Abstract:
BACKGROUND:The establishment of an effective clinical and academic culture within an institution is a multifactorial process. This process is cultivated by dynamic elements such as recruitment of an accomplished and diverse faculty, patient geographic outreach, clinical outcomes research, and fundamental support from all levels of an institution. This study reviews the academic evolution of a single academic plastic surgery practice, and summarizes a 10-year experience of microsurgical development, clinical outcomes, and academic productivity. METHODS:A 10-year retrospective institutional review was performed from fiscal years 2006 to 2016. Microsurgical flap type and operative volume were measured across all microsurgery faculty and participating hospitals. Microvascular compromise and flap salvage rates were noted for the six highest volume surgeons. Univariate and multivariable predictors of flap salvage were determined. RESULTS:The 5000th flap was performed in December of 2015 within this institutional study period. Looking at the six highest volume surgeons, free flaps were examined for microvascular compromise, with an institutional mean take-back rate of 1.53 percent and flap loss rate of 0.55 percent across all participating hospitals. Overall, 74.4 percent of cases were breast flaps, and the remaining cases were extremity and head and neck flaps. CONCLUSIONS:Focused faculty and trainee recruitment has resulted in an academically and clinically productive practice. Collaboration among faculty, staff, and residents contributes to continual learning, innovation, and quality patient care. This established framework, constructed based on experience, offers a workable and reproducible model for other academic plastic surgery institutions. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Carney MJ,Weissler JM,Tecce MG,Mirzabeigi MN,Wes AM,Koltz PF,Kanchwala SK,Low DW,Kovach SJ,Wu LC,Serletti JM,Fosnot Jdoi
10.1097/PRS.0000000000004200subject
Has Abstractpub_date
2018-04-01 00:00:00pages
855-863issue
4eissn
0032-1052issn
1529-4242pii
00006534-201804000-00006journal_volume
141pub_type
杂志文章abstract::A study of our hospital records has confirmed a striking increase in the number of melanoma cases. An examination of the New York State statistics demonstrates a 202 percent increase in the case rate from 1950 to 1971. The Connecticut statistics extending from 1935 to 1972 show an age-adjusted incidence rate increase ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197601000-00010
更新日期:1976-01-01 00:00:00
abstract::Deficiency of the free border of the lip is frequently encountered in secondary cleft lip deformities. The free border of the lip consists of the orbicularis oris marginalis muscle and its overlying subcutaneous tissue, vermilion, and mucosa. The pathology may involve any or all of these components. When there is an a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract::I didactically compared the breast as a glandular cone with an envelope of skin and subcutaneous tissue. The aesthetic alterations of the breast are classified in four groups related to form, to volume, to grams, and to ptosis in centimeters. An imaginary plane that passes by the mammary sulcus (plane A) will determin...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199005000-00013
更新日期:1990-05-01 00:00:00
abstract::One of the critical parameters that has not been examined carefully following laser skin resurfacing is the effect of eschar on the wound healing process. Because occlusive dressings minimize the occurrence of eschar, the present study was undertaken to evaluate the effect of occlusion following laser resurfacing. It ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200005000-00044
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Conventional palatoplasty relies on extensive mucosal incisions and isolation of flaps on the palatine vessels to facilitate midline closure and velar reconstruction. This introduces substantial scarring, which has adverse effects on vascularity and growth. The authors have developed a minimally invasive pal...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000280
更新日期:2014-07-01 00:00:00
abstract::Protein depletion appears to augment, rather than decrease, the length of a skin flap surviving in rats. We were able to document a lowering of serum viscosity in these animals. The augmentation of flap survival produced by protein depletion may even be greater than that produced by the delay phenomenon. A reduction i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197804000-00015
更新日期:1978-04-01 00:00:00
abstract::Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon neoplasia occurring in women with either cosmetic or reconstructive breast implants. The actual knowledge about BIA-ALCL deriving from the literature presents several limits, and it remains difficult to make inferences about BIA-ALCL ep...
journal_title:Plastic and reconstructive surgery
pub_type: 共识发展会议,杂志文章
doi:10.1097/PRS.0000000000003933
更新日期:2018-01-01 00:00:00
abstract::This study was designed to test the efficacy of enriched cell culture medium as a wound dressing. The rationale was to create within the wound space an optimal microenvironment, conducive to cellular proliferation, vascular granulation tissue formation, and epithelialization. This study was performed on various wounds...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200107000-00016
更新日期:2001-07-01 00:00:00
abstract::Although prominent ears are the most common congenital deformity in the head and neck region, only approximately 8 percent of patients who present for treatment of this deformity will have some family history of the abnormality. More than 200 techniques have been described for correction of this deformity, indicating ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200109150-00038
更新日期:2001-09-15 00:00:00
abstract:BACKGROUND:The treatment of lentigo maligna and lentigo maligna melanoma presents a difficult problem for clinicians. Published guidelines recommend a 5-mm excision margin for lentigo maligna and a 1-cm margin for lentigo maligna melanoma, yet these are often inadequate. The authors' purpose is to report their 10-year ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181bcf002
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Harvesting of rib as a source of cartilage can result in significant donor-site morbidity. In experienced hands, excellent results from using autologous rib cartilage are achievable for ear reconstruction, rhinoplasty, and otolaryngology. The authors report the morbidity associated with the harvest of costal...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318170709e
更新日期:2008-06-01 00:00:00
abstract::Congenital constriction band syndrome is a rare entity with a wide spectrum of associated congenital anomalies. Review of the pathogenesis and an unusual case of constriction band syndrome in a newborn are presented. Surgical excision of the deformity and the band was performed within the first week of life. There wer...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1999-07-01 00:00:00
