Abstract:
BACKGROUND:Implant-based breast reconstruction is commonly performed by plastic surgeons worldwide. Bacterial contamination is of paramount concern because of its role in biofilm formation and capsular contracture. Plastic surgeons have adopted a variety of perioperative interventions in efforts to reduce implant contamination; however, definitive evidence supporting these practices is lacking. OBJECTIVE:The goal of this study was to assess current practice patterns aimed at reducing implant-related infections. METHODS:A 20-question survey assessing practices aimed at preventing breast implant-associated infections was generated and distributed via SurveyMonkey to members of the American Society of Plastic Surgery whose e-mail addresses were listed on the American Society of Plastic Surgery member Web site in April 2015. RESULTS:A total of 1979 invitations to participate in the survey were sent, and 253 responses were received during the 4-month study period. Of respondents, 81% were in private practice. Respondents averaged 21 ± 9 years in practice, and 34 ± 50 implant-based breast reconstructions were performed per year. A majority of surgeons used chlorhexidine to prepare the surgical site (52%), a triple antibiotic soak for the implant prior to placement (50%) and povidone-iodine for implant pocket irrigation (44%). A no-touch technique utilizing the Keller funnel was adopted by 69% of surgeons. Regarding antibiotic use in the postoperative period, first-generation cephalosporins (eg, cephalexin, cefadroxil) were used by a majority of surgeons (84%), and the most common duration was until drain removal (45%). CONCLUSIONS:There is considerable heterogeneity in surgical practices aimed at preventing bacterial contamination in implant-based breast reconstruction. Surgeons may benefit from high-level studies designed to create standardized evidence-based practice guidelines.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Gowda AU,Chopra K,Brown EN,Slezak S,Rasko Ydoi
10.1097/SAP.0000000000000822subject
Has Abstractpub_date
2017-02-01 00:00:00pages
153-156issue
2eissn
0148-7043issn
1536-3708journal_volume
78pub_type
杂志文章abstract::Autogenous rib cartilage and silicone rubber are materials currently used for ear reconstruction. Increased morbidity and operative time with rib cartilage grafts and a high rate of extrusion with silicone implants render them less than ideal for reconstruction of the human ear. The purpose of the current investigatio...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199001000-00006
更新日期:1990-01-01 00:00:00
abstract::Lateral malleolus avulsion is uncommon, and fusion of the syndesmosis of the ankle joint is usually performed in such cases. Others have reported successful reconstruction of the lateral malleolus with a vascularized fibular head. A case of reconstruction in a 17-year-old girl, with a free scapular apophysis flap, is ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200109000-00018
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journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
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doi:10.1097/SAP.0b013e3182467f7b
更新日期:2012-02-01 00:00:00
abstract::Long vein loops derived from the major upper extremity superficial veins may be accessed for venous outflow in difficult cases of trunk, arm, or head and neck free tissue transfers when local possibilities have proved inadequate. This technique may negate the need for an interposition vein graft to a deep venous syste...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
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abstract::Positioning extremities after soft-tissue reconstructive procedures can be difficult, particularly when flaps or skin grafts have been placed for posterior or circumferential defects. We describe a method using the patient's existing external fixator, when present, to aid in the postoperative care and positioning of t...
journal_title:Annals of plastic surgery
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abstract::One important complication of tracheostomy procedure is the depressed scar left after the airway is removed. The problem is more challenging for the surgeon if tracheal tug accompanies. Six male patients with unaesthetic, depressed tracheostomy scars due to late removal of tracheostomy tubes after maxillofacial high-v...
journal_title:Annals of plastic surgery
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abstract::There have been numerous techniques and refinements for nipple-areola reconstruction described that have required the use of distant donor sites. A further modification of the skate flap is described, whereby the entire reconstruction can be performed on site, thus avoiding a second scar and any subsequent morbidity. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199203000-00014
更新日期:1992-03-01 00:00:00
abstract::The blood supply, venous drainage, and innervation of the lateral skin flap of the leg were studied in 52 fresh specimens by dissection, angiography, and selected injection of cutaneous arteries with india ink. This flap has a long vascular pedicle that contains the peroneal artery and vein and their branches. The dia...
journal_title:Annals of plastic surgery
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doi:10.1097/00000637-198510000-00007
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journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197909000-00009
更新日期:1979-09-01 00:00:00
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journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0b013e318053eb5e
更新日期:2008-02-01 00:00:00
abstract:INTRODUCTION:The peripheral adipose tissue is a vital component of many procedures in reconstructive and esthetic surgery. There is a limited knowledge on hemodynamic changes of adipose tissue. A direct intravital microscopic observation method is needed for the measurement of microcirculatory changes occurring in peri...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31814da751
更新日期:2008-06-01 00:00:00
abstract::The Asian breast reconstruction patient is usually of lower mean age, lower body mass index (BMI), and has relatively small breasts. This study aimed to investigate the outcome of 1-stage immediate breast reconstruction using saline-filled implants in the Asian patients.Between April 2002 and July 2005, 30 patients un...
journal_title:Annals of plastic surgery
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abstract::Giant omphalocele is a rare, large abdominal wall defect in which the intra-abdominal organs herniate through the umbilical cord and are covered by a sac. Surgical management of giant omphalocele is challenging, and optimal treatment remains controversial. Two generally accepted treatment options are staged closure an...
journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
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doi:10.1097/SAP.0b013e31820b3af6
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journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000250761.26824.4f
更新日期:2007-01-01 00:00:00
abstract:PURPOSE:This study aims to determine the relationship between race and ischemic complications in women undergoing breast reconstruction with pedicled TRAM (pTRAM) and perforator flaps (DIEP). PATIENTS AND METHODS:A retrospective, cross-sectional study of women who underwent breast reconstruction utilizing either pTRAM...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
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journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199102000-00006
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journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
pub_type: 杂志文章
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journal_title:Annals of plastic surgery
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更新日期:1994-05-01 00:00:00
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journal_title:Annals of plastic surgery
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journal_title:Annals of plastic surgery
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更新日期:1988-04-01 00:00:00
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journal_title:Annals of plastic surgery
pub_type: 杂志文章
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更新日期:1992-09-01 00:00:00