Abstract:
INTRODUCTION:Sentinel lymph node biopsy (SLNB) and lymphadenectomy (LAD) are commonly performed in the staging and care of patients with malignant melanoma. These procedures are accompanied by complications that may result in hospital readmission, negatively affecting patient outcomes and potentially affecting surgical procedure reimbursement. The National Surgical Quality Improvement Program (NSQIP) database offers a large data set allowing physicians to evaluate 30-day readmission for surgical complications. We used this database to explore predictors of 30-day hospital readmission for SLNB and LAD in the axillary, cervical, and inguinal regions. METHODS:Data from the years 2005 to 2014 of the American College of Surgeons NSQIP database were used. Cohorts were constructed according to International Classification of Diseases, Ninth Revision, classification and current procedural terminology codes. The outcome of 30-day return to hospital was defined as patients who were readmitted to the hospital or the operating room within 30 days. Multiple logistic regression results are presented for a prespecified set of predictors and predictors that were significant on univariate logistic regression analysis. Odds ratios and confidence intervals were calculated using maximum likelihood estimates, along with Wald test P values. RESULTS:A total of 3006 patients were included. Of those, 151 (5.0%) returned to the hospital. Among 1235 LAD patients, 65 (5.3%) returned; among 1771 SLNB patients, 86 (4.9%) returned. Smoking was a predictor of hospital readmission for overall SLNB and for cervical SLNB on multivariate analysis. Age was a significant predictor for cervical and inguinal LAD. Hypertension was significant for cervical LAD. Diabetes, preoperative hematocrit, and male sex were predictors for inguinal SLNB. There were no significant predictors for axillary SLNB and axillary LAD, as well as overall LAD procedures. CONCLUSIONS:This is the first and largest study using American College of Surgeons NSQIP to examine 30-day readmission after SLNB and LAD for melanoma in 3 commonly operated anatomical regions. We have found several significant risk factors associated with hospital readmission, which are now being used as a quality measure for hospital performance and reimbursement, that may help surgeons optimize patient selection for SLNB and LAD.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Ascha M,Ascha MS,Gastman Bdoi
10.1097/SAP.0000000000001152subject
Has Abstractpub_date
2017-11-01 00:00:00pages
509-515issue
5eissn
0148-7043issn
1536-3708journal_volume
79pub_type
杂志文章abstract:BACKGROUND:Oncologic defects resulting from extremity amputations are often extensive and require substantial soft tissue for reconstruction. METHODS:A review of all patients, who underwent an external hemipelvectomy, forequarter amputation, or hindquarter amputation from 2001 to 2010 at the MD Anderson Cancer Center,...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318232b096
更新日期:2012-05-01 00:00:00
abstract::A rare case of congenital midline sinus of the upper lip is presented. The patient had recurrent cellulitis with swelling at the base of the medial crus of the right lower lateral cartilage. Excision was performed using the intraoral approach. Theories concerning the etiology of the midline sinus of the upper lip are ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200044010-00013
更新日期:2000-01-01 00:00:00
abstract:UNLABELLED:Due to the importance of hand functions, fingertip injuries should be reconstructed by flap coverage. Although reverse homodigital island flap is an option that is widely used, the classical homodigital flap, which includes a skin graft for the donor site, leads to many donor-site problems such as maceration...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000137
更新日期:2015-08-01 00:00:00
abstract::The structural and circulatory dynamics of expanded skin in connection with expander fillings were assessed in pigs following 7, 14, and 21 days of expansion by measuring the pressure of te fluid in the expander (Pexp) and the dermal blood flow. The results differed consistently on thoracic and abdominal sites. It was...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198808000-00007
更新日期:1988-08-01 00:00:00
abstract::Several experimental studies have demonstrated that granulocytes have an important role in causing the necrosis of ischemic tissue by capillary plugging and superoxide radical formation. Adenosine is spontaneously released by ischemic cells and inhibits the granulocytic superoxide radical formation. 5-Aminoimidazole-4...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199106000-00008
更新日期:1991-06-01 00:00:00
abstract::Definitive repair of recurrent ventral hernias using abdominal wall reconstruction techniques is an essential tool in the armentarium for general and plastic surgeons. Despite the great morbidity associated with incisional hernia, no consensus exists on the best means for treatment (Korenkov et al, Langenbecks Arch Su...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181dc8409
