Abstract:
BACKGROUND:Venous thromboembolism, including deep venous thrombosis and pulmonary embolism, is a morbid and costly complication following surgical procedures. The authors aim to assess the added risk of venous thromboembolism in patients undergoing immediate breast reconstruction. METHODS:The 2005 to 2011 American College of Surgeons National Surgical Quality Improvement Program data sets were used to identify patients undergoing mastectomy with or without immediate breast reconstruction. The dependent variable and our primary outcome was 30-day venous thromboembolism. Venous thromboembolism events were treated as a dichotomous variable. Subgroup analyses were performed with respect to procedure and body mass index stratifications. RESULTS:A total of 48,634 patients were identified. Postoperative venous thromboembolism occurred in 184 patients (0.4 percent), including deep venous thrombosis (n = 118) and pulmonary embolism (n = 82). A multivariate regression analysis demonstrated that immediate breast reconstruction, either implant-based (OR, 1.65; p = 0.01) or autologous (OR, 2.14; p = 0.009), was associated with a greater odds of venous thromboembolism. Obesity was also identified as a risk factor for venous thromboembolism: class I (OR, 2.20; p < 0.001), class II (OR, 1.6; p < 0.092), and class III (OR, 2.88; p < 0.001). Impaired patient functional status (OR, 2.56; p = 0.035), recent irradiation (OR, 3.60; p = 0.03), and underlying renal comorbidities (OR, 5.60; p < 0.001) were associated with venous thromboembolism in adjusted analysis. Subgroup analysis of nonobese patients demonstrated that implant reconstruction (0.2 percent versus 0.3 percent; p = 0.383) did not confer an added risk of venous thromboembolism, whereas analysis of obese patients revealed a modality-specific increased risk of venous thromboembolism (0.4 percent versus 0.8 percent versus 1.8 percent; p < 0.001) between mastectomy compared to implant and autologous reconstruction, and for which all intergroup comparisons were significant (p < 0.05). CONCLUSIONS:Immediate breast reconstruction is associated with an added risk of venous thromboembolism relative to mastectomy, but this risk is procedure and body mass index dependent. Overall, autologous reconstruction and states of obesity placed patients at significant added risk for venous thromboembolism, particularly when both factors are present. CLINICAL QUESTION/LEVEL OF EVIDENCE:Risk, III.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Fischer JP,Wes AM,Tuggle CT,Wu LCdoi
10.1097/01.prs.0000438062.53914.22subject
Has Abstractpub_date
2014-03-01 00:00:00pages
263e-273eissue
3eissn
0032-1052issn
1529-4242pii
00006534-201403000-00009journal_volume
133pub_type
杂志文章abstract:BACKGROUND:Monobloc distraction has been demonstrated to be an efficacious, safe, and stable method of providing functional and aesthetic improvement in children with syndromic craniosynostosis. Although the movement of bony structures following monobloc distraction has been quantitatively assessed before, objective an...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181a07625
更新日期:2009-05-01 00:00:00
abstract::Diphallia is a rare congenital condition that presents in many, varied ways. Associated anomalies are to be expected. These anomalies should be sought out and treated as early in the patient's life as possible because they are the principal cause of mortality in these individuals. Half the patients reviewed by Ravitch...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1991-02-01 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::The purpose of this study was to evaluate the blockage of polymorphonuclear neutrophil endothelial adhesion by using a monoclonal antibody to the intercellular adhesion molecule 1 (ICAM-1) ligand to prevent ischemia-reperfusion injury in rat skin flaps. A skin and subcutaneous tissue flap (3.0 cm x 4.5 cm) supplied by...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199805000-00023
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:The purpose of the study was to investigate the morphologic changes of distraction osteogenesis performed on the mandible in growing minipigs. METHODS:Eighteen piglets were divided into four groups. In group A (n = 6), animals received unilateral osteotomy and the distractor device was activated for 2 weeks...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000163326.63031.30
更新日期:2005-06-01 00:00:00
abstract::The breast can be considered conceptually as a cone. This article compares and contrasts short-scar breast reduction techniques with inverted T techniques using the cone model. Four issues are examined-the base of the breast, breast projection, the inframammary fold, and the pedicle. The short-scar techniques focus on...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200104010-00010
更新日期:2001-04-01 00:00:00
abstract::Desmoplastic fibroma is an exceedingly rare primary bone tumor. Previous reports have not included the presentation of this tumor associated with the zygoma. This report describes the unusual presentation and surgical management of a desmoplastic fibroma of the zygoma. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199906000-00023
更新日期:1999-06-01 00:00:00
abstract::We present the first case of complete hemithoracic reconstruction of an irradiated postpneumonectomy recurrent empyema cavity that was unresponsive to multiple conventional treatments. The procedure described used a chain-link of two coupled free flaps consisting of an omental and TRAM flap. A single abdominal donor s...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200001000-00032
更新日期:2000-01-01 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::The buccal space, with its fat pad, is a valuable, overlooked target in facial rejuvenation procedures. The authors identified a specific group of patients who have normal or prominent malar projection in the presence of atrophy of the buccal fat pad, with or without prominent gonial angles. Eight of 24 prospectively ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003384
更新日期:2017-06-01 00:00:00
abstract::Spontaneous "overnight" deflation of inflatable prostheses is rather uncommon, but we have had a 5.7% incidence of it in a 24-month period in which we used implants with a suturable tab and fastened them to the subjacent fascia. At exploration we found these tabs had torn the bag of the implant, usually at the vulcani...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197909000-00004
更新日期:1979-09-01 00:00:00
abstract::Extensive composite defects of the oromandibular area are usually created after the surgical treatment of T3 and T4 cancers, requiring complex reconstructive plastic surgical procedures. The preferred treatment method for this type of defect is reconstruction with two free flaps. The use of the vascularized fibula ost...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200201000-00008
