Abstract:
BACKGROUND:In a comprehensive review of 17,096 deep inferior epigastric perforator (DIEP) flaps in 693 articles published between the first description of the DIEP flap in 1989 and August of 2011, the authors found that the methods used to categorize partial necrosis and fat necrosis were inconsistent. As a result, these surgical outcomes cannot be meaningfully compared among series and centers. In contrast, complete flap failure is an unambiguous and universally reported outcome that represents only a portion of the entire spectrum of flap necrosis. METHODS:The authors created a database of every article with data on DIEP flaps by searching PubMed and Embase for the terms "DIEP," "DIEAP," "epigastric AND perforator," "perforator," and "flap AND reconstruction" and manually reviewing the 14,480 citations the search generated. The authors then reviewed 693 articles with data on DIEP flaps for incidence and other clinical details of flap loss, partial necrosis, and fat necrosis. RESULTS:The authors found a broad range of definitions of partial and fat necrosis based on different parameters (e.g., percentage of flap lost, area of flap lost, necessity of reoperation) that were not directly comparable. Of 152 documented DIEP flap losses, 67 had reported causes: 40 percent (27 of 67) involved venous problems, 28 percent (19 of 67) arterial, and 21 percent (14 of 67) mechanical (pedicle kinking, hematoma). CONCLUSIONS:At present, there is no consensus on the reporting of partial necrosis and flap necrosis. The authors propose a new flap necrosis classification system that prevents ambiguity and allows direct objective comparison of surgical outcomes among centers.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Lie KH,Barker AS,Ashton MWdoi
10.1097/01.prs.0000434402.06564.bdsubject
Has Abstractpub_date
2013-12-01 00:00:00pages
1401-1408issue
6eissn
0032-1052issn
1529-4242pii
00006534-201312000-00005journal_volume
132pub_type
杂志文章,meta分析,评审abstract::Vertical mammaplasty was evaluated after 10 years of experience and the study of 250 personal consecutive cases, and a few minor technical modifications are presented. In the beginning, the main advantage of the technique seemed to be the reduced amount of scarring, as this technique avoids submammary scars. With more...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199909030-00024
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:The aims of the current study were to (1) measure trends in the type of mastectomy performed, (2) evaluate sociodemographic/hospital characteristics of patients undergoing contralateral prophylactic mastectomy versus unilateral mastectomies, and (3) analyze reconstruction rates and method used following diff...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31827cf576
更新日期:2013-03-01 00:00:00
abstract::The described method for correction of the inverted nipple adds both bulk and structural stability to the nipple. This is done by means of a dermal sling and creation of a narrow base to prevent inversion of the nipple. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198004000-00020
更新日期:1980-04-01 00:00:00
abstract:BACKGROUND:Although nearly all medical students pursuing integrated plastic surgery residency participate in elective rotations away from their home medical school, the value and costs of these "away" rotations have not been well studied. METHODS:The authors surveyed all integrated plastic surgery program directors an...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002029
更新日期:2016-04-01 00:00:00
abstract::Prevailing theories on the causation of choanal atresia are presented, with emphasis on some of the embryologic and anatomic abnormalities that are consistently found. The teleologic significance of nose breathing has been emphasized. This neonatal characteristic leads to a tongue-palate seal that can be rapidly fatal...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198311000-00007
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abstract:BACKGROUND:The cephalic index is often used to evaluate sagittal craniosynostosis corrections; however, validation of this measure remains untested. METHODS:A three-part study was designed to (1) determine the normal distribution of cephalic indices in untreated sagittal craniosynostosis; (2) examine index values in t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003422
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abstract:BACKGROUND:Although many plastic surgeons perform autologous fat grafting (lipofilling) for breast reconstruction after oncologic surgery, it has not been established whether postoncologic lipofilling increases the risk of breast cancer recurrence. The authors assessed the risk of locoregional and systemic recurrence i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000475741.32563.50
更新日期:2016-02-01 00:00:00
abstract::A distally based fasciocutaneous flap for heel coverage is reported. Its blood supply depends on distal septocutaneous perforators interconnected with the suprafascial plexus. A "turn-down" transposition and distal deepithelialization were utilized to avoid kinking of the pedicle. After a 1-year follow-up, it has prov...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199001000-00022
更新日期:1990-01-01 00:00:00
abstract::None of the paresis scoring systems used satisfies an adequate description of all the details necessary to document the degree of facial paresis before and after any treatment. We developed a new documentation system considering all details of the history of the patient and of the treatment that could have any influen...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199406000-00002
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abstract::The submental artery island flap is a versatile option in head and neck reconstruction. This flap may be used for the coverage of perioral, intraoral, and other facial defects, leaving a relatively acceptable donor-site scar. In this study, the submental region of 13 formalin-fixed cadavers was dissected bilaterally. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000142479.52061.7d
