Abstract:
PURPOSE:Combined ventral hernia repair and panniculectomy (VHR/PAN) is controversial, and the safety profile including anticipated complications has been questioned. We present a retrospective case series review of patients from the University of Maryland Medical Center to help surgeons counsel patients on the risks and benefits of this procedure. METHODS:A retrospective database was collected using current procedural terminology codes for VHR/PAN. The patient-specific variables that were studied include the following: sex, body mass index (BMI), smoking, diabetes, chronic obstructive pulmonary disease, cirrhosis, immunosuppression, length of operation, acute incarcerated hernias, hernia size and location, mesh size and location, pannus weight, concomitant component separation, use of negative-pressure wound therapy, intestinal violation, follow-up duration, ventral hernia working group, history of bariatric surgery, previous hernia repair, skin dehiscence, skin necrosis, chronic wound, surgical site infection, seroma, hematoma, fascial dehiscence, hernia recurrence, unplanned return to operating room, and medical complication. Both univariate and multivariate analyses were performed to determine which factors affected the complication outcomes. RESULTS:There were 106 patients with an average age and BMI of 53 years and 39, respectively. Fifty-eight patients (54.72%) had at least 1 surgical site occurrence. Twenty-three patients (21.70%) had at least 1 repair failure. Twenty-eight patients (26.42%) had an unplanned trip back to the operating room. Seventeen patients (16.04%) had at least 1 medical complication. CONCLUSIONS:The risk factors associated with developing complications are higher BMI, longer operating time, larger mesh size, larger hernia size, component separation, use of biologic mesh, chronic obstructive pulmonary disease, and intestinal violation. The use of negative-pressure wound therapy decreased complication rates, and patients with a previous hernia repair seemed to benefit the most from having a combined VHR/PAN. However, when compared with previous reports of VHR alone, VHR/PAN does seem to increase wound complications and reoperation rates.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
McNichols CHL,Diaconu S,Liang Y,Ikheloa E,Kumar S,Kumar S,Nam A,Rasko Ydoi
10.1097/SAP.0000000000001277subject
Has Abstractpub_date
2018-04-01 00:00:00pages
391-394issue
4eissn
0148-7043issn
1536-3708journal_volume
80pub_type
杂志文章abstract:INTRODUCTION:Breast implant selection is multifactorial and must assess risk profiles of the implants. Textured implants are available in an anatomically shaped form and are thought to have lower rates of capsular contracture. However, evidence is mounting that they carry a significantly higher risk of breast implant a...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001880
更新日期:2019-04-01 00:00:00
abstract::The authors demonstrate successful cases of stepladder dorsal metacarpal V-Y advancement and rotation-advancement flaps for reconstructing defects on the dorsum of the finger and hand. One side of the flap is designed in a multilobed shape, and each lobed flap is designed on the dorsum of adjacent fingers. These flaps...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200201000-00007
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Chest wall reconstruction after radiation damage is a challenge in oncologic and plastic surgery. The defect can be reconstructed with laparoscopically harvested omental flap and meshed skin grafts. Our aim was to evaluate the use of vacuum-assisted closure (V.A.C.) in combination with laparoscopically harve...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000237644.29878.0f
更新日期:2007-02-01 00:00:00
abstract::A prospective study of anatomic variations of the median nerve and its relationship to the surrounding structures was performed of 354 consecutive operations in 192 patients with carpal tunnel syndrome at Korea University Anam Hospital from July 1995 to September 1997. A total of 184 patients were women and 8 patients...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200044030-00006
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Various pedicle techniques have been described in breast reduction surgery. However, in cases of massive hypertrophy, the free nipple graft technique is still being performed by some surgeons out of fear of losing the nipple-areolar complex (NAC). As such, we evaluated patients with severe gigantomastia who ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000388
更新日期:2016-04-01 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::Functional disorders due to alar valve collapse and cosmetic unsatisfactory results can be seen after rhinoplasty operation in some patients. Because of overresection of the upper and lower lateral cartilages, nasal lateral walls may collapse during inspiration pressing against the septum and obstructing airway. On th...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181344453
更新日期:2008-06-01 00:00:00
abstract::Intraosseous ganglia are occasionally found affecting the carpal bones of the hand and should be considered in the differential diagnosis of chronic wrist pain. They have characteristic radiographic findings of a cyst with a thin sclerotic rim. This case report illustrates an unusual presentation of a cyst in the luna...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200204000-00018
更新日期:2002-04-01 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: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...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001152
更新日期:2017-11-01 00:00:00
abstract::Traditional gastrocnemius flap harvest requires a long skin incision, starting from the popliteal fossa to the mid leg. The authors designed three instruments to facilitate harvest of this flap through a small incision without the help of an endoscope in 10 patients. All 10 gastrocnemius muscle flaps survived with a 1...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200108000-00005
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Posttraumatic midface pain secondary to injury of the anterior superior alveolar nerve (ASAN) is characterized as pain localized to the central and lateral incisors, canines, and maxilla. This nerve is susceptible to injury and subsequent formation of neuromas after midface trauma. Surgical intervention requ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000335
更新日期:2015-11-01 00:00:00
abstract:INTRODUCTION:Transcatheter arterial embolization (TAE) has gained importance in the management of maxillofacial fractures with life-threating hemorrhage (MFH). However, clinical evidence supporting the use of TAE has not been clearly established in the literature. Therefore, we evaluated the effectiveness of TAE for MF...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001405
更新日期:2018-06-01 00:00:00
