Abstract:
BACKGROUND:In deep inferior epigastric perforator (DIEP) flap breast reconstructions, a free tissue flap from the abdomen is shaped into a breast and transferred to the thorax. Survival of this free flap relies on minuscule blood vessels, so-called perforators, providing blood supply to this newly molded breast. Preoperative mapping of these randomly distributed blood vessels is essential to avoid complications. The purpose of this study was to investigate whether the preoperative projection of a virtual three-dimensional plan based on computed tomographic angiography onto the abdomen leads to more correctly identified perforator locations and less operative time spent on dissecting the free flap compared to the commonly used Doppler ultrasound planning method. METHODS:The authors conducted a randomized, open, single-center, superiority trial in patients undergoing DIEP flap breast reconstruction with 1-week follow-up. Randomized participants were 60 adults (projection method, n = 33; Doppler method, n = 27) undergoing DIEP flap breast reconstruction without lymph node transfer. RESULTS:Sixty patients provided 69 DIEP flaps for analysis. The projection method is capable preoperatively of displaying significantly more perforators compared to the Doppler method (61.7 ± 7.3 percent versus 41.2 ± 8.2 percent, respectively; p = 0.020)). During the procedure, flap harvest time is decreased by 19 minutes (136 ± 7 minutes versus 155 ± 7 minutes; p = 0.012). Complications were comparable across both groups. CONCLUSION:Not only can more perforators be identified intraoperatively using the projection method compared with Doppler ultrasound, there is also a significant time reduction in harvesting the DIEP flap. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, II.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Hummelink S,Hoogeveen YL,Schultze Kool LJ,Ulrich DJOdoi
10.1097/PRS.0000000000005614subject
Has Abstractpub_date
2019-06-01 00:00:00pages
1151e-1158eissue
6eissn
0032-1052issn
1529-4242pii
00006534-201906000-00008journal_volume
143pub_type
杂志文章,随机对照试验abstract::The buccal space, with its fat pad, is a valuable, overlooked target in facial rejuvenation procedures. The authors identified a specific group of patients who have normal or prominent malar projection in the presence of atrophy of the buccal fat pad, with or without prominent gonial angles. Eight of 24 prospectively ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003384
更新日期:2017-06-01 00:00:00
abstract::The effect of sepsis on neovascularization in fractures that follows open fractures is important to the understanding of bone and soft-tissue healing. An animal model was designed that mimics the open fracture and the clinical repair of the human, high-energy open fracture. Vascular endothelial growth factor (VEGF) mR...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000066170.56389.27
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abstract:BACKGROUND:Patient- and parent-reported outcomes are increasingly considered as measures of treatment effectiveness for congenital conditions. The authors' specific aim was to review the use of patient- and parent-reported outcomes of quality of life, activities of daily living, perception of hand appearance, and satis...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000003358
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abstract::Tissue expansion can be characterized as a unique reconstructive procedure that takes advantage of the intrinsic ability of tissues to stretch and, in some instances, to grow in response to expansive forces. The efficacy of combined intraoperative expansion to obtain sufficient expanded tissue more rapidly was tested ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:1993-03-01 00:00:00
abstract::The median facial dysplasia group of patients is a unique, distinct, definable group characterized by mid-line facial deficiencies in the presence of a unilateral or bilateral cleft lip with or without cleft palate and without clinically detectable anomalies of the brain. This group of patients comprised 2 percent of ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::Successful rhinoplasty depends on nasal tip support and its influence on nasal tip projection. The factors involved in nasal tip support are numerous; however, the role of the anterior septum versus the lower lateral cartilages has been debated in the literature. The purpose of this study was to quantitate, using fres...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199901000-00040
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181e6051e
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abstract::The surgical correction of vertical malpositions of the human eye has been made relatively safe and reliable by recent surgical techniques. The authors define this condition as vertical orbital dystopia and review the etiology of this deformity in 38 recent consecutive cases that were surgically treated at the Craniof...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1981-02-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:1991-02-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
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更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Botulinum toxin A (BTA) is one of the most diversely used medications of the 21st century and is now being researched as a treatment for major depressive disorder (MDD). METHODS:The authors performed a literature search of PubMed, Web of Science, and the Cochrane Register of Controlled Trials. The primary i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000279491.48283.51