abstract::The current Accreditation Council for Graduate Medical Education guidelines separate residents' education into six core competencies or subjects. The authors address the least intuitive of these, systems-based practice. In systems-based practice, educators and residents must demonstrate an awareness of and responsiven...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000245064.78012.ca
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:The serratus anterior flap is commonly used without its cutaneous component and is covered with a skin graft. The authors have successfully used the free serratus anterior flap along with its skin paddle and have found it to be valuable for reconstruction of the face. METHODS:Fresh cadaveric dissections and...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000208297.02556.a5
更新日期:2006-04-01 00:00:00
abstract::A 24-year-old female diabetic patient was hospitalized because of ketoacidosis and a necrotic wound on the hand. Debridement and antibiotic therapy failed to halt the process. After demonstration of Mucor in cultures from the wound, the patient underwent extensive surgery and amphotericin B was administered. When the ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199809030-00030
更新日期:1998-09-01 00:00:00
abstract::Fifty women scheduled for breast reconstruction surgery with tissue expansion were randomly divided into two groups. In the first group the tissue was expanded rapidly, i.e., once a day, starting 1 week postoperatively, and in the other group it was expanded slowly, i.e., once a week, starting after 2 weeks. The expan...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1993-04-01 00:00:00
abstract:LEARNING OBJECTIVES:After reading this article, the participant should be able to: 1. Clinically describe various cutaneous neoplasms. 2. Identify the corresponding histopathologic findings. 3. Discuss the optimal treatment approach for each entity. SUMMARY:Cutaneous neoplasms are broadly viewed as benign, premalignan...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e3181d6e89a
更新日期:2010-05-01 00:00:00
abstract:LEARNING OBJECTIVES:After reading this article, the participant should be able to: 1. Understand the indications for implant-based breast reconstruction and the indications for nipple preservation compared to skin-sparing or skin-reducing patterns. 2. Understand the indications for direct-to-implant breast reconstructi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006510
更新日期:2020-02-01 00:00:00
abstract::Three-dimensional measurement and characterization of facial surface anatomy are fundamental to the objective analysis of facial deformity. However, existing clinical tools are inadequate. Recent innovations in laser scanning technology provide a potentially useful technique for accurate three-dimensional documentatio...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199608000-00004
更新日期:1996-08-01 00:00:00
abstract::The viability of the rabbit epigastric flap was investigated after a period of cold ischemia of 3, 4, or 5 days. Groups of flaps were either perfused with Ross's solution before ischemia (early perfusion), after ischemia (late perfusion), or not at all (control). Significantly more flap necrosis was formed at explorat...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198507000-00017
更新日期:1985-07-01 00:00:00
abstract:BACKGROUND:Acute and chronic wounds are costly and invariably expose significant structures. Surgical reconstruction causes donor-site morbidity, scarring, and the need for intensive care. Reconstruction using an artificial dermis avoids donor sites, but available collagen-based solutions are susceptible to poor take. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000218843.86011.f8
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to objectively report practices commonly used in cleft palate repair in the United States. This study investigates current surgical techniques, postoperative care, and complication rates for cleft palate repair surgery. METHODS:All 803 surgeon members of the American Cleft Pala...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181b03824
更新日期:2009-09-01 00:00:00
abstract::Advancements in modern robotic technology have led to the development of highly sophisticated upper extremity prosthetic limbs. High-fidelity volitional control of these devices is dependent on the critical interface between the patient and the mechanical prosthesis. Recent innovations in prosthetic interfaces have fo...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e3182a97e5f
更新日期:2013-12-01 00:00:00
abstract::Five cases of burns occurring in TRAM flaps utilized for breast reconstruction are presented in this study. These injuries resulted from exposure to thermal and/or solar radiation. We believe that the physiologic changes that result from flap elevation and transposition, mainly denervation, negate the autonomic protec...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract::Human liposuction aspirates contain pluripotent adipose-derived mesodermal stem cells that have previously been shown to differentiate into various mesodermal cell types, including osteoblasts and chondrocytes. To develop an autologous research model of bone and cartilage tissue engineering, the authors sought to dete...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200203000-00037
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Health care reforms aimed at bundling payments attempt to contain costs. Uncovering variation in spending provides one strategy for decreasing expenditure. This study aims to investigate interhospital cost variation for thumb replantation. METHODS:A retrospective cross-sectional analysis of patients undergo...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006022
更新日期:2019-10-01 00:00:00
abstract::Prepectoral breast reconstruction carries many benefits to patients, including its minimally invasive (muscle-sparing) nature, and its reduction in symptoms such as pain and animation deformity, relative to subpectoral reconstruction. However, without the traditional use of the pectoralis major muscle to mask the uppe...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005949
更新日期:2019-07-01 00:00:00
abstract::Multiple-segment osteotomy is defined as an osteotomy that divides the tooth-bearing arch of the maxilla or mandible into three or more segments. Combining large-segment orthognathic surgery and unitooth or small-segment surgery is an effective approach for dealing with a wide range of dentofacial deformities with occ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199908000-00009
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Upper airway narrowing has been a concern of mandibular setback. The aims of this study were (1) to evaluate the effect of bimaxillary rotational setback surgery on upper airway structure in patients with skeletal class III deformities, and (2) to compare the preoperative and postoperative upper airways of c...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000913
更新日期:2015-02-01 00:00:00
abstract::The case is presented of a primary toe-to-thumb transfer by microvascular anastomosis for reconstruction of an acute degloving amputation of the thumb. This approach is not recommended as the standard practice for this type injury, however, there were certain advantages in this patient: (1) one stage procedure, (2) re...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1981-02-01 00:00:00