Abstract:
BACKGROUND:Since the 2012 approval of shaped implants, their use in breast reconstruction has increased in the United States. However, large-scale comparisons of complications and patient-reported outcomes are lacking. The authors endeavored to compare surgical and patient-reported outcomes across implant types. METHODS:The Mastectomy Reconstruction Outcomes Consortium database was queried for expander/implant reconstructions with at least 1-year postexchange follow-up (mean, 18.5 months). Outcomes of interest included postoperative complications, 1-year revisions, and patient-reported outcomes. Bivariate and mixed-effects regression analyses evaluated the effect of implant type on patient outcomes. RESULTS:Overall, 822 patients (73.5 percent) received round and 297 patients (26.5 percent) received shaped implants. Patients undergoing unilateral reconstructions with round implants underwent more contralateral symmetry procedures, including augmentations (round, 18.7 percent; shaped, 6.8 percent; p = 0.003) and reductions (round, 32.2 percent; shaped, 20.5 percent; p = 0.019). Shaped implants were associated with higher rates of infection (shaped, 6.1 percent; round, 2.3 percent; p = 0.002), that remained significant after multivariable adjustment. Other complication rates did not differ significantly between cohorts. Round and shaped implants experienced similar 2-year patient-reported outcome scores. CONCLUSIONS:This prospective, multicenter study is the largest evaluating outcomes of shaped versus round implants in breast reconstruction. Although recipients of round implants demonstrated lower infection rates compared with shaped implants, these patients were more likely to undergo contralateral symmetry procedures. Both implant types yielded comparable patient-reported outcome scores. With appropriate patient selection, both shaped and round implants can provide acceptable outcomes in breast reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, III.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Khavanin N,Clemens MW,Pusic AL,Fine NA,Hamill JB,Kim HM,Qi J,Wilkins EG,Kim JYSdoi
10.1097/PRS.0000000000003238subject
Has Abstractpub_date
2017-05-01 00:00:00pages
1063-1070issue
5eissn
0032-1052issn
1529-4242pii
00006534-201705000-00007journal_volume
139pub_type
杂志文章,多中心研究abstract::Adequate tissue perfusion is essential to minimize postoperative complications following microsurgery. Intraoperative knowledge of tissue perfusion could aid surgical decision-making and result in reduced complications. Laser speckle imaging is a new, noninvasive technique for mapping tissue perfusion. This article di...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005223
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:The authors conducted a review of the recent literature on the monitoring of free flaps to create an overview of the current monitoring devices and their potential as an ideal monitoring method. METHODS:A literature-based study was conducted using the PubMed and Cochrane databases. The following search term...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e3181c49580
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:The teres major can be seen as an additional head of the latissimus dorsi muscle for three-dimensional movement of the arm. It gained importance in pedicled muscle transfers for the treatment of plexus palsies and shoulder instability. Its supplying vessels belong to the subscapular system. According to the ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000252268.06443.61
更新日期:2007-03-01 00:00:00
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
更新日期:2011-05-01 00:00:00
abstract::Three-dimensional surface reconstruction from computed tomographic (CT) data has been used to plan craniofacial operations. Cephalometric and anthropometric databases were integrated with three-dimensional CT reconstructions to quantitate the skeletal deformity and to assist in the design of the surgical procedure. In...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:Perforator flap nomenclature continues to evolve, with many classification schemes reported. Each of them focuses on the fascial penetration pattern of perforators, which has no impact on flap perfusion. With the advent of advanced imaging technologies, the subcutaneous course of perforators can be highlight...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31824ecaff
更新日期:2012-07-01 00:00:00
abstract::Using 1.5 x 6 cm caudally based rat dorsal pedicled flaps, the effect of isoxsuprine on skin flap survival was studied. The results showed isoxsuprine to have no augmentation effect on the survival of random pattern flaps. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198007000-00020
更新日期:1980-07-01 00:00:00
abstract::When nasal augmentation is performed with implants fashioned from a piece of solid silicone block or commercially available prefabricated implants, the precise sculpturing of the ventral surface of the implant in order to conform to the convex contour of the nose is often difficult to achieve, increasing the possibili...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199602000-00026
更新日期:1996-02-01 00:00:00
abstract:BACKGROUND:Chronic infections affect 17 million people yearly, and approximately 550,000 people die each year from, or with, their chronic infections. Acute and chornic infection differences are well known to clinicians, but the role of bacteria in producing these clinical differences remains poorly understood. METHOD...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e3181fca244
更新日期:2011-01-01 00:00:00
abstract::This study was undertaken to understand the control mechanisms differentiating circulation to normal skin and acute skin flaps. The approach was to compare the effects of systemic vasoactive drugs on skin blood flow in rats in acute skin flaps and identical areas of control skin. With this model it was felt that syste...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198303000-00018
更新日期:1983-03-01 00:00:00
abstract::The challenge of the current graduate medical education environment requires in plastic surgery acceptance of those contemporary pressures that cannot be substantially modified and address of those that can be successfully met. To do so implies an examination of conference didactics, intraoperative teaching, and a val...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000479982.67922.8a
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Augmentation gluteoplasty has been performed more frequently in the past decade, with over 21,000 procedures performed in the past year alone. The most popular methods for buttock augmentation involve silicone prostheses and autologous fat grafting. A comparison of complications of these two techniques does ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000002005