更新日期:2010-05-01 00:00:00
abstract::There is still controversy about the correlation of thrombocytosis and thrombosis complication. Using a rodent splenectomy-induced thrombocytosis model and a thrombogenic endothelial damage model (inverted suture resulting in an intraluminal thrombogenic adventitia of divided femoral artery), the authors investigated ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200301000-00010
更新日期:2003-01-01 00:00:00
abstract::We investigated three sheathing materials (autogenous vein, silastic, and polyglycolic acid fine mesh) using the rat model. Forty rats were divided into five groups of eight animals each. Group A animals underwent transection of the sciatic nerve but had no repair. In Group B, a standard epineural repair was performed...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199509000-00008
更新日期:1995-09-01 00:00:00
abstract::The two major surgical methods for improving the midface and its profile of Binder's syndrome (commonly referred to as "dish face" deformity of "C-shape" deformity) are bone or cartilage graft and osteotomy. The bone or cartilage graft limited to the nasal sill area is ineffective in changing the flatness of the paran...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199602000-00020
更新日期:1996-02-01 00:00:00
abstract::This paper presents 4 consecutive cases using negative-pressure dressings (VAC) to bolster skin grafts in male genital reconstruction. In this series reconstruction followed 1 case of tumor ablation and 3 cases of debridement of abscesses or Fornier's gangrene. The VAC was applied circumferentially to the penis to sec...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000143606.39693.3f
更新日期:2005-02-01 00:00:00
abstract::A patient with multiple keratoacanthomas association with a well-differentiated squamous cell carcinoma is presented. Incomplete excision of a keratoacanthoma deprives the pathologist of his main criteria in differentiating this lesion from a squamous cell carcinoma. Wide excision appears to be the treatment of choic...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197908000-00015
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:Component separation techniques (CSTs) have allowed for midline fascial reapproximation in large midline ventral hernias. In certain cases, however, fascial apposition is not feasible, resulting in a bridged repair that is suboptimal. Previous estimates on myofascial advancement are based on hernia location ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3182773915
更新日期:2013-09-01 00:00:00
abstract::The purpose of this pilot study was to compare proliferation, collagen synthesis, and growth factor production, which are important contributing factors for wound healing, of the bone marrow stromal cells (BSCs) with those of dermal fibroblasts in vitro. Cultured human BSCs and dermal fibroblasts from the same patient...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000178809.01289.10
更新日期:2005-10-01 00:00:00
abstract:PURPOSE:We had reported the surgical outcome of reverse skin redraping technique for restoration of previously performed epicanthoplasty. In this study, we introduce a modified reverse skin redraping technique that added mini-epicanthoplasty in patients with unsatisfactory results after epicanthoplasty. METHODS:Three ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000991
更新日期:2017-06-01 00:00:00
abstract::Upper airway obstruction after superiorly based pharyngeal flap procedures for the treatment of velopharyngeal insufficiency is described in this series of 32 flaps performed in 29 patients at our institution between 1979 and 1993. A high incidence of upper airway obstruction symptoms (38%) occurred in the early posto...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199601000-00006
更新日期:1996-01-01 00:00:00
abstract::Although microsurgery has rapid expanded, problems related to microarterial anastomosis continue. Cigarette smoking is one of the major risks for anastomosis by increasing platelet adhesion, and its effects on endothelial cells. Aim of this article is to study the negative effects of cigarettes on microarterial anasto...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181b404fa
更新日期:2010-07-01 00:00:00
abstract:PURPOSE:The cholinergic anti-inflammatory pathway may play an important role in early burn edema. Therefore, we evaluated the influence of cdp-choline on early systemic burn edema and leukocyte activation in shock in rat mesenteries after burn plasma transfer. METHODS:Burn plasma harvested from donor rats 4 hours afte...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000605
更新日期:2015-10-01 00:00:00
abstract::Cleidocranial dysplasia (CCD) is a rare hereditary disorder characterized by skeletal malformations and dental abnormalities. Mutations of the transcription factor RUNX2 are responsible for the pathogenesis of CCD. We present a case of a 10-year-old boy with CCD, presenting with hypoplastic clavicles, delayed closure ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0000000000001827
