Abstract:
INTRODUCTION:Abdominal wall integrity may be compromised after abdominal flap harvest for breast reconstruction, leading to bulging or herniation due to weakening of the abdominal wall and dissection through the rectus muscle. Mesh can be used to reinforce the abdominal wall to reduce the risk of hernia formation postoperatively, especially in patients who may be at high risk. In this study, we describe this institution's experience with the use of mesh in the abdominal wall and critically evaluate its impact on patient outcomes and complications. METHODS:We retrospectively reviewed all patients with an abdominal free flap harvested for breast reconstruction at Stanford Health Care from 2005 to 2015. Multivariate-adjusted logistic regression analysis was used to compare the odds of abdominal complications-infection, bulging, and herniation-between patients with and without an abdominal mesh implanted during breast reconstruction. RESULTS:Three hundred eighty patients met inclusion criteria. One hundred sixty-one patients received mesh, whereas 219 received no reinforcement. In the mesh group, there were 7 (4.3%) cases of postoperative abdominal bulging, 11 (6.8%) cases of abdominal infection, and no (0.0%) cases of herniation. In the group without mesh, there were 17 (7.8%) cases of abdominal bulging, 11 (5.0%) cases of abdominal infection, and 5 (2.3%) cases of herniation. There was a significant difference in the odds of bulging (odds ratio [OR], 0.30; P = 0.01). There was not a significant difference in the odds of herniation (OR, 2.26E-10; P = 0.99) or infection (OR, 1.21; P = 0.69). CONCLUSIONS:In our current treatment algorithm, patients who received mesh were selected based upon several criteria, including obesity, weak fascia identified during surgery, and extensive muscle dissection. We confirm that the risk of bulging and herniation is decreased in patients receiving mesh. Furthermore, the risk of wound infection was not associated with the use of mesh; instead, a patient's elevated body mass index, as well as tension of closure, and other comorbidities are more likely causes of superficial wound complications. We find the use of mesh to be safe and beneficial in select patients undergoing abdominal free flap breast reconstruction who are at risk for hernias and bulges.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Leon DS,Nazerali R,Lee GKdoi
10.1097/SAP.0000000000001468subject
Has Abstractpub_date
2018-05-01 00:00:00pages
S295-S298issue
5S Suppl 5eissn
0148-7043issn
1536-3708journal_volume
80pub_type
杂志文章abstract:BACKGROUND:Suboptimal pain management is a common, yet largely unrecognized, problem in the postsurgical patient population. Current treatment protocols heavily rely on opioid use and, though generally effective in providing pain relief, are associated with multiple side effects. The present systematic review aims to o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001916
更新日期:2019-12-01 00:00:00
abstract::Autologous fat is an excellent soft-tissue filler, given its abundance and ease of harvest. Nevertheless, the technique is accompanied by postoperative complications such as fat necrosis, calcification, and sclerotic nodules. These problems directly influence surgical efficacy. Computed tomography or magnetic resonanc...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318189a98a
更新日期:2009-08-01 00:00:00
abstract::Lymphedema is a condition characterized by progressive swelling and adipose deposition that occurs commonly after lymphadenectomy. Recent clinical studies have suggested that the transfer of lymph nodes to the lymphedematous limb can improve lymphatic function. In this report, we investigate dynamic modulation of lymp...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000428
更新日期:2016-04-01 00:00:00
abstract::In an effort to standardize use of the dorsal rat flap model originally described by McFarlane, we determined the following. The effect of delay is readily demonstrated but does not prevent necrosis entirely. Almost all flaps showed some necrosis, but delayed flaps showed approximately 15% less necrosis. Measurement o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198309000-00006
更新日期:1983-09-01 00:00:00
abstract::Isolated dorsoradial capsule injuries of the thumb metacarpophalangeal joint are different from those associated with collateral ligament disruption. Early suspicion of this rare injury is important because, if overlooked, ulnarward subluxation of extensor pollicis longus tendon can develop. Functionally, active thumb...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001202
更新日期:2018-02-01 00:00:00
abstract::Thirty cases of constriction band syndrome diagnosed and treated with surgery at Ramathibodi Hospital, Bangkok, during 1973 to 1986 are reported. The incidence of this congenital anomaly could not be verified in this series because the number of cases was limited and the cause could not be concluded. The less frequent...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198811000-00017
