Abstract:
BACKGROUND:Obesity has been viewed as a relative contraindication against autologous free flap breast reconstruction because of increased risks of complications, including flap loss. METHODS:The authors conducted a prospective analysis of obese patients undergoing autologous breast reconstruction. RESULTS:Overall, 72 patients (average age, 48.5 years; average body mass index, 35.7 kg/m) underwent abdominal free flap breast reconstruction. There were 43 bilateral reconstructions and the remainder were unilateral (n = 115 flaps). There were 67 muscle-sparing transverse rectus abdominis musculocutaneous (TRAM) flaps (58.3 percent), 44 deep inferior epigastric perforator (DIEP) flaps (38.2 percent), two free bipedicle DIEP flaps, one superficial inferior epigastric perforator flap, and one free TRAM flap. Forty-two patients (58.3 percent) had prior radiation, and 51 (70.8 percent) had prior chemotherapy. Forty-three patients (59.7 percent) underwent delayed reconstruction and 21 (29.2 percent) underwent immediate reconstruction. Eight patients (11.1 percent) had bilateral reconstruction, with one breast reconstructed in an immediate and the other in a delayed fashion. Half of the patients (n = 36) had mesh placed in an underlay fashion to reinforce the donor site. Regarding breast complications, there were 11 wound dehiscences, one hematoma, one infection, and two patients with mastectomy skin flap necrosis. Twelve patients had donor-site wound healing complications, there were four infections, and three patients developed a bulge/hernia. There were no flap losses. Comparison to historic controls demonstrated no significant differences in overall flap loss rates (p = 0.061) or donor-site bulge/hernia (p = 0.86). CONCLUSION:Autologous abdominal free flaps can be performed safely in obese patients without increased risks for donor-site bulge/hernia or flap loss compared to nonobese patients; however, patients should be counseled carefully regarding the potential risks of complications. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Chang EI,Liu Jdoi
10.1097/PRS.0000000000004550subject
Has Abstractpub_date
2018-08-01 00:00:00pages
120e-125eissue
2eissn
0032-1052issn
1529-4242pii
00006534-201808000-00006journal_volume
142pub_type
临床试验,杂志文章abstract::There are several anecdotal clinical articles claiming wound healing and scar superiority using obsidian (volcanic glass) scalpels. In order to determine if skin incisions made with obsidian were superior to those made with standard surgical steel, wound tensile strength, scar width, and histology were assessed in 40 ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract::Pigmented villonodular synovitis is a lesion containing giant cells and, because of its tendency to recur, it is easily confused with a malignant process. However, careful review of the histological material will reveal that there is no nuclear atypism or mitotic figures. Also, there have been no reports attributing m...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1977-02-01 00:00:00
abstract:BACKGROUND:This purpose of this study was to perform a systematic review to identify articles that discuss ethical issues relating to the field of plastic and reconstructive surgery and to evaluate whether ethical issues are underrepresented in the plastic surgery literature. METHODS:Four medical databases were select...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e3181b98a9f
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:The deep inferior epigastric artery perforator (DIEP) flap is the gold standard in autologous breast reconstruction. When the abdomen is not available, alternative donor sites can be found at the buttock, the lumbar region, or the thighs. These flaps are referred to as second-choice flaps. This study compare...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000007094
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Ventral hernias are a common, challenging, and expensive problem for general and reconstructive surgeons. The authors assessed the impact of epidurals on morbidity following abdominal wall reconstruction for hernia. METHODS:A retrospective review of abdominal wall reconstruction patients operated on between...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000438048.91139.31
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:The maxillary artery is recognized as the main vascular supply of the facial bones; nonetheless, clinical evidence supports a codominant role for the facial artery. This study explores the extent of the facial skeleton within a facial allograft that can be harvested based on the facial artery. METHODS:Twent...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000111
更新日期:2014-05-01 00:00:00
abstract::This study was designed to test the hypothesis that demineralized perforated bone matrix implant from canine skull and tibia induces new bone formation within the calvarial defect comparable with the bone induced by autogenous graft. We also were interested in determining whether demineralized perforated bone matrix i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199509001-00002
更新日期:1995-09-01 00:00:00
abstract::Reconstruction of the nipple is the penultimate step in breast reconstruction after mastectomy. A number of reconstructive techniques have been described for nipple reconstruction including skin grafts, composite grafts, and various local flaps. The authors' preferred reconstructive technique is the local C-V or modif...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000076245.12249.BE
更新日期:2003-09-15 00:00:00
abstract:BACKGROUND:The application of aesthetic, craniofacial, and microsurgical principles in the execution of face transplantation may improve outcomes. Optimal soft-tissue face transplantation can be achieved by incorporating subunit facial skeletal replacement and subsequent tissue resuspension. The purpose of this study w...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002122
更新日期:2016-05-01 00:00:00
abstract::Three patients presented who needed reconstruction of the entire esophagus. Because the stomach and colon were not available in these patients, a posterior tibial artery flap was employed for reconstruction. In the first stage, the long and wide skin flap was elaborated into a skin tube to create the major portion of ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199112000-00006
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND:The pedicled descending branch muscle-sparing latissimus dorsi flap with a transversely oriented skin paddle presents distinct advantages in breast reconstruction, including reduced donor-site morbidity and greater freedom of orientation of the skin paddle. This study reports the anatomical basis, surgical t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181934838
更新日期:2009-01-01 00:00:00
abstract:SUMMARY:The method of abdominal hernia repair known as components separation, described by Ramirez et al. in 1990, has enjoyed widespread popularity because of the sound anatomical principles it uses and most importantly the clinical success of the procedure. Although the authors who described this technique made no pr...
