Abstract:
BACKGROUND:Computed tomographic angiography is a diagnostic tool increasingly used for preoperative vascular mapping in abdomen-based perforator flap breast reconstruction. This study compared the use of computed tomographic angiography and the conventional practice of Doppler ultrasonography only in postmastectomy reconstruction using a cost-utility model. METHODS:Following a comprehensive literature review, a decision analytic model was created using the three most clinically relevant health outcomes in free autologous breast reconstruction with computed tomographic angiography versus Doppler ultrasonography only. Cost and utility estimates for each health outcome were used to derive the quality-adjusted life-years and incremental cost-utility ratio. One-way sensitivity analysis was performed to scrutinize the robustness of the authors' results. RESULTS:Six studies and 782 patients were identified. Cost-utility analysis revealed a baseline cost savings of $3179, a gain in quality-adjusted life-years of 0.25. This yielded an incremental cost-utility ratio of -$12,716, implying a dominant choice favoring preoperative computed tomographic angiography. Sensitivity analysis revealed that computed tomographic angiography was costlier when the operative time difference between the two techniques was less than 21.3 minutes. However, the clinical advantage of computed tomographic angiography over Doppler ultrasonography only showed that computed tomographic angiography would still remain the cost-effective option even if it offered no additional operating time advantage. CONCLUSIONS:The authors' results show that computed tomographic angiography is a cost-effective technology for identifying lower abdominal perforators for autologous breast reconstruction. Although the perfect study would be a randomized controlled trial of the two approaches with true cost accrual, the authors' results represent the best available evidence.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Offodile AC 2nd,Chatterjee A,Vallejo S,Fisher CS,Tchou JC,Guo Ldoi
10.1097/PRS.0000000000001133subject
Has Abstractpub_date
2015-04-01 00:00:00pages
662e-669eissue
4eissn
0032-1052issn
1529-4242pii
00006534-201504000-00002journal_volume
135pub_type
杂志文章,评审abstract::Although it is one of the most commonly occurring craniofacial congenital disabilities, craniosynostosis (the premature fusion of cranial sutures) is nearly impossible to prevent because the molecular mechanisms that regulate the process of cranial suture fusion remain largely unknown. Recent studies have implicated t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract:UNLABELLED:Hidradenitis suppurativa is a chronic, recurrent inflammatory disease of the skin characterized by abscesses and scars. The axillary region is predominantly affected, leading to limited mobility of the arm due to scar retraction. This prospective study aimed to analyze the surgical treatment of severe lesion...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182268c38
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Previous studies assessing outcomes following orthognathic surgery rely primarily on single-center/surgeon experience. In addition to issues of generalizability, these studies are limited in evaluating the effect of operative volume on patient outcomes. METHODS:Orthognathic procedures were identified in the...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/PRS.0000000000002384
更新日期:2016-08-01 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:BACKGROUND:The ptotic breast is surgically rejuvenated through a mastopexy procedure. Recurrent ptosis or other negative changes to the breast shape are not uncommon following mastopexy, as the tissue laxity and skin quality that contributed to ptosis are not surgically corrected. The purpose of this study was to asses...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/PRS.0000000000002922
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Severe orbital soft-tissue loss and contracted eye sockets often present in patients who have had enucleation, exenteration, or other ocular diseases. In this article, the authors report a novel contracted eye socket reconstruction technique using lateral upper arm free flaps and review the surgical outcome ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000133
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Although most craniosynostoses can be determined by pattern recognition, some patients defy phenotypic diagnosis and require computed tomography to determine sutural fusions. METHODS:The authors' craniofacial database was reviewed for patients treated for craniosynostosis between 1989 and 2007. Children wit...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31817f45f0
更新日期:2008-09-01 00:00:00
abstract::The use of diced cartilage grafts in rhinoplasty surgery was recently revived by Erol with the publication of his technique for "Turkish delight" grafts (i.e., diced cartilage grafts wrapped in Surgicel). The present study details the authors' experience with 50 consecutive diced cartilage grafts used in three configu...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000122544.87086.b9
更新日期:2004-06-01 00:00:00
abstract::We present 30 cases of ankylosis of the lower jaw following cancrum oris. The clinical and radiological findings, the anesthetic methods, and the surgical management are described. Adequate excision of limiting scar and any bony ankylosis, with immediate mucosal or skin coverage of any raw surfaces created, is the pro...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197603000-00011
更新日期:1976-03-01 00:00:00
abstract:BACKGROUND:Elective surgical management of neonatal brachial plexus palsy is complex, variable, and often individualized. Little is known about the medical decision-making process among adolescents with neonatal brachial plexus palsy and their families when faced with making complex treatment decisions. The experiences...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31828bd52b
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Narcotic pain medications are a significant component of most postoperative pain control regimens. Although they are usually effective, they produce several untoward side effects and sometimes provide inadequate analgesia. The continuous infusion of local anesthetic agents (via pain pump) has been used to su...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.prs.0000299372.91051.1b
更新日期:2008-03-01 00:00:00
abstract::Thoracoabdominal ectopia cordis is a congenital malposition of the heart and abdominal viscera, which are externally situated, carrying an extremely poor prognosis. We report a case of a complete thoracoabdominal ectopia cordis that had undergone successful coverage over the exposed heart and abdominal contents. A few...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199501000-00026
更新日期:1995-01-01 00:00:00
abstract::The purpose of this article is to introduce plastic surgeons to a theory of adult education. Most surgeons have been hired by their parent institution because of their clinical skills, and rightly so. At the same time, these same surgeons choose or are expected to be involved to varying degrees in the surgical educati...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318252f19d
