Abstract:
INTRODUCTION:Capsular contracture after breast reconstruction is a morbid complication, occurring in 30.0% to 47.5% of patients undergoing postoperative radiotherapy. Although it is well known that radiation increases rate of capsular contracture, there are few well-established animal models that faithfully replicate standard-of-care clinical practice, that is, prosthesis placement at the time of mastectomy followed by delayed radiotherapy. To better recapitulate current clinical practice, we developed a murine model in which the implant sites were irradiated 10 days postoperatively, rather than at time of surgery. METHODS:Hemispherical implants were created from polydimethylsiloxane and implanted bilaterally in the subcutaneous dorsa of 20 C57Bl/6 mice. Mice were randomized to 5 treatment groups, differing in irradiation dose: 0 to 40 Gy. Ten days postoperatively, irradiation was performed using 250-kVp x-rays (XRAD225Cx, Precision X-ray, North Branford, Conn). In 1 mouse per group, dosimeters were placed subcutaneously to measure the delivered absorbed dose. Thirty-one days postoperatively, the mice were sacrificed and examined grossly, and periprosthetic tissues were removed for histologic analysis of periprosthetic capsule thickness and cellular deposition. RESULTS:Total radiation dose was calculated by the treatment planning software and confirmed by the in vivo dosimeters. Physical examination of the irradiated region demonstrated evidence of local radiation delivery, including circular patterns of hair blanching and thinning directly over the implants. Furthermore, histologic analysis of the irradiated epidermis demonstrated dose-dependent radiation changes including keratin whorls and patches of uneven epidermal thickness. There was no statistically significant difference in capsule thickness among the groups. Mice in the 30 and 40 Gy groups endured complications including shortness of breath, coagulopathy, and death, signs of systemic radiation poisoning. CONCLUSIONS:There was no evidence of increased periprosthetic capsule thickness with localized irradiation, irrespective of dose up to 20 Gy. These results differ from those previously published, which demonstrated increased capsule thickness with 10 Gy irradiation. Given the evidence of local radiation delivery, we believe that the lack of increase in capsule thickness observed in our experiment is a real phenomenon and demonstrate the difficulty in creating an easily reproducible rodent model that mimics the effects of postmastectomy implant-based reconstruction and irradiation.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Lin AJ,Karinja SJ,Bernstein JL,Jin J,Toyoda Y,Miller AJ,Zanzonico PB,Spector JAdoi
10.1097/SAP.0000000000001362subject
Has Abstractpub_date
2018-04-01 00:00:00pages
S204-S210issue
4 Suppl 4eissn
0148-7043issn
1536-3708journal_volume
80pub_type
杂志文章abstract:BACKGROUND:Obstetric brachial plexus palsy is caused by traction during birth. Most patients regain useful function with spontaneous recovery. In some cases, cross reinnervation occurs between the biceps and triceps muscles. In these cases, smooth active motion of the elbow joint is impaired by simultaneous biceps and ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002075
更新日期:2019-10-01 00:00:00
abstract::Technically we can divide full-thickness thoracic reconstruction into 2 parts: providing a rigid support and ensuring well-vascularized coverage. Since 1986, the authors' center has had ample experience with bone banks and the use of cryopreserved bone grafts, which led them to consider the possibility of using these ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000099961.00590.9b
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Whether postoperative care in the intensive care unit (ICU) is a necessity for patients undergoing head and neck free flap reconstruction remains debatable. In August 2012, our institute initiated a policy to care for these patients in the ICU, opposed to the previous policy of care in the ward. Thus, we use...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001301
更新日期:2018-02-01 00:00:00
abstract::Proper treatment for injuries to the ulnar collateral ligament (UCL) of the metacarpophalangeal joint of the thumb relies on an accurate diagnosis of the pathology of the ligament. The current study evaluates the accuracy of ultrasonography to diagnose the specific pathology related to UCL injuries. The charts of 16 p...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200207000-00003
更新日期:2002-07-01 00:00:00
abstract::More than 16 years' experience with approximately 1,000 cases of Peyronie's disease and a review of 110 patients evaluated more than 1 year postoperatively are presented. Peyronie's disease is difficult to treat. There is no known etiological agent, and because occasional spontaneous disappearance of the lesion occurs...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198702000-00005
更新日期:1987-02-01 00:00:00
abstract::Infected femoral shaft fractures and femoral nonunions are difficult to manage. In the presence of associated segmental bony defects, limb length discrepancy, or complex deformities, Ilizarov techniques seem to be the ideal choice for management. We would like to describe small case series of 3 patients managed using ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3182a795f0
更新日期:2013-11-01 00:00:00
abstract::Subgalea-periosteal flaps were successfully used in a turnover pattern to reconstruct two scalp defects with exposed calvaria caused by tumor ablation. A copious vascular network of the subgaleal fascia in the base and its attached lateral territories provide adequate blood inflow for the turnover flap. The periosteum...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1993-03-01 00:00:00
abstract::Free flaps are increasingly being chosen to solve complex reconstruction problems. We describe a fascial sleeve approach to elevation of the donor flap which increases its safety and reliability. We report examples in which resultant revascularization of the recipient site causes the free flap to be irreplaceable for ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198212000-00006
更新日期:1982-12-01 00:00:00
abstract::A randomized, prospective, double-blind study designed to compare the effectiveness of the use of cloxacillin with the result of nontreatment in patients undergoing surgical intervention of axillary hyperhidrosis was conducted from August 1987 to October 1987 at the Veterans General Hospital, Taipei, Taiwan. Forty-two...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000637-198905000-00009
更新日期:1989-05-01 00:00:00
abstract::How and why aponeurotic blepharoptosis develops was investigated in terms of the relationship between the levator aponeurosis and Mueller's muscle functioning as the muscle spindle of the levator muscle. A total of 200 consecutive patients with moderate to severe acquired blepharoptosis completed questionnaires regard...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200101000-00006
