Indications and Limitations of Bilayer Wound Matrix-Based Lower Extremity Reconstruction: A Multidisciplinary Case-Control Study of 191 Wounds.

Abstract:

BACKGROUND:Little is known about the efficacy of newer skin substitute scaffolds to reconstruct complex lower extremity wounds. The investigators present a multihospital experience of reconstructive surgeons utilizing collagen-GAG bilayer wound matrix in lower extremity soft-tissue reconstruction with the goals to (1) characterize a suitable patient population, (2) categorize failures to optimize patient selection, and (3) determine wound factors affecting success. METHODS:Subjects underwent collagen-GAG-based lower extremity wound reconstruction from May of 2010 to June of 2017. The primary outcome variable was 180-day graft success, defined as eventual split-thickness skin grafting after bilayer wound matrix application; failure was defined as inadequate wound bed for split-thickness skin grafting, requirement for vascularized tissue transfer, or eventual amputation. Eligible subjects had at least one lower extremity wound and were at least 18 years old. Exclusion criteria included third-degree burn wounds or failure to follow up for at least 60 days postoperatively. Predictor variables included demographics, medical comorbidities, perioperative characteristics, postoperative complications, and cost-related data for each hospitalization. RESULTS:There were 147 subjects with 191 wounds. Mean patient age was 60.1 years (range, 21.0 to 95.6 years), and mean body mass index was 30.5 kg/m (range, 14.4 to 64.7 kg/m). Average wound size was 73.1 ± 137.7 cm, with 49.0 percent of subjects receiving adjunct postoperative negative-pressure wound therapy. Seventy percent of wounds were successfully healed at 180 days. Most were localized between the knee and ankle (50.8 percent) or foot (46.1 percent). Tendon exposure (p < 0.05), bone exposure (p < 0.01), and bone excision (p < 0.04) were associated with reconstructive failure. CONCLUSIONS:The authors present the largest reported multihospital, multidisciplinary experience with collagen-GAG wound matrix for lower extremity reconstruction. Tendon and/or bone exposure and socioeconomic factors were associated with failure. CLINICAL QUESTION/LEVEL OF EVIDENCE:Risk, III.

journal_name

Plast Reconstr Surg

authors

Shakir S,Messa CA 4th,Broach RB,Rhemtulla IA,Chatman B,D'Angelantonio A,Levin LS,Kovach SJ 3rd,Serletti JM,Fischer JP

doi

10.1097/PRS.0000000000006609

subject

Has Abstract

pub_date

2020-03-01 00:00:00

pages

813-822

issue

3

eissn

0032-1052

issn

1529-4242

pii

00006534-202003000-00042

journal_volume

145

pub_type

杂志文章
  • Results with Furlow palatoplasty in management of velopharyngeal insufficiency.

    abstract::A retrospective study was undertaken to assess speech outcomes in patients undergoing Furlow palatoplasty. Since 1994, the authors have used the position of the levator veli palatini musculature to determine type of surgical intervention recommended for the management of velopharyngeal insufficiency. Furlow palatoplas...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200107000-00004

    authors: Sie KC,Tampakopoulou DA,Sorom J,Gruss JS,Eblen LE

    更新日期:2001-07-01 00:00:00

  • "Brazilian Butt Lift" under Local Anesthesia: A Novel Technique Addressing Safety Concerns.

    abstract:BACKGROUND:The gluteal lift ("Brazilian butt lift") has improved significantly in technique and in outcomes. Some postulate that fat embolism occurs because of damage to veins superficial to the gluteus muscles and that fat must be injected intramuscularly to achieve satisfactory aesthetic results. The purpose of this ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000005067

    authors: Chia CT,Theodorou SJ,Dayan E,Tabbal G,Del Vecchio D

    更新日期:2018-12-01 00:00:00

  • A new classification for the standardization of nomenclature in free flap wound closure.

    abstract::A profusion of terms are currently used to describe free flap wound closure. It is important to broadly standardize nomenclature when embarking on a comparison of functional outcomes between institutions. Therefore, a series of 68 "emergency" (within 24 hours) free flaps performed by a single surgeon were reviewed wit...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199903000-00020

    authors: Ninkovic M,Mooney EK,Ninkovic M,Kleistil T,Anderl H

    更新日期:1999-03-01 00:00:00

  • Early results of vermilion lip augmentation using acellular allogeneic dermis: an adjunct in facial rejuvenation.

