Abstract:
:Massive localized lymphedema (MLL) is rare, but as the prevalence of obesity in adults rises, it can be foreseen that cases will increase in prevalence. These patients are unable to ambulate and have uncontrollable rash and skin breakdown. Operative management for MLL is offered when nonsurgical measures are ineffective. The surgery can be difficult with ambiguous tissue planes saturated with lymphatic fluid, ill-defined margins, large arteries and dilated veins, and extensive intraoperative fluid and blood loss. We performed a retrospective chart review and analysis with a focus on the intraoperative findings and management in order to provide improved awareness and recommendations for preoperative care. We reviewed the charts of 15 patients with MLL undergoing a total of 17 surgical resections at our institution. Patients were morbidly obese with an average body mass index of 63 kg/m and 5.5 other medical comorbidities. Average operative time was 4.5 hours. Operative time showed a moderate correlation with increased blood loss. Operative transfusion averaged approximately 1 U per case, with 12% (2/17) of cases needing additional transfusions following surgery. An increase in operative time correlated with an increase in crystalloid infusion. In conclusion, we recommend close communication between the surgery and anesthesia teams regarding the extent of the resection and potential for fluid resuscitation and transfusions. Preoperative laboratory tests are recommended, as well as type and cross-match prior to the operation to obtain a baseline for intraoperative and postoperative monitoring. Recommendations for intraoperative management include strict input and output monitoring and aggressive fluid resuscitation with appropriate arterial and venous access.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Moore E,Vasconez H,Wong Ldoi
10.1097/SAP.0000000000001475subject
Has Abstractpub_date
2018-07-01 00:00:00pages
75-79issue
1eissn
0148-7043issn
1536-3708journal_volume
81pub_type
杂志文章abstract::Malignant melanoma of the head and neck can metastasize to lymph nodes within the parotid gland. Selective lymphadenectomy is the modern method of staging regional lymph node basins in clinically localized melanoma. This procedure involves intraoperative lymphatic mapping and directed, selective removal of the first d...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199907000-00001
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Placement of suction drainage in submuscular pockets is routinely performed in breast reconstruction. Days of drain permanence (DDP) are associated with hospital stay and related health care costs. The aims of this study are to retrospectively compare data related to DDP and total drainage volume between hig...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001246
更新日期:2018-04-01 00:00:00
abstract::A 16-year-old male with fibrous dysplasia, in which rapidly increasing proptosis of the left eye was induced by a mucocele behind the globe, is reported. The mucocele was removed and the expanded bone was completely recontoured back to normal dimensions with the aid of an acrylic skull replica fabricated preoperativel...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199802000-00015
更新日期:1998-02-01 00:00:00
abstract::Individuals with gender dysphoria often seek medical interventions, such as hormone treatment and surgery, to live as their identified gender. Cross-sex hormone therapy typically consists of various estrogen formulations which confer varying risks of venous thromboembolism (VTE). Currently, there is no standard practi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002300
更新日期:2021-01-01 00:00:00
abstract::It is well known that multiparas who had previously been delivered of newborns with obstetric brachial plexus palsy are at risk of having the same complication in subsequent deliveries. However, none of the studies in the literature have actually attempted to estimate how high is that risk. The aims of the current pap...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199611000-00015
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:The facial dismasking flap (FDF) approach to operations on the deep skull base region consists of a coronal incision and a circumpalpebral incision. This approach provides a wide surgical field for extirpation of deep extended craniofacial tumors without leaving any undesirable scars on the face. Therefore, ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000662
更新日期:2017-01-01 00:00:00
abstract::Augmentation and corrective malarplasty are relatively new procedures that require careful preoperative evaluation to ensure that the effect produced will blend harmoniously with the existing facial structure. A variety of implant types and materials are available to accommodate varying needs, and several surgical app...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197904000-00008
更新日期:1979-04-01 00:00:00
abstract:BACKGROUND:Breast implant illness (BII) after aesthetic breast augmentation remains a poorly defined syndrome encompassing a wide spectrum of symptoms. While previously published series have observed overall symptomatic improvement after breast implant removal, there is a lack of studies evaluating changes in specific ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002446
更新日期:2020-07-01 00:00:00
abstract::Reconstruction of the lower and upper lips, commissure, and full-thickness cheek defects using a composite radial forearm palmaris longus free flap with secondary commissuroplasty is described. This flap is useful for reconstruction of the total lower lip as well as larger defects that include full-thickness cheek and...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199411000-00013
更新日期:1994-11-01 00:00:00
abstract::The purpose of this study is to objectively evaluate donor-site morbidity of the inferior gluteal musculocutaneous flap in teenagers. All cases of breast reconstruction performed between 1996 and 2005 using an inferior gluteal flap were reviewed. Flap size, weight, and pedicle origin were noted. Donor-site morbidity w...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000259595.65804.2f
更新日期:2007-12-01 00:00:00
abstract::Coronary artery bypass grafting is a common surgical procedure for myocardial revascularization. This operation usually involves the use of the left internal mammary artery to bypass the left anterior descending coronary artery. The internal mammary artery and its perforators are also an important blood supply to the ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000141597.38288.3c
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:The ingredients of substances implanted for breast augmentation sometimes remain unknown due to lack of information from patients. Significant clinical problems sometimes necessitate removal and reconstruction. Thus, preoperative diagnostic imaging to identify the ingredients of implants may improve the trea...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000214185.94467.a3
更新日期:2006-07-01 00:00:00