更新日期:2012-05-01 00:00:00
abstract::Free submandibular salivary gland transfer was investigated as a surgical method for the treatment of severe keratoconjunctivitis sicca. In an animal model, we examined the tolerance of warm ischemia of the submandibular gland. After temporary interruption of the blood supply (1 to 6 hours), the morphologic changes in...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:Abdominal donor-site flaps, including the transverse rectus abdominis musculocutaneous (TRAM) and deep inferior epigastric artery (DIEA) perforator flaps, are standard in autologous breast reconstruction. With significant variation in the vascular anatomy of the abdominal wall, preoperative imaging is essent...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000293874.71269.c9
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The most commonly used technique in the treatment of contracture bands is Z-plasty. The subcutaneous pedicle rhomboid flap is a relatively new flap whose efficiency in the treatment of wide or linear contractures with two or more contracture bands has been demonstrated. This experimental study was planned to...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000197212.84348.db
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Lipofilling is a treatment modality to restore tissue volume, but it may also rejuvenate the aging skin. Platelet-rich plasma has been reported to augment the efficacy of lipofilling, both on graft take and rejuvenation, by altering the adipose-derived stem cells. The authors hypothesized that addition of pl...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/PRS.0000000000004081
更新日期:2018-02-01 00:00:00
abstract::A conchal floor composite flap pedicled by skin of the helical crus has been well described in the literature. Here the flap is elevated based on the supply by an upper auricular branch of the superficial temporal artery. In this article, a newly defined conchal floor arterial flap is proposed. The flap is based on th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200207000-00010
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Outcomes for a continuously applied alveolar bone grafting protocol, established in 1982, are reported and compared to previously published outcomes from the authors' unit and elsewhere. METHODS:A descriptive, retrospective cohort study of alveolar bone grafting outcomes at a tertiary referral cleft center ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006494
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:The cephalic index is often used to evaluate sagittal craniosynostosis corrections; however, validation of this measure remains untested. METHODS:A three-part study was designed to (1) determine the normal distribution of cephalic indices in untreated sagittal craniosynostosis; (2) examine index values in t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003422
更新日期:2017-07-01 00:00:00
abstract::A case of removal of a large compound nevus of the leg by serial excision is reported. Failure to perform the initial excision entirely intralesionally led to the appearance of pigmentary deposits within normal skin. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198012000-00008
更新日期:1980-12-01 00:00:00
abstract::To evaluate the practice patterns of general and plastic surgeons regarding patients with early-stage breast cancer, all general and plastic surgeons in Quebec and Maryland were mailed self-administered questionnaires evaluating surgeon demographics, practice patterns, treatment preferences, and satisfaction with the ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200003000-00013
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Large congenital neoplasms of the extremities may be associated with coagulopathies and significant hemorrhage in the neonatal period. At times, the differences between coagulation derangements can be very subtle, leading to errors in diagnosis. Infants with vascular lesions and coagulopathies are often foun...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000206314.29607.2b
更新日期:2006-04-15 00:00:00
abstract::Previous investigations have demonstrated the superior strength and toughness of the MGH four-strand tendon repair technique and shown that it neither weakens during maximum tendon softening nor interferes with healing in an in vivo rabbit model. In the current study, the biomechanical performance of the modified Beck...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:Limited follow-up data on aesthetic outcome and survival after microsurgical reconstruction of complex scalp and forehead defects are available. These data are important to improve reconstruction quality and patient counseling. The purpose of this study was to evaluate surgical, aesthetic, and oncologic outc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181de2260
更新日期:2010-08-01 00:00:00
abstract::Arterial and venous anatomy and their relation to the anterolateral thigh flap were examined in 10 specimens of six fresh cadavers in which radiopaque materials were injected into both the arterial and venous systems. Territories and positions of individual perforating arteries were measured, and the venous drainage p...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000135332.97062.7f
更新日期:2004-10-01 00:00:00
abstract::Controversy exists in the literature regarding reconstruction of the radial artery after elevation of the radial forearm flap. The literature suggests that reconstructing the radial artery with a vein graft is an important aspect in the use of this flap. In our experience, this has never been performed with no sequela...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-04-01 00:00:00
abstract::The free anterolateral thigh flap is becoming one of the most preferred options for soft-tissue reconstruction. Between June of 1996 and August of 2000, 672 anterolateral thigh flaps were used in 660 patients at Chang Gung Memorial Hospital. Four hundred eighty-four anterolateral thigh flaps were used for head and nec...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200206000-00007
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Keloids and hypertrophic scars are the result of abnormal healing responses and dermal tissue proliferation; current surgical procedures can give rise to exuberant scarring and permanent functional loss or disfigurement. Considering the promising results reported when treating keloids and hypertrophic scars ...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/PRS.0b013e3182a053c8
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:The purpose of the present study was to determine the locations of the infraorbital foramen and mental foramen based on soft-tissue landmarks to facilitate prediction of the locations of these structures during facial surgery. METHODS:Fifty embalmed cadavers (100 sides) of Koreans were dissected to expose t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000279558.86727.5a
更新日期:2007-10-01 00:00:00