    abstract::The definitive approach to lip augmentation has yet to be defined. Herein is described a technique using acellular allogeneic dermal grafts that is easy, effective, and reproducible. Our results over the past 2 years include 47 patients (94 grafts). Three grafts to the upper lip have exhibited significant resorption, ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200001000-00065

    authors: Rohrich RJ,Reagan BJ,Adams WP Jr,Kenkel JM,Beran SJ

    更新日期:2000-01-01 00:00:00

  • Objective Clinical Assessment of Posture Patterns after Implant Breast Augmentation.

    abstract:BACKGROUND:An increased weight of the breasts causes several spinal postural alterations that reduce the ability to perform dynamic tasks requiring a stable balance. The effects of the increased weight of the breasts on static posture after implant breast augmentation have not been investigated yet. METHODS:Forty volu...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000001454

    authors: Nicoletti G,Mandrini S,Finotti V,Dall'Angelo A,Malovini A,Chierico S,Faga A,Dalla Toffola E

    更新日期:2015-08-01 00:00:00

  • Decreased thrombogenicity of vascular prostheses following gas denucleation by hydrostatic pressure.

    abstract::The high rate of thrombosis of 1.0-mm polytetrafluoroethylene (PTFE) grafts has limited their use in microvascular surgery. One possible reason for this is the blood-gas interface due to entrapped air in the interstices. The present study examines the effect on patency rates of elimination of this blood-gas interface ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198812000-00016

    authors: Demas CP,Vann R,Ritter E,Sepka RS,Klitzman B,Barwick WJ

    更新日期:1988-12-01 00:00:00

  • The lateral arm flap for elbow coverage.

    abstract::A technique for coverage of periolecranon (elbow) defects is presented. The technique uses the local tissues of the lateral upper arm as an axial flap and minimizes the donor defect for this type of reconstruction by obviating the need for a skin graft. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Lazarou SA,Kaplan IB

    更新日期:1993-06-01 00:00:00

  • Recurrence of subglandular breast implant capsular contracture: anterior versus total capsulectomy.

    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

    authors: Collis N,Sharpe DT

    更新日期:2000-09-01 00:00:00

  • The constricted (cup and lop) ear.

    abstract::The author classifies ear deformities into 3 major groups and two sub-groups. The surgical procedures used to correct the deformity in each group are described. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Tanzer RC

    更新日期:1975-04-01 00:00:00

  • The GILLS score: part I. Patient selection for tongue-lip adhesion in Robin sequence.

    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

    authors: Rogers GF,Murthy AS,LaBrie RA,Mulliken JB

    更新日期:2011-07-01 00:00:00

  • Plagiocephaly: differential diagnosis based on endocranial morphology.

    abstract::Plagiocephaly is a descriptive term that connotes an asymmetrically oblique or twisted head. Such cranial dysmorphology has a number of etiologies, the most common of which are unicoronal synostosis, unilambdoid synostosis, and plagiocephaly without synostosis. Use of the term plagiocephaly in the literature is often ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199602000-00003

    authors: Lo LJ,Marsh JL,Pilgram TK,Vannier MW

    更新日期:1996-02-01 00:00:00

  • Surgical correction of the inverted nipple with a tendon graft: hammock procedure.

    abstract::Our procedure, in which the inverted nipple was suspended using autogenous tendon grafts, was easy to perform, and it was not necessary to cut the lactiferous ducts. There was no deformity of the nipple or areola after this procedure, and the surgical scars were inconspicuous. Three patients who were followed up for o...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199011000-00030

    authors: Kurihara K,Maezawa N,Yanagawa H,Imai T

    更新日期:1990-11-01 00:00:00

  • Intralesional bleomycin injection treatment for vascular birthmarks: a 5-year experience at a single United Kingdom unit.

    abstract:BACKGROUND:The authors present their experience using an established chemotherapeutic agent as a scarless treatment for vascular birthmarks. One hundred sixty-four of more than 600 patients seen in the authors' center received intralesional bleomycin injection over 5 years. METHODS:Patient demographics, clinical respo...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e31820e923c

    authors: Sainsbury DCG,Kessell G,Fall AJ,Hampton FJ,Guhan A,Muir T

    更新日期:2011-05-01 00:00:00

  • Browpexy: lateral orbicularis muscle fixation as an adjunct to upper blepharoplasty.

