Abstract:
LEARNING OBJECTIVES:After reading this article, participants should be able to: 1. Understand the evidence regarding the timing of expander/implant breast reconstruction in the setting of radiation therapy. 2. Discuss the implications of a patient's risk factors for possible outcomes and complications of expander/implant breast reconstruction. 3. Implement proper prophylactic antibiotic protocols. 4. Use the guidelines to improve their own clinical outcomes and reduce complications. SUMMARY:In March of 2013, the Executive Committee of the American Society of Plastic Surgeons approved an evidence-based guideline on breast reconstruction with expanders and implants, as developed by a guideline-specific work group commissioned by the society's Health Policy Committee. The guideline addresses ten clinical questions: patient education, immediate versus delayed reconstruction, risk factors, radiation therapy, chemotherapy, hormonal therapy, antibiotic prophylaxis, acellular dermal matrix, monitoring for cancer recurrence, and oncologic outcomes associated with implant-based reconstruction. The evidence indicates that patients undergoing mastectomy should be offered a preoperative referral to a plastic surgeon. Evidence varies regarding the association between postoperative complications and timing of postmastectomy expander/implant breast reconstruction. Evidence is limited regarding the optimal timing of expand/implant reconstruction in the setting of radiation therapy but suggests that irradiation to the expander or implant is associated with an increased risk of postoperative complications. Evidence also varies regarding the association between acellular dermal matrix and surgical complications in the setting of postmastectomy expander/implant reconstruction. Data support the use of an appropriate preoperative antibiotic, but antibiotics should be discontinued within 24 hours of the procedure, unless a surgical drain is present. Furthermore, postmastectomy expander/implant breast reconstruction does not adversely affect oncologic outcomes.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Alderman A,Gutowski K,Ahuja A,Gray D,Postmastectomy ExpanderImplant Breast Reconstruction Guideline Work Group.doi
10.1097/PRS.0000000000000541subject
Has Abstractpub_date
2014-10-01 00:00:00pages
648e-655eissue
4eissn
0032-1052issn
1529-4242pii
00006534-201410000-00044journal_volume
134pub_type
杂志文章,实务指引abstract:BACKGROUND:The ability of the immature skull to spontaneously heal large bony defects created after craniofacial procedures was examined over a 25-year period of craniofacial surgery at the Children's Hospital of Philadelphia. METHODS:Only patients who underwent frontal orbital advancement and reconstruction, had at l...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000232353.44086.af
更新日期:2006-09-15 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: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 purpose of the study was to determine the feasibility of preserving ovarian function after heterotopic transplantation by means of microvascular anastomosis of the transplanted vascular pedicles to a set of preselected vessels. Six groups of 10 Sprague-Dawley inbred rats were used in this study. Group I underwent ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000055731.22839.74
更新日期:2003-04-15 00:00:00
abstract::Since its commercial release, Zyderm collagen implant has been used to treat more than 200,000 subjects in the United States for soft-tissue contour defects and more than 250,000 patients internationally (including the United States). Approximately 3 percent of subjects' skin tested with Zyderm collagen experience loc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1987-04-01 00:00:00
abstract::The recent report of a transforming growth factor-beta 3 (TGF-beta 3) knock-out mouse in which 100 percent of the homozygous pups have cleft palate raised the question as to the potential usefulness of these animals as a model for cleft palate research. The specific aim in this study was to carefully document the anat...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200109150-00018
更新日期:2001-09-15 00:00:00
abstract::The ischemia tolerance of free-muscle flaps was investigated in the rat by orthotopic and syngeneic transplantation of muscle flaps measuring 4 x 2.5 cm. The effects of ischemia with a maximal duration of 7 hours on the raised flaps and of anoxia caused by occlusion of the flap vessels were studied for the first time ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199303000-00015
更新日期:1993-03-01 00:00:00
abstract::The purpose of this study was to determine the incidence of cleft palatal fistula in a series of nonsyndromic children treated at the authors' institution. This retrospective analysis of 103 patients with cleft palate treated by five surgeons between 1982 and 1995 includes 60 boys and 33 girls, whose median age was 18...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200111000-00011
更新日期:2001-11-01 00:00:00
abstract::Severe crush to the hand is associated with a poor prognosis. The authors investigated the hypothesis that compartment syndrome complicates such injuries. From 1996 to 2000, the authors retrospectively identified 11 patients who, after sustaining a closed crush injury, developed acute hand compartment syndrome. Diagno...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000025183.78057.9B
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Peripheral neuropathy is highly prevalent among patients with diabetes mellitus and demonstrates well-established consequences of limb loss following lower extremity ulceration, infection, and amputation and upper extremity loss of function. Symptomatic neuropathy is recognized by neuropathic pain, paresthes...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e31820063d4
更新日期:2011-01-01 00:00:00
abstract::We studied the healing process in surgically created cleft lips in fetal mice and compared it with that in newborn mice with cleft lips. Our purpose was to determine the time for optimal healing, defined as minimal scarring, for a repaired cleft lip. Full-thickness paramedian lip incisions were made in NMRI mice in ut...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::The transverse rectus abdominis musculocutaneous flap is widely used for breast reconstruction, but it does not have a rich blood supply. A previous article described the inclusion of superficial epigastric vessels and superficial circumflex iliac vessels to "supercharge" the flap. Subsequent experience has shown that...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199309001-00033