更新日期:1988-11-01 00:00:00
abstract:BACKGROUND:Patients with hormone receptor-positive breast tumors receive hormonal therapy with either selective estrogen receptor modulators (SERMs) (eg, tamoxifen) or aromatase inhibitors (AIs) (eg, anastrozole) for 5 to 10 years. Patients are using these therapies frequently during breast reconstruction. Literature i...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002394
更新日期:2020-10-01 00:00:00
abstract::The transverse rectus abdominis musculocutaneous flap and deep inferior epigastric perforator flap are the flaps of choice for autologous breast reconstruction. The better understanding of the vascular anatomy of these flaps has reduced the incidence of flap loss and fat necrosis, and positioning the flap's least vasc...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000162509.32962.9c
更新日期:2005-06-01 00:00:00
abstract::Neurocutaneous flaps are utilized routinely in reconstructive surgery and even more so during the past decade. In this study, the vascular supply of the neurocutaneous flap in the rat model is presented and evaluated. Thirty-six flaps (3.5x3 cm2) were dissected on the medial aspect of the leg based on a pedicle of the...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199910000-00012
更新日期:1999-10-01 00:00:00
abstract::Textured silicone expanders are alleged to be less painful in the filling process, to have less capsular contracture, and to stay in position better than smooth silicone expanders. To test these three hypotheses, 6 patients undergoing bilateral simultaneous expander implant placement for breast reconstruction after ma...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000637-199403000-00001
更新日期:1994-03-01 00:00:00
abstract::A 4-year-old girl was referred to the plastic surgery unit with metastatic malignant melanoma diagnosed in a cervical lymph node. She had previously undergone excision of a Spitz nevus of the cheek at age 18 months. The management of this patient is discussed along with a review of the literature relating to Spitz nev...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000037277.03962.4F
更新日期:2003-05-01 00:00:00
abstract::Several perforator-based flaps have been developed recently and, although preoperative evaluation of perforator vessels is important, the conventional method using the Doppler flowmeter is still being used. The authors tried to identify perforator vessels in the abdominal region using scanning laser Doppler imaging an...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200206000-00008
更新日期:2002-06-01 00:00:00
abstract::Pitanguy conducted a series of anatomic studies on the dermocartilaginous ligament of the nose. However, information on its structure is as yet insufficient. In addition, some of the histologic findings described by Pitanguy are controversial. The present study was undertaken to clarify the anatomy of the dermocartila...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318031c1b7
更新日期:2007-10-01 00:00:00
abstract::Dupuytren's contracture, a benign condition characterized by fibrosis of the palmar and digital fascia, may be a debilitating condition that limits daily function. Several techniques exist for managing symptomatic contractures of the hand related to Dupuytren's. These techniques include the more invasive open fascioto...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0000000000001607
更新日期:2018-12-01 00:00:00
abstract::Full-thickness excision wounds infected with Staphylococcus hyicus, a pig pathogen, or Staphylococcus aureus, a human pathogen, were produced in pigs. The inoculated wounds were kept occluded for 2 days and then exposed and biopsied at intervals for 9 to 12 days. The exposed lesions were edematous and exudative. The S...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198909000-00004
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:High-quality physician communication is the foundation for achieving high patient satisfaction. Increasing importance is placed on eliciting feedback from patients. However, there have been few studies looking at the impact of resident involvement on patient satisfaction. Our hospital system values the patie...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001339
更新日期:2018-05-01 00:00:00
abstract::Arterialized venous flaps are the result of the search for new flap techniques because conventional flaps are sometimes insufficient and have donor-site morbidity problems. In the patient presented here, a free arterialized venous flap measuring 12 x 8 cm was transferred from the forearm to a burn-scarred area on the ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199501000-00019
更新日期:1995-01-01 00:00:00
abstract::A superior advantage of the superficial circumflex iliac artery perforator flap is that any donor site residue can easily be hidden by clothing. Usually designed as narrow or moderate-sized flaps based on medial perforators of the superficial branch, this readily allows primary donor site closure. However, for larger ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002159