更新日期:2002-01-01 00:00:00
abstract::The evolution and present criteria for early soft palate closure are reviewed. A definitive group of patients (operated on at 3 to 7 months of age) is reviewed at least 2 years following their surgery. They are compared with our general clinic population (operated on at 12 to 18 months of age) and had significantly fe...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198305000-00007
更新日期:1983-05-01 00:00:00
abstract::In Part IV of this examination of the phenol-croton oil peel, the author presents peeling solutions using phenol in concentrations between 16% and 50% as the carrier for croton oil. Previously, in Part I, the author showed that phenol alone in concentrations of less than 50% has no significant peeling effect on the sk...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200003000-00035
更新日期:2000-03-01 00:00:00
abstract::The current Accreditation Council for Graduate Medical Education guidelines separate residents' education into six core competencies or subjects. The authors address the least intuitive of these, systems-based practice. In systems-based practice, educators and residents must demonstrate an awareness of and responsiven...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000245064.78012.ca
更新日期:2007-01-01 00:00:00
abstract::This investigation suggests that free autogenous grafts, when placed in preformed silicone rubber pseudosheath pockets, will survive as well, if not better, than in delayed or immediate surgical pockets. This supports the clinical assumption that silicone rubber implants can be used and exchanged periodically for larg...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197612000-00008
更新日期:1976-12-01 00:00:00
abstract::We used an ultrasonic surgical aspirator on the epidermal surface to perform dermabrasion instead of the conventional motor-driven grinder. It was determined on histologic examination that it is possible to fragment the epidermis with greater selectively using the ultrasonic surgical aspirator. Abrasion also can be pe...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199604001-00024
更新日期:1996-04-01 00:00:00
abstract::An experimental study was undertaken in pigs to clarify the pathophysiologic events occurring in a failing skin flap. It was demonstrated that skin flaps fail because of arterial insufficiency. Arteriovenous shunting is not a major cause of skin flap necrosis. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198312000-00003
更新日期:1983-12-01 00:00:00
abstract::Twenty cadaver auricles were injected with a latex solution to define the arterial supply of the anteroauricular surface. Two arterial networks exist, the network of the triangular fossa-scapha and the network of the concha. Both eventually communicate on the anthelix. The triangular fossa-scapha network originates fr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199207000-00005
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:Data from large-scale studies of breast reconstruction surgery outcomes and downstream costs are lacking. The authors assessed outcomes, patient return rates, and costs across a large, geographically diverse patient population undergoing autologous breast reconstruction. METHODS:Insurance claims for patient...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000064
更新日期:2014-03-01 00:00:00
abstract::Prosthetic rehabilitation is essential for maintaining postoperative oral function after maxillary reconstruction. However, the maxillary prosthesis becomes unstable in some patients because of extensive palatomaxillary resection and drooping of the transferred flap. In such patients, maintaining sufficient oral funct...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000041941.98504.B6
更新日期:2003-02-01 00:00:00
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/impla...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,实务指引
doi:10.1097/PRS.0000000000000541
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:The management of postoperative deep sternal wound infection varies widely based on the discretion of the cardiovascular surgeon and the plastic surgeon. METHODS:Analysis of patients with deep sternal wound infection undergoing one-step radical sternal débridement and muscle flap reconstruction by a single ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181a205f9
更新日期:2009-05-01 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:BACKGROUND:Although the use of free flaps has become a major option for head and neck reconstruction, the pectoralis major myocutaneous flap still plays an important role because of its advantages and its convenience as a pedicle flap located adjacent to head and neck lesions. However, there remain two problems with th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31819f2967
更新日期:2009-04-01 00:00:00
abstract::The individual perforating vessels have a high degree of anatomical variation, therefore it is desirable to conduct a careful examination of them before undertaking a perforator flap operation. Because locating the vessels beforehand makes performing the operative procedure much easier, the aim of the present study wa...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200006000-00011
更新日期:2000-06-01 00:00:00
abstract::The buccinator myomucosal island pedicle flap is a useful means of introducing relatively large amounts of vascularized mucosa into the oral cavity. Using cadaver dissections and clinical cases, the anatomy and clinical relevance of this tissue are defined. Emphasis is placed on the technical caveats and pitfalls of t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1991-07-01 00:00:00
abstract::Despite the existence of basic clinical standards in plastic surgery, specific guidelines for body contour photography have not been detailed previously. In this report we propose standard and supplemental views for positioning of the subject for suction-assisted lipectomy and body contour surgery. Also demonstrated a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199707000-00034
更新日期:1997-07-01 00:00:00
abstract::The Human Genome Project was launched in 1989 in an effort to sequence the entire span of human DNA. Although coding sequences are important in identifying mutations, the static order of DNA does not explain how a cell or organism may respond to normal and abnormal biological processes. By examining the mRNA content o...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/00006534-200209010-00021
更新日期:2002-09-01 00:00:00
abstract::A variety of useful recipient sites exist for breast reconstruction with free flaps, and correct selection remains a significant decision for the surgeon. Among the main pedicles, the disadvantages of the internal mammary vessels are the necessity of costal cartilage resection and the impairment of future cardiac bypa...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000129074.88594.d7
更新日期:2004-07-01 00:00:00