Abstract:
BACKGROUND:Unplanned surgical readmissions represent a benchmark outcome and pose a considerable cost burden for health care systems. The authors evaluated risk factors associated with readmission following pediatric plastic surgery using a prospective, validated, national database. METHODS:Patients younger than 18 years who underwent primary pediatric plastic surgery procedures were identified from the 2013 pediatric American College of Surgeons National Surgical Quality Improvement Program database.Two cohorts were compared: patients who experienced readmission and those who did not. Patient characteristics, comorbidities, intraoperative details,and 30-day postoperative outcomes, including complications and readmissions,were analyzed. Multivariate logistic regression analysis was used to identify factors associated with readmission. RESULTS:A total of 5376 patients were included, for an overall 2.40 percent readmission rate. The study cohort was, on average, 5.47 ± 5.21 years old,51.60 percent (n = 2774) were male, and 65.92 percent of cases (n = 3544)were outpatient procedures. The average number of relative value units per case was 10.15 ± 8.01. Patients with medical comorbidities (p < 0.001) and those with a preoperatively contaminated or infected wound were at higher risk for readmission (p < 0.001). Patients with higher American Society of Anesthesiologists scores (p < 0.001), longer operative times (p < 0.001), and longer hospitalizations (p < 0.0171) were also independently at greater risk for readmission. The most significant independent predictors of readmission were postoperative surgical and medical complications (OR, 6.94 and 11.92,respectively; p < 0.001). CONCLUSION:These results help target patients at greater risk for readmission and afford an opportunity to provide evidence-based interventions to mitigate risk and minimize cost burden for health care systems. (Plast. Reconstr. Surg.135: 521, 2015.) CLINICAL QUESTION/LEVEL OF EVIDENCE:Risk, III.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Tahiri Y,Fischer JP,Wink JD,Paine KM,Paliga JT,Bartlett SP,Taylor JAdoi
10.1097/PRS.0000000000000889subject
Has Abstractpub_date
2015-02-01 00:00:00pages
521-529issue
2eissn
0032-1052issn
1529-4242pii
00006534-201502000-00037journal_volume
135pub_type
杂志文章,评审abstract:BACKGROUND:Periprosthetic infections represent major complications in breast reconstruction, frequently leading to expander-implant loss. No consensus regarding a management algorithm for attempted salvage currently exists. This study assessed outcomes of the authors' salvage protocol using an antibiotic-impregnated po...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006501
更新日期:2020-02-01 00:00:00
abstract::In difficult reconstructions, ipsilateral or cross-over nerve grafting is sometimes necessary to achieve reinnervation and motor function. This experimental study in sheep was to answer the question of limitation of elongation of a motor nerve by grafting, the question of the optimal time for suturing the nerve graft ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199001000-00014
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Lymphedema is a common and debilitating condition. Management options for lymphedema are limited and controversial. The purpose of this prospective study was to provide a preliminary analysis of lymphaticovenular bypass for the treatment of upper limb lymphedema in breast cancer patients. METHODS:Twenty pat...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181e5f6a9
更新日期:2010-09-01 00:00:00
abstract::Traumatic amputation of the lip is a rare yet devastating event affecting both form and function. Considering the available methods for reconstruction, replantation may offer a reasonable solution. We sought to characterize the variables associated with lip replantation and to assess the outcome in a retrospective rev...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199808000-00009
更新日期:1998-08-01 00:00:00
abstract::Protein depletion appears to augment, rather than decrease, the length of a skin flap surviving in rats. We were able to document a lowering of serum viscosity in these animals. The augmentation of flap survival produced by protein depletion may even be greater than that produced by the delay phenomenon. A reduction i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197804000-00015
更新日期:1978-04-01 00:00:00
abstract::Injection of aspirated fat for the correction of tissue defects is a common procedure in plastic surgery. The reported rates of fat cell survival vary greatly in the medical literature, and different techniques of harvesting, processing, and reinjecting the fat cells are claimed to be responsible for these differences...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::This article presents a method for passing a cerclage suture around the nasal tip complex to narrow it. The method does not require elevation of the skin from the lower lateral cartilages. The method requires a double-pointed straight needle with the suture swaged on in the center. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Local anesthetic injection is often cited in literature as the most painful part of minor procedures. It is also very possible for all doctors to get better at giving local anesthesia with less pain for patients. The purpose of this article is to illustrate and simplify how to inject local anesthesia in an a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e31829ad1e2
更新日期:2013-09-01 00:00:00
abstract::We describe the use of a fascial flap for covering the framework in ear reconstruction. When covered in turn with a skin graft, this fascial flap provides an abundant amount of a thin, tough, vascular, hairless cover of good quality in all cases except those where injuries in the auricular area have been deep enough t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1977-09-01 00:00:00
abstract::This paper describes the wound management and treatment of 12 consecutive patients with severe radiation damage to the hands. Three of these were secondary to therapeutic radiation for squamous cell carcinoma in one and synovial sarcoma in two, and nine were healthy professional people exposed to radiation in the work...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199308000-00015
更新日期:1993-08-01 00:00:00
abstract::A technique for orienting cut nerve ends for suturing is presented. A mirror is used to reflect one end, making its image identical to that of the other end--so that proper orientation is greatly facilitated. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197901000-00033
更新日期:1979-01-01 00:00:00
abstract::The external ear of the rat is an excellent model for practicing microsurgical dissection and for the refinement of microvascular anastomoses, techniques that are crucial for microvascular en bloc tissue transfer and replantation. Preparation of the rat ear for replantation requires familiarity with the vascular anato...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199005000-00020