abstract::Multiple studies have compared the outcome of surgery for cubital tunnel syndrome (CUTS), yet there remains no clear guidelines for treatment. We describe an approach to CUTS that includes tailoring the procedure to the pathology found at surgery. Patients treated surgically were retrospectively reviewed. Following in...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318219183d
更新日期:2011-06-01 00:00:00
abstract::Lateral malleolus avulsion is uncommon, and fusion of the syndesmosis of the ankle joint is usually performed in such cases. Others have reported successful reconstruction of the lateral malleolus with a vascularized fibular head. A case of reconstruction in a 17-year-old girl, with a free scapular apophysis flap, is ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200109000-00018
更新日期:2001-09-01 00:00:00
abstract::Carpal tunnel decompression (CTD) is the most commonly performed surgical procedure within a hand unit. We have analyzed data on outcomes after carpal decompression performed by both open and closed techniques to assess whether outcomes differed between the 2 procedures. Data were jointly gathered from 2 units. The ai...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000267
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:To investigate the molecular mechanism of nerve "babysitter" for nerve regeneration and muscle preservation in peripheral nerve repair. METHODS:Eighty rats were equalized into 4 groups: peroneal nerve transected, group A received no treatment; group B underwent end-to-end repair; group C underwent end-to-sid...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000952
更新日期:2017-06-01 00:00:00
abstract::To date, full-thickness skin ulcers of the heel of the foot are still difficult wounds to cover. Many choices of coverage are available, but few provide long-term coverage due to bone exposure, deficient sensibility, and subsequent breakdown. An advancement flap based on the medial plantar artery with sensory nerve br...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199705000-00018
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:The objective of this trial is to evaluate the flexibility of the cartilaginous component of the cleft nose after diced cartilage rhinoplasty by determining the degree of possible bending in relation to the vertical nasal dorsum axis and to compare with to a control group of the unaffected population. PATIE...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002688
更新日期:2021-01-11 00:00:00
abstract::Lymphatic vasculature is known to spontaneously reconnect after hand replantation. Nonetheless, lymphatic outflow has not been specifically studied in hand transplantation.Lymphedema was studied clinically and scintigraphically in 3 bilateral upper limb transplants performed in Valencia, Spain, since 2006. Case 1 was ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31828349ff
更新日期:2013-07-01 00:00:00
abstract::Despite the advances in laser treatment of port wine stains (PWS), re-emergence of these lesions still occurs. We carried out a retrospective audit of all children that received laser treatment of PWS between 1997 and 2000 using the flashlamp-pumped dye laser with a 585-nm wavelength. Out of 110 patients treated, 15 r...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000221620.83178.fc
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:The use of internal mammary perforators (IMPs) as recipient vessels in autologous free flap breast reconstruction has many additional benefits compared with the internal mammary or thoracodorsal vessels. Our goals were to analyze the characteristics of these vessels and to evaluate the reliability of using t...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SAP.0b013e318270704b
更新日期:2014-08-01 00:00:00
abstract::Many techniques for cleft lip repair have been reported, but these techniques do not consider the contour lines of the upper lip and, in fact, destroy them. The upper lip has complicated contour lines including the vermilion free margin, vermilion border, upper lip horizontal groove (upper lip groove), philtrum (dimpl...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199109000-00008
更新日期:1991-09-01 00:00:00
abstract::Diagnosing osteomyelitis in patients with pressure ulcers is complicated by overlying soft-tissue inflammation and reactive bone formation. We set out to evaluate the efficacy of indium scanning in the diagnosis of chronic osteomyelitis in spinal-cord-injury patients with grade IV pressure ulcers. The goal was to esti...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000164467.97551.ed
更新日期:2005-06-01 00:00:00
abstract::The authors performed palatal mucoperiosteal grafting for contracture of the artificial eye socket in 4 patients. Mucoperiosteal grafts were collected from the paramedian area of the hard palate. After release of contracture, the grafts were sutured with absorbable thread to the defective areas on the conjunctival sid...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000068115.91989.A4
更新日期:2003-09-01 00:00:00
abstract::The vascular anatomy of the dorsalis pedis-first dorsal metatarsal artery was investigated with regard to its general distribution and variation. We especially focused on the status of the dorsalis pedis-first dorsal metatarsal-first plantar metatarsal arterial interconnection and the sagittal course of the first dors...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199701000-00010
更新日期:1997-01-01 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::We present a new concept of vascular anatomy, proposing that a complex subcutaneous vascular network, located between the dense and loose adipose tissue, connects the larger subcutaneous vessels, the vertical perforators, and the subdermal plexus. Knowledge of the location of these vessels helps determine optimal flap...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198308000-00002
更新日期:1983-08-01 00:00:00
abstract:BACKGROUND:Despite their widespread use, there are no evidence-based guidelines on the management of closed-suction drains or antibiotics in postmastectomy breast reconstruction. The purpose of this study was to assess consensus and variation in postoperative care among plastic surgeons. METHODS:The authors designed a...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31820c0593
更新日期:2011-05-01 00:00:00
abstract::We report the use of topic negative pressure for seromas resulting from mobilization of tensor fascia lata miocutaneous flap in the trochanteric areas for pressure sores. In 5 consecutive patients we successfully treated seroma with the use of external and internal topic subatmospheric pressure. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31819adf94
更新日期:2009-12-01 00:00:00
abstract::We report the long-term use of tissue expanders for the reconstruction of a shoulder mound. Following a total forequarter amputation for the management of a fibrosarcoma, the patient continues to enjoy the benefits of a soft-tissue expander reconstruction eight years after its initial insertion. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199208000-00014
更新日期:1992-08-01 00:00:00