journal_title:Plastic and reconstructive surgery
pub_type: 传,历史文章,杂志文章
doi:10.1097/PRS.0b013e3181b98ab8
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Closed-suction drains are widely used to reduce the incidence of seroma whenever potential spaces are surgically created. However, few studies have examined the parameters that affect drain efficacy. METHODS:An in vitro model was created to assess the effects of tubing length, tubing size, tubing type, flui...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004413
更新日期:2018-06-01 00:00:00
abstract::The objectives of this study were (1) to determine the extent of sensory recovery on hemitongues reconstructed with innervated radial forearm flaps and (2) to assess the influence of various clinical and surgical factors over the return of sensation, including the use of different recipient nerves for neurorrhaphy. Tw...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199902000-00013
更新日期:1999-02-01 00:00:00
abstract::Prophylactic bilateral mastectomy is an option for women who are at an increased risk of developing breast cancer. Prophylactic mastectomy is often performed with immediate reconstruction (i.e., at the same time and under the same anesthetic as the mastectomy). Satisfaction with reconstruction has been described previ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000131877.52740.0e
更新日期:2004-08-01 00:00:00
abstract::The recent report of a transforming growth factor-beta 3 (TGF-beta 3) knock-out mouse in which 100 percent of the homozygous pups have cleft palate raised the question as to the potential usefulness of these animals as a model for cleft palate research. The specific aim in this study was to carefully document the anat...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200109150-00018
更新日期:2001-09-15 00:00:00
abstract:BACKGROUND:Despite well-established correlation of postmastectomy radiotherapy and surgical complications in breast reconstruction, its impact on patient reported outcomes is less clear. We sought to determine the effect of postmastectomy radiotherapy on patient reported outcomes throughout the breast reconstruction pr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004105
更新日期:2018-03-01 00:00:00
abstract::In a blind, randomized study, two groups, each of seven rabbits, were treated with either a very low dose of human melanoma cell line-derived tissue-type plasminogen activator (t-PA) or isotonic saline. t-PA (0.067 mg/kg of body weight) was administered intraaortically, 20 percent being given as a 30-second "bolus" in...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1992-08-01 00:00:00
abstract::The transverse rectus abdominis musculocutaneous flap is widely used for breast reconstruction, but it does not have a rich blood supply. A previous article described the inclusion of superficial epigastric vessels and superficial circumflex iliac vessels to "supercharge" the flap. Subsequent experience has shown that...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199309001-00033
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abstract::Craniofacial reconstructive procedures are frequently associated with some dissection or transposition of the temporalis muscle. During active growth, such muscle manipulations may influence craniofacial development. The purpose of this study was to determine the effects of surgical manipulation of the temporalis musc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199601000-00002
更新日期:1996-01-01 00:00:00
abstract::Ultrasound and CT scans have been used to examine 12 patients with suspected medial orbital wall fractures. A good correlation between ultrasound and CT scanning was demonstrated, and the authors believe that either investigation is a suitable alternative to conventional radiology when this type of injury is suspected...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198103000-00001
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abstract:BACKGROUND:Successful clinical application of dermal filler products requires an understanding of their physical characteristics and in vivo behavior. This study reviewed the data for hyaluronic acid dermal filler products derived from an animal source--the rooster comb. METHODS:A review of the hyaluronic acid literat...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000248806.70402.7b
更新日期:2007-11-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198912000-00016
更新日期:1989-12-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199505000-00010
更新日期:1995-05-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000436848.02033.2e
更新日期:2014-02-01 00:00:00
abstract::We have devised a new method for secondary commissuroplasty after reconstruction of the lower lip using Estlander's method with both aesthetically and functionally satisfactory results. This method consists of forming two equilaterally triangular mucosal flaps on the vermilion and a small triangular skin flap in the n...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:1992-10-01 00:00:00
abstract::The hydrogen clearance technique was introduced for monitoring postoperative blood flow after free-tissue transfer in this prospective clinical study. This technique allows unlimited repeatable quantitative measurements of tissue blood flow in milliliters per minute per 100 gm of tissue at any site including buried fl...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
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更新日期:1997-02-01 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:2016-12-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2009-03-01 00:00:00