更新日期:2007-12-01 00:00:00
abstract::The described method for correction of the inverted nipple adds both bulk and structural stability to the nipple. This is done by means of a dermal sling and creation of a narrow base to prevent inversion of the nipple. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198004000-00020
更新日期:1980-04-01 00:00:00
abstract:BACKGROUND:There are few studies that compare the deep inferior epigastric artery perforator (DIEP) flap to the pedicled transverse rectus abdominis myocutaneous (pTRAM) flap for use in reconstructive breast surgery. The authors examined four factors that aid in decision-making: donor-site morbidity, need for surgery r...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000001747
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Recent literature has focused on the advantages and disadvantages of using acellular dermal matrix in breast reconstruction. Many of the reported data are from low level-of-evidence studies, leaving many questions incompletely answered. The present randomized trial provides high-level data on the incidence a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/PRS.0000000000000809
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Breast asymmetry is commonly accompanied by tuberous deformity. To date, no study has reported the incidence of this breast deformity in the presence of asymmetry. A retrospective analysis of standard preoperative photographs was performed on 375 consecutive female patients presenting for mammaplasty over a ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000189206.94466.a9
更新日期:2005-12-01 00:00:00
abstract::Using a simplified pressure-measuring device, we determined the pressures under 4 anatomical sites in 11 human subjects to compare 3 commercially available sleeping surfaces. The 3 surfaces tested were a water mattress, a water bed, and our standard hospital bed. There were no significant differences in the recorded p...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197710000-00016
更新日期:1977-10-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the case mix of plastic surgeons in their early years of practice by examining candidate case logs submitted for the oral examination. METHODS:Deidentified data from 2000 to 2009 consisting of case logs submitted by young plastic surgery candidates for the oral exam...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31821b6307
更新日期:2011-08-01 00:00:00
abstract::The purpose of this primer is to provide the clinical surgeon with a survey overview of the basic biochemistry of collagen and the methods and rationale of collagen cross-linking in the processing and preparation of bioprosthetics for surgical implantation. The author highlights the critical biologic factors, such as ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
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abstract::The anatomic distribution and potential arterial flow patterns of the circumflex scapular artery were investigated by Microfil injection. These studies demonstrated that the circumflex scapular artery lies within the dorsal thoracic fascia, which plays a significant role in the circulation of the overlying skin and su...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199808000-00021
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,随机对照试验
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abstract:BACKGROUND:Breast reconstruction is most frequently performed using implants or expanders. Adjunctive materials such as acellular dermal matrix and synthetic meshes are used to support the implant or expander. A paucity of large studies exist on the use of synthetic mesh for breast reconstruction. METHODS:A retrospect...
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pub_type: 杂志文章
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更新日期:2020-12-01 00:00:00
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journal_title:Plastic and reconstructive surgery
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更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Enhanced recovery after surgery (ERAS) protocols have known benefits in the inpatient setting, but little is known about their impact in the subsequent outpatient setting. On discharge, multimodal analgesia has been discontinued, nerve blocks and pain pumps have worn off, and patients enter a substantially d...
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更新日期:2020-03-01 00:00:00
abstract::Rising health care costs and quality demands have driven both the Centers for Medicare and Medicaid Services and the private sector to seek innovations in health system design by placing institutions at financial risk. Novel care models, such as bundled reimbursement, aim to boost value though quality improvement and ...
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abstract::Free-tissue transfer has facilitated and refined the reconstructive surgeon's ability to repair or reconstruct acquired or congenital defects in children. Although parallels exist between indications for free-tissue transfer in adults and children, the technical challenges and surgical skill required in pediatric pati...
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