    abstract::Lateral ptosis of the eyebrow is a major part of the complex changes that patients are seeking to improve with an upper blepharoplasty. Two hundred and eight patients have undergone a browpexy procedure at the time of blepharoplasty. This operative maneuver, which is performed through the blepharoplasty incision, prev...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199710000-00029

    authors: Zarem HA,Resnick JI,Carr RM,Wootton DG

    更新日期:1997-10-01 00:00:00

  • Critical analysis of reduction mammaplasty techniques in combination with conservative breast surgery for early breast cancer treatment.

    abstract:BACKGROUND:Although reduction mammaplasty is a well-described technique for aesthetic purposes, there are few previous reports regarding its application and clinical outcome following conservative breast surgery reconstruction. The purpose of this study was to analyze the feasibility of the technique and its outcome fo...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000202121.84583.0d

    authors: Munhoz AM,Montag E,Arruda EG,Aldrighi C,Gemperli R,Aldrighi JM,Ferreira MC

    更新日期:2006-04-01 00:00:00

  • Improving reemployment rates after limb salvage of acute severe tibial fractures by microvascular soft-tissue reconstruction.

    abstract::Patients with severe open tibial fractures may have a low rate of reemployment after reconstruction. Sixty-five limb-salvage patients were followed for at least 2 years to determine the factors that influence future employment. The preinjury conditions found to influence reemployment included age less than 40, higher ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199404001-00019

    authors: Francel TJ

    更新日期:1994-04-01 00:00:00

  • Management of postneurosurgical bone flap loss caused by infection.

    abstract:LEARNING OBJECTIVES:After studying this article, the participant should: 1. Be able to define indications and timing for secondary cranioplasty. 2. Understand the surgical options for reconstructing the cranium and overlying soft-tissue defect including their advantages and disadvantages. 3. Be able to apply this knowl...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0b013e3181858eee

    authors: Baumeister S,Peek A,Friedman A,Levin LS,Marcus JR

    更新日期:2008-12-01 00:00:00

  • Keloids have continuous high metabolic activity.

    abstract::The adenosine triphosphate (ATP) content of keloids and scars resected from patients was demonstrated by high-performance liquid chromatography. The surface color of hypertrophic scars was red or pink and that of atrophic scars was white. The ATP content of red scars was (in mmol/g protein) 1.06 +/- 0.14, of pink scar...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199909030-00012

    authors: Ueda K,Furuya E,Yasuda Y,Oba S,Tajima S

    更新日期:1999-09-01 00:00:00

  • Ocular advancement in monobloc distraction.

    abstract:BACKGROUND:Monobloc distraction has been demonstrated to be an efficacious, safe, and stable method of providing functional and aesthetic improvement in children with syndromic craniosynostosis. Although the movement of bony structures following monobloc distraction has been quantitatively assessed before, objective an...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181a07625

    authors: O'Connor EJF,Marucci DD,Jeelani NO,Witherow H,Richards R,Dunaway DJ,Hayward RD

    更新日期:2009-05-01 00:00:00

  • Quantitative analysis of blood and fat in suction lipectomy aspirates.

    abstract::This study of suction lipectomy aspirates from 15 consecutive patients was undertaken to biochemically quantitate the blood-to-fat ratios of the aspirates. A wide variation in the blood-to-fat ratios (8 to 54 percent) was noted, but the authors failed to demonstrate any relationship between the blood-to-fat ratios and...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198678060-00009

    authors: Goodpasture JC,Bunkis J

    更新日期:1986-12-01 00:00:00

  • A classification system for partial and complete DIEP flap necrosis based on a review of 17,096 DIEP flaps in 693 articles including analysis of 152 total flap failures.

    abstract:BACKGROUND:In a comprehensive review of 17,096 deep inferior epigastric perforator (DIEP) flaps in 693 articles published between the first description of the DIEP flap in 1989 and August of 2011, the authors found that the methods used to categorize partial necrosis and fat necrosis were inconsistent. As a result, the...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/01.prs.0000434402.06564.bd

    authors: Lie KH,Barker AS,Ashton MW

    更新日期:2013-12-01 00:00:00

  • Subcutaneous mastectomy in small, large, or ptotic breasts with immediate submuscular placement of implants.