更新日期:1990-05-01 00:00:00
abstract::In spite of adequate preoperative evaluation, lagophthalmos may appear during a brow lift procedure if the patient has had a prior upper lid blepharoplasty. Relief of this condition may be obtained by incising the upper lid scar and spreading the wound. Subsequent granulation results in an acceptable scar. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199511000-00037
更新日期:1995-11-01 00:00:00
abstract::A rare case of calcifying epithelioma of Malherbe presenting as a large parotid mass is reported in this paper. Preoperative evaluation and considerations are discussed. An exact diagnosis and definitive treatment in this patient consisted of superficial parotidectomy and histologic study. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198610000-00016
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:Recent literature has focused on the advantages and disadvantages of using acellular dermal matrix in breast reconstruction. Many of the reported data are from low level-of-evidence studies, leaving many questions incompletely answered. The present randomized trial provides high-level data on the incidence a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/PRS.0000000000000809
更新日期:2015-01-01 00:00:00
abstract::A retrospective quantitative analysis of 40 infants who underwent surgery for sagittal craniosynostosis was conducted to determine whether any difference in outcome, with respect to cranial index (cranial width/cranial length x 100), could be associated with either the age at surgery or the extent of the operation. Ch...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199905060-00004
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:Although reduction mammaplasty is a well-described technique for aesthetic purposes, there are few previous reports regarding its application and clinical outcome following conservative breast surgery reconstruction. The purpose of this study was to analyze the feasibility of the technique and its outcome fo...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000202121.84583.0d
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to identify the environmental factors that contribute to facial aging in identical twins. METHODS:During the Twins Day Festival in Twinsburg, Ohio, 186 pairs of identical twins completed a comprehensive questionnaire, and digital images were obtained. A panel reviewed the image...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31819c4d42
更新日期:2009-04-01 00:00:00
abstract::A noncontact three-dimensional measuring system (liquid crystal range finder system) is described. Three-dimensional facial surface data (more than 30,000 points) could be obtained in 1 second, and the resolution was approximately 0.4 mm. The reliability and repeatability of the results were validated with a calibrati...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199811000-00046
更新日期:1998-11-01 00:00:00
abstract::The author classifies ear deformities into 3 major groups and two sub-groups. The surgical procedures used to correct the deformity in each group are described. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1975-04-01 00:00:00
abstract::Reconstruction for polysyndactyly of the toes aims at cosmetic improvement. A previous method that uses a skin graft has inherent disadvantages of mismatched pigmentation between the graft and the surrounding skin and scar formation at the donor site. The authors' new improved surgical technique for the treatment of p...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000131882.19567.65
更新日期:2004-08-01 00:00:00
abstract::Tissue engineering and dermal substitution are currently prominent topics of wound-healing research. However, no extensive clinical trials with objective evaluation criteria have been published so far that support the clinical effectiveness of dermal equivalents in the long term. The dermal substitute that is discusse...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00006534-200112000-00014
更新日期:2001-12-01 00:00:00
abstract::Given the short recovery and immediate results, facial fillers have become a popular alternative to surgical rejuvenation of the face. Reported complications arising from facial filler injections include erythema, tissue loss, blindness, stroke, and even death. In this article, the authors describe their anatomically ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003309
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:The new design of the gluteus maximus perforator-based island flap for coverage of gluteal defects has the distinct advantage of being able to use customizable tissue components for coverage and at the same time sparing the source vessel. This adds a further option for use in reconstruction. METHODS:After e...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181cb675f
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate the incidence of symptomatic and asymptomatic deep venous thrombosis in patients undergoing harvest of a free flap from the lower extremity who were receiving standard chemoprophylaxis while hospitalized. METHODS:A retrospective review of 65 consecutive patients ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002399
更新日期:2016-08-01 00:00:00
abstract::We describe the use of the extensor pollicis longus tendon as an extension of the motor unit in an opponens transfer. Its advantages, and its successful application in 4 cases, are illustrated. To the best of our knowledge, this method has not been described before. We believe it to be a satisfactory addition to the o...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197602000-00010
更新日期:1976-02-01 00:00:00
abstract::This article presents our experience with microsurgical lymphaticovenous implantation in the treatment of chronic lymphedema. Our attempt is to create a lymphaticovenous shunt with an implantation of the collecting lymphatics, including some lymphatic vessels and lymphatic capillaries, within external connective adven...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199801000-00026
更新日期:1998-01-01 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::Craniofacial osteomas are lesions of bone that most commonly occur in the paranasal sinuses. Characteristically they remain dormant or slowly enlarge but remain asymptomatic. The more rapidly expanding tumor types may extend to adjacent structures, but signs and symptoms of such involvement are rare before the third d...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198312000-00031
更新日期:1983-12-01 00:00:00
abstract::Fifty female face-lift patients were evaluated preoperatively with psychological tests and psychiatric interviews. Their postoperative psychological courses were studied for up to 6 months. Approximately 30% had postoperative depressive reactions. These reactions were primarily correlated with a preexisting, clinicall...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198004000-00007
更新日期:1980-04-01 00:00:00