abstract::A new method of lower lip reconstruction using a full-thickness cheek island flap based on the facial vessels is described. The functional potential of the method is assessed in six patients. The technique outlined is simple in design and execution. It is capable of total lower lip reconstruction without appreciable m...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198301000-00002
更新日期:1983-01-01 00:00:00
abstract::Pigmented lesions of the nail bed, especially without a history of trauma, represent a diagnostic challenge to the clinician. These lesions are often categorized as melanonychia striata (MS), which refers to any linear tan-brown-black pigmentation of the nail bed. The differential diagnosis of MS includes subungual he...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199608000-00002
更新日期:1996-08-01 00:00:00
abstract::Norian CRS, Bone Cement (Synthes CMF), and Mimix (Lorenz) have been used to reconstruct large cranio-orbital defects in 85 patients. Resorbable mesh (Macropore), used in combination in selected patients, obviates dura pulsations that have been postulated to cause fragmentation of alloplastic material. Norian is compos...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000168157.10664.9c
更新日期:2005-07-01 00:00:00
abstract:PURPOSE:Patients with necrotizing fasciitis are managed with multiple prompt, radical surgical debridements and critical care support. Debridement and reconstruction are often provided by different surgical teams. Anecdotally, single-specialty management seemed to be a more efficient management strategy. This study aim...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000173
更新日期:2014-05-01 00:00:00
abstract::Chain saws may produce devastating facial injuries when the blade kicks back after striking a hard object. A review of experience with 12 male patients indicates that in addition to extensive ragged lacerations of skin and soft tissues, bone and teeth are frequently fractured. Eye injuries are rare, but the eyelids ma...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198602000-00001
更新日期:1986-02-01 00:00:00
abstract:INTRODUCTION:Common upper body findings after massive weight loss (MWL) include breast ptosis, projection loss, flattening, inframammary fold descent, and back rolls. Although implants address volume loss, manifestations of circumferential excess (ie, back rolls) are ignored. We review our experience with extended late...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000413
更新日期:2015-05-01 00:00:00
abstract::The suppression of elements associated with wound contracture and unfavorable scarring is a potentially important strategy in clinical wound management. In this study, the presence of α smooth muscle actin (αSMA), a protein involved in wound contraction, was analyzed in a series of wounds in which bovine fetal collage...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000449
更新日期:2015-06-01 00:00:00
abstract::The purpose of this study was to determine whether remote ischemic preconditioning can be induced by a late mechanism. The rat cremaster flap model was used for assessment of ischemia-reperfusion injury. In the control group (N = 9), 2 hours of flap ischemia was induced after preparation of the cremaster muscle. Ten m...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000054186.10681.E2
更新日期:2003-07-01 00:00:00
abstract::Congenital segmental amputations are difficult to correct. Free interposition bone grafts with growth centers were tried experimentally by many investigators even at the beginning of this century. Attempts at clinical application of this principle, however, were mostly failures. More recently, with the advent of micro...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199210000-00010
更新日期:1992-10-01 00:00:00
abstract::Extra-articular crystalline deposition secondary to gout, and less commonly, pseudogout is a well known phenomenon. Despite this well-documented entity of extra-articular deposition, there have been few reports of infiltration of the flexor tendon sheath of the hand. Here, we present a case series of this unique occur...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181788e98
更新日期:2009-02-01 00:00:00
abstract::Possessing viscous and elastic rheological properties, skin is viscoelastic. Mechanical creep, defined as the elongation of skin with a constant load over time beyond intrinsic extensibility, has been described as the vehicle harnessed for wound closure with presuturing, intraoperative tissue expansion, skin-stretchin...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-199808000-00019
更新日期:1998-08-01 00:00:00
abstract:PURPOSE:This study aims to review the incidence and outcomes for children with superficial spreading melanomas (SSM) using population-based data. METHODS:The Surveillance, Epidemiology, and End Results database (1974-2009) was analyzed for all patients less than 20 years of age diagnosed with SSM. RESULTS:Overall, 72...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000141
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:The surgical management of craniofacial fibrous dysplasia is controversial. The purpose of this study was to report the surgical outcomes of individualized management of craniofacial fibrous dysplasia of a single institution. METHODS:Data from patients (n = 20) with craniofacial fibrous dysplasia, who were ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000640
更新日期:2016-08-01 00:00:00
abstract::The Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) procedure entails performing a lymphovenous bypass (LVB) at the time of axillary lymph node dissection to reduce lymphedema risk. The two most common fluorophores utilized in LVB are blue dye and indocyanine green. We developed a novel application of flu...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001034
更新日期:2017-06-01 00:00:00
abstract::Chronic wounds have been defined as those that do not follow the orderly manner of healing, and thus do not achieve closure. Such wounds are notoriously difficult to treat and the number of treatments around attest to the fact that management of chronic wounds is not possible with one agent and definitely never achiev...
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::The history of the artificial eye, from antiquity to the present, is described. Around the beginning of the nineteenth century, glass eyes replaced the earlier metal ones--not always well tolerated. In 1835, cryolite glass was used instead of lead glass; to this day it remains the lightest and most desirable substance...
journal_title:Annals of plastic surgery
pub_type: 历史文章,杂志文章
doi:10.1097/00000637-197908000-00014
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:In addition to the already-known postoperative complications in patients formerly obese, for medial thigh lift, there are many more problematic issues. The main ones are represented as follows: by the frequent downward displacement of the scars that become, in this way, extremely visible; by the distortion o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000075
更新日期:2015-09-01 00:00:00