Abstract:
BACKGROUND:Keloids cause aesthetic disfigurement and physical complaints, mainly pain and pruritus. Treatment of these scars is difficult, with high recurrence rates forming the main issue. Surgical excision with adjuvant radiotherapy is considered the most efficacious treatment. At their institution, the authors have been treating keloids with a high-dose-rate brachytherapy procedure for over 10 years, using a protocol with the lowest total radiation dosage known in the literature. METHODS:This prospective study included 43 patients of all Fitzpatrick skin types, with 67 keloids in total. After extralesional excision, a radiation scheme of 2 × 6 Gy was administered in two fractions: the first within 4 hours after surgery and the second within 24 hours. Scars were measured and recurrence was judged. Scar appearance was evaluated using the Patient and Observer Scar Assessment Scale. RESULTS:The recurrence rate was 3.1 percent at a mean follow-up of 33.6 months. A significant average scar surface decrease of 56.7 percent was measured (p = 0.01). Complaints of pain and pruritus decreased by 82.9 and 87.2 percent, respectively. Patients were satisfied with the treatment in 88.6 percent of the cases and with the cosmetic result in 77.1 percent. Pigmentation problems were seen in 21.4 percent of the patients, mostly in Fitzpatrick type V and VI/African American individuals. CONCLUSIONS:The results of this prospective study show a good cosmetic outcome with a low recurrence rate. The unique radiation schedule proves the efficacy and safety of high-dose-rate brachytherapy and suggests the importance of immediate postoperative irradiation. In addition, only one outpatient treatment is required after surgery, enhancing patient convenience. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
van Leeuwen MCE,Stokmans SC,Bulstra AJ,Meijer OWM,van Leeuwen PAM,Niessen FBdoi
10.1097/PRS.0000000000000415subject
Has Abstractpub_date
2014-09-01 00:00:00pages
527-534issue
3eissn
0032-1052issn
1529-4242pii
00006534-201409000-00026journal_volume
134pub_type
临床试验,杂志文章abstract::Current literature recommends the use of a carbon dioxide laser for excision of lesions where minimal damage and wound contracture are desirable. The extent of tissue damage is evaluated as a correlate of percentage of split-thickness skin graft "take" following excision of full-thickness skin with scalpel, electrocut...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198006000-00002
更新日期:1980-06-01 00:00:00
abstract::A technique is described for reinforcing and sealing a microvascular anastomosis by using a detached vessel segment as a cuff around the anastomosis. This may allow fewer microvascular sutures to be used. This would allow a simpler, less traumatic, and more rapid repair and may allow "more vessels to be repaired by mo...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199103000-00029
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Recently, the profunda artery perforator flap has become one of the popular flap choices for patients who desire autologous breast reconstruction but are not optimal candidates for deep inferior epigastric perforator (DIEP) flap surgery. These patients are not ideal patients for DIEP flap surgery because of ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005375
更新日期:2019-03-01 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::Not only is the long temporal vertical flap not centered on the temporosuperficial artery, but it is also countercurrent to this artery. The difficulties of its design are largely compensated for by the natural aspect of the anterior area once achieved. It must be emphasized that all techniques of transplantation can ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198411000-00007
更新日期:1984-11-01 00:00:00
abstract::The latissimus dorsi muscle flap is a versatile flap used in a variety of reconstructive procedures. The major complication reported with its use is donor-site seroma, reported to occur in 20 to 79 percent of cases. A retrospective review of 47 patients undergoing latissimus dorsi muscle harvest from April of 1998 thr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000090542.68560.69
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:Great auricular nerve injuries are the most frequent nerve injuries following rhytidectomy, occurring at a rate of 6 percent. Short-scar techniques may decrease visualization and increase the risk of injury/compression of the great auricular nerve. Recent reviews have identified that great auricular nerve in...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000436861.85892.a1
更新日期:2014-02-01 00:00:00
abstract::Recent studies have identified a subpopulation of craniosynostotic individuals who exhibit progressive or delayed-onset synostosis and mild craniofacial growth abnormalities. These individuals may be good candidates for nonextirpation, distraction osteogenesis therapy. The present study was designed to test this hypot...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Immediate reconstruction of composite head and neck defects using free tissue transfer is an accepted treatment standard. There remains, however, ongoing debate on whether the costs associated with this reconstructive approach merit its selection, especially considering poor patient prognoses and the high co...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000260591.82762.b5
更新日期:2007-06-01 00:00:00
abstract::A method of covering lower-extremity wounds using a free fascial scalp flap has been described. The flap provides thin, stable wound coverage, with minimal bulk and an inconspicuous donor site. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198008000-00004
更新日期:1980-08-01 00:00:00
abstract::Reconstruction of bilateral cleft lip nose deformity is difficult and the outcome is inconsistent. This study was conducted to evaluate the gross outcome and the difference in the assessment of nasal appearance as judged by two groups of raters, cleft surgeons and laypersons. Sixty-four patients with bilateral cleft l...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200209010-00001
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Insufficient soft-tissue coverage following total knee arthroplasty jeopardizes prosthesis retention and may lead to significant complications. The aim of this study was to evaluate the natural history of total knee arthroplasty following flap reconstruction of soft-tissue defects. METHODS:A retrospective r...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000001929
更新日期:2016-01-01 00:00:00