    abstract::We present a series of 70 patients who have had bilateral subcutaneous mastectomies with immediate placement of implants under the intact pectoralis major and upper part of the serratus anterior. Twenty-two of these patients have had a simultaneous mastopexy, with a free nipple graft. All 70 patients have both of thei...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-197811000-00006

    authors: Jarrett JR,Cutler RG,Teal DF

    更新日期:1978-11-01 00:00:00

  • "Sensible" flap coverage of pressure sores in patients with meningomyelocele.

    abstract::Restoration of sensibility in the paraplegic patient is the optimal therapy for the management and prevention of debilitating pressure sores. In patients with an absence of sensibility below the L3 spinal level, a locally transposed arterialized neuromyocutaneous gracilis flap may be uniquely utilized for ischial rest...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Lesavoy MA,Dubrow TJ,Korn HN,Cedars MG,Castro DJ

    更新日期:1990-03-01 00:00:00

  • Comparison of free and reversed pedicled posterior interosseous cutaneous flaps.

    abstract::The posterior interosseous cutaneous flap is characterized by its thinness and the adjustable length of its vascular pedicle. This flap can be used both as a free and reversed vascular pedicled flap. We applied the free flap mostly for reconstruction of the digits, and the reversed vascular pedicled flap for soft-tiss...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199703000-00028

    authors: Shibata M,Iwabuchi Y,Kubota S,Matsuzaki H

    更新日期:1997-03-01 00:00:00

  • Bipedicle paraspinous muscle flaps for spinal wound closure: an anatomic and clinical study.

    abstract::The purpose of this study was to evaluate the vascular anatomy of the paraspinous muscles and review their clinical use as bipedicled flaps in spinal wound closure. Anatomically, through cadaver dissections, lead oxide injections, and radiographic imaging, the blood supply to the paraspinous muscles was determined. Cl...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200011000-00011

    authors: Wilhelmi BJ,Snyder N,Colquhoun T,Hadjipavlou A,Phillips LG

    更新日期:2000-11-01 00:00:00

  • True median cleft of the upper lip associated with three pedunculated club-shaped skin masses.

    abstract::A rare case of true median cleft of the upper lip associated with three skin masses is reported. While 114 cases of median cleft of the upper lip have been reported, in our literature review we found only 1 case, reported by Sharma, in which the median cleft was associated with skin masses. The embryology of this case...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198505000-00022

    authors: Nakamura J,Tomonari H,Goto S

    更新日期:1985-05-01 00:00:00

  • Techniques of monitoring buried fasciocutaneous free flaps.

    abstract:BACKGROUND:Although postoperative monitoring of microsurgical reconstruction is key to discovering early vascular compromise, monitoring a buried flap can be problematic. METHODS:A single surgeon's tracheal and pharyngoesophageal reconstructions with fasciocutaneous free flaps performed between 2002 and 2007 are revie...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e318196b9a3

    authors: Ferguson REH Jr,Yu P

    更新日期:2009-02-01 00:00:00

  • Propranolol-epinephrine interaction: a potential disaster.

    abstract::Presented here are six examples of potentially life-threatening propranolol-epinephrine interactions. The only report found that warns of a deleterious clinical interaction between propranolol and epinephrine appeared in 1980. With widespread use of propranolol for approved and unapproved conditions, the population at...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198307000-00017

    authors: Foster CA,Aston SJ

    更新日期:1983-07-01 00:00:00

  • The surgical treatment of congenital webbing (pterygium) of the popliteal area.

    abstract::We describe a case of congenital popliteal pterygium in conjunction with other specific congenital malformations. This syndrome has been called the quadruple syndrome. The literature is reviewed. A rationale for more aggressive treatment of this deformity is discussed. One child who has undergone major multiple nerve ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-197509000-00020

    authors: Tuerk D,Edgerton MT

    更新日期:1975-09-01 00:00:00

  • Learning How to Ask: Women and Negotiation.

    abstract::Women are less likely to reach top-level leadership positions, and more likely to leave academic positions, than men, and are likely to earn less money than men. Women are also less likely to initiate a negotiation-a process that is crucial for professional advancement. This reluctance to ask hinders their advancement...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000003063

    authors: Fischer LH,Bajaj AK

    更新日期:2017-03-01 00:00:00