更新日期:1993-09-01 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:A previous report indicated that secondary rhinoplasty patients with normal preoperative noses displayed significantly higher prevalences of depression, demanding behavior, previous aesthetic operations, and confirmed trauma (abuse/neglect) histories than patients who originally had dorsal deformities or str...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000552
更新日期:2014-10-01 00:00:00
abstract::Aneurysmal bone cyst is a rare but recognized osseous lesion of the orbit. We report the presentation, treatment, and postoperative course of an orbital aneurysmal bone cyst in a patient with McCune-Albright syndrome. To our knowledge, this report represents the first description of aneurysmal bone cyst of the orbit i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199508000-00029
更新日期:1995-08-01 00:00:00
abstract::Why do some surgeons retire (or not), and perhaps more importantly, when should some surgeons retire? Interviews were conducted with 21 senior plastic surgeons to determine why plastic surgeons choose not to retire. In an effort to answer the second question (When should surgeons retire?), an analogy is constructed be...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e318206328d
更新日期:2011-03-01 00:00:00
abstract::The widespread use of bioprosthetic mesh in breast reconstruction has revealed an increased risk of seroma and infection, and a high financial cost. This study introduces a technique that mitigates these shortcomings using an autologous dermal graft (Autoderm). Indications, operative technique, and 1-year outcomes are...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182865af3
更新日期:2013-05-01 00:00:00
abstract::A prospective clinical study was undertaken to compare the results of intradermal layer closure using two popular absorbable suture materials, polydioxanone and polyglactin 910. On an alternating basis, 6-0 polydioxanone and 6-0 polyglactin 910 were used to repair 80 surgical sites of the temple and occipital regions ...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00006534-199610000-00010
更新日期:1996-10-01 00:00:00
abstract::Fibrin glue was applied at the anastomotic site of the vein graft that was placed in rat femoral artery defects by the telescoping anastomotic technique at both proximal and distal anastomoses. All 35 vein grafts thus placed were patent, yielding a statistically higher patency rate than those placed in the same femora...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199511000-00026
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:Upper airway narrowing has been a concern of mandibular setback. The aims of this study were (1) to evaluate the effect of bimaxillary rotational setback surgery on upper airway structure in patients with skeletal class III deformities, and (2) to compare the preoperative and postoperative upper airways of c...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000913
更新日期:2015-02-01 00:00:00
abstract::Patients with severe maxillary hypoplasia secondary to congenital facial clefting present numerous challenging problems for the reconstructive surgeon. Traditional surgical/orthodontic approaches for these patients often fall short of expectations, especially for achieving normal facial aesthetics and proportions. The...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Lipoaspirate centrifugation creates graded density of adipose tissue. High-density fat contains more vasculogenic cytokines and progenitor cells and has greater graft survival than low-density fat. The authors hypothesize that accelerating the bone marrow-derived progenitor cell response to injected low-dens...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182589c45
更新日期:2012-08-01 00:00:00
abstract::Primary melanomas of the skin of the breast are uncommon lesions. Fifty-four patients were surgically treated for this lesion during a 13-year period, accounting for 3.8 percent of a total of 1431 patients with cutaneous melanoma. Nineteen patients were female and 35 were male. Most recently, in patients with high-ris...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198709000-00011
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND:Acellular dermal matrix is used in most postmastectomy implant-based breast reconstructions in the United States. It is believed to be safe, despite a slightly increased complication rate. Although never established in a unifying study, the primary advantage of acellular dermal matrix is believed to be an en...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,meta分析
doi:10.1097/PRS.0000000000006212
更新日期:2019-12-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/01.prs.0000209971.08264.b0
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Craniofacial injuries secondary to earthquake-related trauma are uncommonly reported and can pose a significant reconstructive challenge. The objective of this study is to report and analyze earthquake-related craniofacial injury reconstruction and the disaster relief capabilities of a U.S. Navy hospital shi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181f5272d
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:One of the most common complications of the use of foreign material, in both reconstructive and cosmetic breast surgery, is capsular contracture. Historically, research on capsular contracture has focused mainly on reducing bacterial contamination through antibiotic solutions. Only secondary studies have foc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006553
更新日期:2020-03-01 00:00:00
abstract::Utilizing the techniques of biostereometric photography and current state-of-the-art computergraphics, topographic contourgrams have been generated in a series of patients with complex craniofacial malformations. These contourgrams are considered useful in diagnosis and treatment planning and as an aid in postoperativ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198504000-00007
更新日期:1985-04-01 00:00:00
abstract::A model simulating intraosseous wire fixation was used to assess different methods of securing wire loops. Square knotting, twisting, and a new method, the "knot twist," were assessed. The importance of anchoring the butt ends of twisted wire is emphasized. A new, convenient technique of wire fixation is described. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:Breast reconstruction after breast cancer surgery has come to be regarded as an achievable treatment option to improve patients' quality of life. Although it has been pointed out that surgeons' information-giving behaviors affect women's decision to undergo breast reconstruction surgery, little is known abou...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000233149.36751.d2
更新日期:2006-12-01 00:00:00