abstract::In a previous study in the rabbit, the authors defined the macroscopic growth alterations after unilateral partial facial paralysis. Dry skull measurements revealed a reduced premaxillary, maxillary, mandibular, and anterior corpus length with a simultaneous increase in mandibular ramal height on the paralyzed side. T...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200201000-00028
更新日期:2002-01-01 00:00:00
abstract::To test the hypothesis that altered collagen metabolism is a contributing factor in the apparent delayed wound healing in denervated regions of spinal cord injury (SCI) patients, a tissue implant (PVA) was used to directly measure collagen deposition. Sterile PVA implants were placed subcutaneously in the inner aspect...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198902000-00019
更新日期:1989-02-01 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::Fewer than 100 cases of desmoid tumor of the breast have been reported. We report the first recorded case of desmoid associated with silicone gel-filled implants. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::A prospective study of speech outcome and maxillofacial growth was carried out in cleft palate patients. Seventy-six cleft palate patients were randomly selected for the study group; 41 patients were operated on at 12 months of age, and 35 patients were operated on at 6 months of age. All patients were followed until ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199809030-00009
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Tibial resection in children presents a unique reconstructive challenge because of technical demands, future growth potential, and repetitive loading of the lower extremity. Positioned in a tibial defect, the free fibula undergoes primary bone healing while maintaining intrinsic resistance to infection and t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318230e463
更新日期:2012-01-01 00:00:00
abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Identify the environmental and genetic risk factors in developing nonmelanoma facial skin malignancy. 2. Understand the proper evaluation of a patient presenting with nonmelanoma facial skin malignancy. 3. Outline the various treatme...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000294670.17051.02
更新日期:2008-01-01 00:00:00
abstract::Twenty-one patients with small localized oral cavity hemangiomas of the lips, tongue, and buccal mucosa are reported in this series. Although the lesions were not massive or high-flow/high-pressure vascular tumors, the simultaneous cutting and coagulation capabilities of the CO2 laser were demonstrated, rendering such...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198501000-00010
更新日期:1985-01-01 00:00:00
abstract::Although local anesthesia will, and should, continue to be the principal method of anesthesia for most face lift operations, we believe that general endotracheal anesthesia, supplemented by local anesthesia with epinephrine, offers significant advantages in a selected group of patients. We review 100 consecutive rhyti...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197711000-00012
更新日期:1977-11-01 00:00:00
abstract:BACKGROUND:The objective of this study was to evaluate the impact of breast implant surgery and its approaches on lactation by comparing women with and without breast implants at the time of childbirth. METHODS:Between April of 2013 and July of 2014, in Rosario (Sanatorio de la Mujer and Centro Quirúrgico Rosario), Ar...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002745
更新日期:2016-12-01 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::The anatomical subunit approximation cleft lip repair advantageously achieves a balanced lip contour, with the line of repair hidden along seams of aesthetic subunits. Dr. David Fisher's original description of the repair reflects the considerable thought that went into the evolution of his design. As his technique ha...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000002257
更新日期:2016-07-01 00:00:00
abstract::Breast-conserving therapy is widely accepted as an appropriate method of primary treatment of T1 and T2 breast cancers that measure up to 5 cm. For safe and cosmetically acceptable breast-conserving therapy in patients with larger breast cancers, the tumor volume has to be reduced preoperatively, and lost tissue volum...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000117191.10766.95
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:In extended upper-type lesions of the brachial plexus, nerve transfers and root grafting have improved the results of shoulder and elbow reconstruction. However, wrist extension reconstruction has received little attention. METHODS:In 20 cadaveric upper limbs, we dissected the anterior interosseous nerve an...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31826d16cf
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:After excess skin and fat are removed, a body-lift suture advances skin and suspends ptotic breasts, the mons pubis, and buttocks. For women, the lift includes sculpturing adiposity. While some excess fat may need removal, muscular men should receive a deliberate effort to achieve generalized tight skin clos...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000933
更新日期:2015-02-01 00:00:00
abstract::The authors performed immediate breast reconstruction on four patients using a sensate latissimus dorsi musculocutaneous flap accompanied by neurorrhaphy during the past 6 years. In the neurorrhaphy, the lateral cutaneous branch of the dorsal primary divisions of the seventh thoracic nerve, which controls the sensatio...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200205000-00018
更新日期:2002-05-01 00:00:00
abstract::A study on the effects of iontophoretic administration of calcitonin gene-related peptide and vasoactive intestinal polypeptide on the healing of venous stasis ulcers of the extremities was carried out on 66 patients. Two randomized groups of patients were compared, one receiving standard treatment plus iontophoresis ...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00006534-199801000-00015
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:In obstetrical brachial plexus palsy, suprascapular nerve reinnervation is a priority. For the most favorable outcomes in shoulder function, it is the authors' policy to also reconstruct the axillary nerve with intraplexus donors to the posterior cord (early cases) or directly with intraplexus or extraplexus...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181881f70
更新日期:2008-11-01 00:00:00