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Open tibia fractures are commonly stratified by the Gustilo classification, an orthopedic grading system that does not incorporate the presence of arterial injury when limb perfusion is intact. In the authors' experience, however, the presence of arterial injury appears to negatively impact microsurgical out...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003766
更新日期:2017-11-01 00:00:00
abstract::Five patients with segmental tibial defects whose contralateral fibula could not be used as a donor were treated with ipsilateral island fibular transfer in an antegrade or retrograde fashion. Antegrade-flow pedicled flaps based on the peroneal vessel as in the conventional free flap were used for the proximal or midd...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199802000-00017
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Pierre Robin sequence is characterized by mandibular retrognathia and glossoptosis resulting in airway obstruction and feeding difficulties. When conservative management fails, mandibular distraction osteogenesis or tongue-lip adhesion may be required to avoid tracheostomy. The authors' goal was to prospecti...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003167
更新日期:2017-04-01 00:00:00
abstract::A prospective, double-blinded study of 30 consecutive face lift patients was conducted to determine if the administration of corticosteroid medication would reduce postoperative facial edema. Half the patients received steroid medications in a random fashion. Three independent plastic surgeons who were blinded to the ...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00006534-199607000-00001
更新日期:1996-07-01 00:00:00
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::The roots of the working hours mandate and controversy are outlined, the effect on resident education is described, and the service versus education equation is defined. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182450c27
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the correlation between plastic surgery education received through residency in Canadian programs and perceived preparedness for independent clinical practice among recently graduated plastic surgeons. METHODS:All practicing plastic surgeons having graduated from a ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181cb6128
更新日期:2010-03-01 00:00:00
abstract::Six patients with pectus excavatum and two patients with pectus carinatum had their conditions corrected by a partial costal cartilage resection with a sternal osteotomy through a 2.5-cm to 4-cm skin incision located just above the xyphoid process assisted by an endoscope. In addition to the incision, stab wounds of l...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199704000-00018
更新日期:1997-04-01 00:00:00
abstract::Both the safety and efficacy of the treatment of isolated craniofacial dysostosis (plagiocephaly) in infancy have been demonstrated. Opinions remain divided, however, as to the optimal type of procedure to be undertaken. In an attempt to answer this question, we have retrospectively evaluated a study population of 48 ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199005000-00003
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:De novo or rare transmitted mutations in the SMAD6 gene affect 7 percent of midline nonsyndromic synostosis patients. This study aimed to determine the neurocognitive sequelae of SMAD6 synostosis. METHODS:Nonsyndromic synostosis patients 6 years or older with SMAD6 mutations and non-SMAD6 nonsyndromic synos...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006319
更新日期:2020-01-01 00:00:00
abstract::Sixty-three white Leghorn chickens were used in a two-stage tendon grafting into the deep flexor of the third toe. In the first stage, a 4- or 8-week-old pseudosheath was created around the Silastic rod. In the second stage, the grafting was carried out: in 33 birds the new sheath covered the entire tendon graft and i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198002000-00011
更新日期:1980-02-01 00:00:00
abstract::A tape and applicator designed to give preoperative blepharoplasty patients an idea of the proposed result has been developed. The use of the tape as a cosmetic device to temporarily give the effect of a surgical blepharoplasty is presented. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198511000-00024
更新日期:1985-11-01 00:00:00
abstract::Injectable dermal filler materials consist of either fluids, biological fragments, or suspensions of particles or microspheres. Particles and microspheres are said to "migrate," but migration can occur only when they are injected into blood vessels. To evaluate biocompatibility and transport, five nonresorbable polyme...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000112764.22839.7a
更新日期:2004-04-15 00:00:00
abstract::In a previous study in the rabbit, the authors defined the macroscopic growth alterations after unilateral partial facial paralysis. Dry skull measurements revealed a reduced premaxillary, maxillary, mandibular, and anterior corpus length with a simultaneous increase in mandibular ramal height on the paralyzed side. T...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200201000-00028
更新日期:2002-01-01 00:00:00
abstract::The authors tested the hypothesis that certain maneuvers (neck flexion/extension and head protrusion/retrusion) alter the appearance of the submental area, jawline, and melolabial groove. They used a questionnaire survey of 20 naïve judges who assessed a standardized photograph album of three subjects. The subjects' f...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000127791.31526.e2
更新日期:2004-07-01 00:00:00
abstract::Understanding patients' perceptions of surgical results and their impacts on quality of life is of primary importance in plastic surgery, as procedures are largely performed to improve either appearance or function. Patient-reported outcome measures are questionnaires specifically designed to quantify aspects of healt...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e3182063276
更新日期:2011-03-01 00:00:00
abstract::A procedure is described in which a direct approach to the underlying pathology of the inverted nipple is undertaken. The inverted nipple is raised as desired by freeing it from the surrounding tissue by vertical and horizontal undermining and then is stabilized by purse-string suture. It can be performed as an office...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198304000-00021
更新日期:1983-04-01 00:00:00
abstract:BACKGROUND:The goal of the authors' study was to determine whether an autologous tissue flap, when combined with an implant for breast reconstruction, reduces the incidence of implant-related complications in previously irradiated breasts. METHODS:The authors reviewed 1000 consecutive cases of implant-based breast rec...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31817d6303
更新日期:2008-08-01 00:00:00