更新日期:2020-08-01 00:00:00
abstract::Seventy-five patients with melanoma were surveyed for recent history of major stress, coping styles, and psychiatric disturbance. Recurrence of disease was strongly related to biological variables (stage and Breslow depths) but not to psychological measures. Major life stress was not related to stage, Breslow, Clark l...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199201000-00007
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Application of collagen products to wounds has been shown to improve wound healing. Using a collagen-based hydrogel (cHG) capable of cellular support previously developed by our laboratory, we hypothesize that our hydrogel will increase the speed of wound healing by providing a 3-dimensional framework for ce...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002380
更新日期:2020-09-01 00:00:00
abstract::The quantitative and morphological characteristics of microbial adherence of four organisms--Staphylococcus epidermidis, S. aureus, Escherichia coli and Candida albicans--to the surfaces of different breast prostheses were observed. Semiquantitative adherence studies based on a modification of Maki's roll culture tech...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198904000-00009
更新日期:1989-04-01 00:00:00
abstract::The reverse sural artery flap is frequently used for reconstruction of the distal third of the leg, ankle, and heel. The major disadvantage of the flap is compression of the pedicle within the subcutaneous tunnel and venous congestion. Others have cited a decrease in this problem by harvesting a midline cuff of gastro...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Soft tissue and bony tumors of the pelvis are rare, but when they occur, treatment presents both an oncologic surgical and a reconstructive challenge. After reconstruction, soft tissue defects can be large and there is usually exposed bone and/or joint. A retroperitoneal abdominal wall defect may also be pre...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000215288.83924.6c
更新日期:2006-08-01 00:00:00
abstract::Through a transfixion incision, a rhomboidal portion of both the depressor muscle of the nasal septum and the orbicular muscle of the mouth are excised. The remaining columellar tissues are brought nearer to each other by means of a mattress suture tied over a double-foam bolus. This simple procedure yields three adva...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198905000-00001
更新日期:1989-05-01 00:00:00
abstract::The outcome of adult phalangeal neck fractures caused by saws has not been previously investigated. Over a 15-year period, a total of 36 cases of saw-related injuries resulting in phalangeal neck fractures of the middle phalanx of the finger or the proximal phalanx of the thumb were treated. All injuries were industri...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31821ee453
更新日期:2012-07-01 00:00:00
abstract:PURPOSE:The reconstruction of complicated defects with 3-dimensional deficits remains challenging. The reconstruction of these defects requires not only coverage of surface but also appropriate obliteration of dead space, and muscle-chimeric perforator flaps can be a valuable option. Here, we present our experience wit...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3182a6363c
更新日期:2015-05-01 00:00:00
abstract::A rigid transparent face mask of cellulose acetate butyrate was developed for the control of scar hypertrophy in the burned face. Excellent patient acceptance has been found in a six-year series of 97 patients. Use of the device for at least twenty hours a day for an average of one and a half years per patient has ena...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198103000-00014
更新日期:1981-03-01 00:00:00
abstract::Surgical site infection after breast reconstruction is associated with increased length of hospital stay, readmission rates, cost, morbidity, and mortality. Identifying methods to reduce surgical site infection without the use of antibiotics may be beneficial at reducing antimicrobial resistance, reserving the use of ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001420
更新日期:2018-06-01 00:00:00
abstract::Controversy as to benefits, risks, and long-term durability of the subcutaneous rhytidectomy as compared with the composite and the subcutaneous musculoaponeurotic system (SMAS) rhytidectomy procedures has persisted over the last several years. Conventional surgical wisdom holds that deep-tissue support would provide ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199511000-00001
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:Human cadaveric skin grafts are considered as the "gold standard" for temporary wound coverage because they provide a more conductive environment for natural wound healing. Lyophilization, packing, and terminal sterilization with gamma-ray can facilitate the application of cadaveric split-thickness skin graf...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001019
更新日期:2017-03-01 00:00:00