更新日期:2019-07-01 00:00:00
abstract:PURPOSE:An increase in bariatric surgery has led to a rise in postbariatric contouring procedures. Despite a comprehensive preoperative assessment, body habitus in these patients may significantly limit the abdominal exam. Abdominal contouring procedures typically elevate large portions of the skin and fat off the abdo...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001546
更新日期:2018-11-01 00:00:00
abstract::We report 2 cases of patients with thumb polydactyly that were difficult to classify into either Wassel type VI with a remarkable hypoplastic metacarpal or Wassel type VII (triphalangeal thumb). The radial digit was functional but hypoplastic, and the ulnar digit presented a dominant appearance but no active motion. T...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31821b6ced
更新日期:2013-01-01 00:00:00
abstract::The clavicular myocutaneous island flap, with circulation provided by the platysma and superficial cervical fascia, was first performed by Paul Tessier in 1970, taking his motivation from the prior experience of John Barron with subcutaneous island flaps. A manuscript written by Dr. Tessier on his experience of 120 ca...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0b013e3182183652
更新日期:2011-12-01 00:00:00
abstract::Whether operating on soft tissue, bony tissue, or both, as in major craniofacial procedures, patient safety is enhanced by better understanding of the anatomical details of the orbit. The myth and mystery of the optic nerve is made clear here, especially by our magnification techniques. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198004000-00001
更新日期:1980-04-01 00:00:00
abstract::A bayonet-shaped airway allowing free respiration and undisturbed deglutition was reconstructed in 2 young women who had undergone tracheotomy and radiotherapy for thyroid carcinoma. The laryngeal vestibule, glottis, and subglottis had been destroyed, and the air passages were closed. An external gutter and an anterio...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198605000-00010
更新日期:1986-05-01 00:00:00
abstract::During the Homeland War in Croatia, many civilians suffered from war wounds of the extremities. Explosive war wounds create composite and devastating injuries mainly by high-energy transfer to the tissue. We present an early reconstruction of explosive heel wound with an iliac osteocutaneous free flap with late follow...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000099704.02280.d6
更新日期:2004-08-01 00:00:00
abstract::The branches of the medial antebrachial cutaneous nerve (MACN) are located at the medial site of the elbow. The MACN, especially the posterior branches, may be injured or transected during cubital tunnel surgery or other medial approaches to the elbow. Damage to the nerve can cause a neuroma, which leads to disabling ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200202000-00007
更新日期:2002-02-01 00:00:00
abstract:INTRODUCTION:The traditions of surgical education have changed little over the years. However, the increasing focus on patient safety and duty hour restrictions mandates that residents start developing complex skill sets earlier to ensure they graduate with procedural competency. Surgical training is poised to exploit ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002265
更新日期:2021-02-01 00:00:00
abstract::A 66-year-old woman with an abdominal wound caused by infected synthetic mesh had failed to heal in spite of many surgical attempts to close the wound. A sealed transparent vinyl chamber was glued to the periphery of the wound and antibiotics in high concentrations (up to 2,500 times the minimum inhibitory concentrati...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199601000-00016
更新日期:1996-01-01 00:00:00
abstract::Metacarpal fractures are a relatively common hand injury that may require operative intervention to ensure adequate reduction and stabilization. The use of permanent hardware, although acceptable, may lead to complications and an increased number of surgical procedures. The use of resorbable hardware such as poly-L-la...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200208000-00015
更新日期:2002-08-01 00:00:00
abstract::Simultaneous breast augmentation and abdominoplasty through a transverse suprapubic incision offers women the opportunity to undergo body restoration with one operation, one anestheitc, one incision, and no scars on or near the breasts. Prompted by the earlier work of Planas [5] and others, we have performed this comb...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198004000-00004
更新日期:1980-04-01 00:00:00
abstract:INTRODUCTION:The reconstruction of the postburn contracture area is always a challenge in the field of plastic surgery. Moreover, the joints are very sensitive to trauma and immobilization, showing a susceptibility to stiffness. The aim of this article is to emphasize the use of "Namaste flap"-modification of subcutane...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002076
更新日期:2019-12-01 00:00:00