:00:00
abstract::The totem pole rib bone graft for nasal reconstruction is presented as an effective way to prepare the donor bone for the correction of saddle-nose deformity. The article's title emanates from the fact that when the sculpturing of the rib is completed it has the appearance of a totem pole before the separate parts are...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198310000-00003
更新日期:1983-10-01 00:00:00
abstract::Local fascial flaps independently are a versatile option, reliable when properly designed, and technically simple to execute especially when compared to microsurgical tissue transfers. Although free flaps continue to be the method of choice to repair major distal extremity defects, for smaller wounds it could be prefe...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199704000-00014
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:Management of the nipple-areola complex is an important issue in primary breast reconstruction. When nipple-sparing mastectomy is not suitable, alternatives are immediate nipple-areola complex replantation and delayed reconstruction. The aim of this study was to examine whether patients benefit more from nip...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000883
更新日期:2017-04-01 00:00:00
abstract:INTRODUCTION:Autologous free flaps are the criterion standard for reconstructions of complex soft tissue defects; however, they are limited by donor-site morbidities. The arteriovenous (AV) loop model enables the generation of soft tissue constructs based on acellular dermal matrices with a functional microvasculature ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001096
更新日期:2017-07-01 00:00:00
abstract::Our study of experimental contracture in rats confirms the existence in laboratory animals of a phenomenon very much like human capsule contracture. The ultrastructural features of capsules in rats are essentially identical to those for humans and rabbits. Macrophages with silicon-containing material were present. Sta...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198103000-00003
更新日期:1981-03-01 00:00:00
abstract::Cytokines are peptide mediators of inflammation that are being extensively studied in several aspects of disease. I provide an introduction to the general features of cytokine biology. Cytokines may be considered as either proinflammatory or anti-inflammatory compounds, and they also have potent hematopoietic effects....
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-199511000-00021
更新日期:1995-11-01 00:00:00