更新日期:2001-01-01 00:00:00
abstract::Limited data of body image and quality of life are available after panniculectomy. Although it is generally considered a medically necessary procedure, we believe that the benefits of this procedure are many. The Short Form of The Situational Inventory of Body Image Dysphoria Short Form and the Multidimensional Body S...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31820b3af6
更新日期:2011-05-01 00:00:00
abstract::After extensive excision of skin cancer on the face, or when skin cancer is located on the 3-dimensional structures of the face, reconstruction with a local flap can be impossible, or clinicians are reluctant to reconstruct defects with a skin graft because of postoperative contraction, hyperpigmentation, or other com...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318209a77f
更新日期:2011-12-01 00:00:00
abstract::Currently, 50 cases of craniocarpotarsal dysplasia, or whistling face syndrome (WFS), have been reported, with more than 60 anatomical anomalies involving the head, hands, and feet, in addition to the face. In spite of the fact that there is much information concerning the surgical correction of many of these deformit...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Questions persist regarding the general applicability of the Furlow palatoplasty technique, and thus, widespread adoption of its use has been uneven. This study describes a consecutive, nonselective series of primary Furlow palatoplasties. Highlighted is the unique fact that plastic surgical residents functi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001261
更新日期:2018-04-01 00:00:00
abstract::Fourteen patients with erythematous and/or hypertrophic scars resulting from remote surgical excision or trauma were evaluated and subsequently treated with one to two flashlamp-pumped pulsed dye (585 nm) laser treatments over a 2-month period. Clinical assessments were performed before commencement and at the end of ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199402000-00015
更新日期:1994-02-01 00:00:00
abstract::Surgical correction of chronic mallet finger caused by terminal tendon disruption was carried out in 22 patients. The distal stump of the tendon was fixed to the base of the distal phalanx with a Mitek micro arc bone anchor. In all patients the mallet finger deformity was corrected. There were 15 patients with excelle...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000151464.03967.a2
更新日期:2005-04-01 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::The present article deals with the surgical experience of treating 72 patients for posttraumatic enophthalmos. Patients were divided into the following 4 groups with respect to the type of injury and the time of surgery: Group 1, recent midfacial injuries with orbital floor fractures; Group 2, recent blow-out fracture...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::Incomplete unilateral cleft lips show a wide range of deformities, ranging from microform to near-complete clefts. Because there are different amounts and qualities of tissue present on the cleft and non-cleft sides, surgical approaches should make distinctions based on the remnant tissue. A new procedure using an upp...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318295dceb
更新日期:2015-03-01 00:00:00
abstract::Melanoma excision requires wide margins, leaving large defects. Surgical dogma has taught that definitive reconstruction of melanoma defects be performed after permanent pathology results, with skin grafts favored. However, this results in an open wound and the need for a second operation. The advantages of immediate ...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SAP.0000000000000166
更新日期:2014-05-01 00:00:00
abstract::To evaluate the usefulness of nerve grafting we studied 38 patients having 11 median, 7 ulnar, and 33 digital nerve grafts. Group funicular (interfascicular) grafting using magnification was performed in all patients. We followed 12 patients with 8 median and 5 ulnar nerve grafts for at least one year and 18 patients ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198009000-00006
更新日期:1980-09-01 00:00:00
abstract::The ability to perform abdominal cosmetic surgery in the ambulatory setting provides a more comfortable environment for the patient, ease of scheduling for the physician, and decreased costs. Avoiding the use of general anesthesia allows for quicker recovery, shorter length of hospital stay, and decreased rate of post...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200105000-00005
更新日期:2001-05-01 00:00:00
abstract::Swallowing and communication are occasionally impaired after free jejunal transfer. Here, the relationship between surgical procedure and functional outcome was analyzed in 236 patients undergoing free jejunal transfer after total laryngopharyngectomy from 1992 through 2003. Swallowing and communication functions were...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31817439c5
更新日期:2009-01-01 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::Chronic, nonhealing wounds place an enormous burden on both the health care system and patients, with no definitive treatments available. There has been increasing evidence that the microbial composition of wounds may play an important role in wound healing. Culture-independent methods for bacterial detection and anal...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0000000000001450
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:It is generally believed that increasing obesity is a predictor of postoperative complications after abdominal contouring procedures such as abdominoplasty and panniculectomy. The purpose of this study is to review the complication rate for abdominal contouring in the level 3 obesity category (body mass inde...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3182012580
更新日期:2011-05-01 00:00:00
abstract::We have developed a method of intermaxillary fixation using beads and wires. This method was effective in mandibular fractures that underwent both open and closed reduction. Our procedure is simple, requires little time, and is inexpensive. We also found several advantages of our technique when compared with the class...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199706000-00011
更新日期:1997-06-01 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
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:OBJECTIVE:The aim of this study was to establish the anatomic basis for functional upper and lower lip reconstruction with locoregional flaps. DESIGN, SETTING, AND PARTICIPANTS:This article is an anatomic fresh cadaver study. RESULTS:For lower lip reconstruction, the modified Bernard-Webster and Karapandzic flaps pre...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001642
更新日期:2019-05-01 00:00:00