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Tissue expansion, while a mainstay of reconstruction for pediatric cutaneous lesions, has significant complication rates. The authors review the complications in a single-surgeon series of tissue expansion to identify risk factors for complications and guide subsequent therapy so that reconstructive goals in...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004650
更新日期:2018-09-01 00:00:00
abstract::On the basis of over 100 endoscopic forehead lifts, we present an in-depth view of the current operative technique. The critical components are the following: (1) a subgaleal resection of muscle insertions rather than a subperiosteal approach to muscle origins, (2) a complete periosteal release along the lateral orbit...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199612000-00003
更新日期:1996-12-01 00:00:00
abstract::Cyclo-oxygenase inhibitors and free-radical scavengers protect the skin against necrosis induced by frostbite. However, the tissue component(s) that determine the evolution of skin necrosis and the mechanism of this pharmacologic protection are not precisely defined. We have studied freezing injury to rabbit ears by s...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198901000-00012
更新日期:1989-01-01 00:00:00
abstract::Thirty-one flexor tendon repairs in 30 patients managed by early passive motion were retrospectively compared with 31 flexor tendon repairs in 30 patients managed by 3 weeks of postoperative immobilization. Repairs were performed by several surgeons, including plastic surgical residents. There were no statistically si...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198501000-00016
更新日期:1985-01-01 00:00:00
abstract::Hemangioma is a primary tumor of microvasculature. Its development typically exhibits a proliferative phase followed by an involuting phase that continues into the involuted phase. Although apoptosis has been reported, the mechanisms regulating the spontaneous regression of hemangioma are largely unknown. The authors ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200111000-00001
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:Cranial vault remodeling procedures are carried out for both syndromic and nonsyndromic craniosynostosis as well as to correct some acquired deformities of the cranial vault. These procedures improve not only cosmesis but also neurological symptoms. The purpose of this study was to determine the incidence of...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000277997.56941.e5
更新日期:2007-09-15 00:00:00
abstract::Nasal deformity in unilateral cleft lip and palate patients increases with time, tongue malposition being one of the causes. Some authors have emphasized the role of nasal and adjacent facial musculature as active extrinsic agents. Another cause of alar deformity can be the lack of a proper foundation because of a max...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199909030-00002
更新日期:1999-09-01 00:00:00
abstract::The stage at diagnosis and the survival experience of 41 women who developed breast cancer after cosmetic breast augmentation were compared with those of all other patients with breast cancer (n = 13,246) diagnosed in Alberta from 1973 to 1990 (inclusive). The tumors in women with breast implants were smaller (65.9 pe...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Explain the epidemiology of severe burn injury in the context of socioeconomic status, gender, age, and burn cause. 2. Describe challenges with burn depth evaluation and novel methods of adjunctive assessment. 3. Summarize the surviv...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000002908
更新日期:2017-01-01 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::Just as everyone has a different learning style, teachers too approach the task from different perspectives. There are five basic teaching perspectives or styles: transmission, apprenticeship, developmental, nurturing, and social justice. The acronym BIAS is useful to describe the beliefs, intentions, assessments, and...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318252f182
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Congenital unilateral lower lip palsy or congenital hypoplasia of the depressor anguli oris muscle, also known as asymmetric crying facies, characterized by deformity of the lower lip, lacks aggressive surgical intervention methods. Although several dynamic and static reconstruction methods have been reporte...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000264062.64251.10
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:The major drawback of adipose grafting is its clinical unpredictability, which leads to surgeon and patient dissatisfaction. The mechanisms underlying angiogenesis and regeneration of the graft tissue are still unclear. METHODS:Mouse adipose tissue was processed using two different methods (fragmental and i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000965
更新日期:2015-03-01 00:00:00
abstract::Reconstruction of shoulder stability and movement in cases with complete paralysis of the brachial plexus was performed to improve the outcomes for universal function of prehension after double free-muscle transfer (Doi's procedure). In cases in which the C5 or C6 nerve root was available as a donor, neurotization of ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000085820.24572.EE
更新日期:2003-11-01 00:00:00
abstract::This study was undertaken to test the hypothesis that the induction of a clot layer on the graft surface of microvascular polytetrafluoroethylene (PTFE) prostheses might improve their healing. PTFE microvascular prostheses (n = 18), mechanically roughened PTFE microvascular prostheses (n = 18), and Chitosan-impregnate...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198912000-00016
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abstract:BACKGROUND:Postoperative monitoring of free flaps is important to minimize the risk of flap failure, but monitoring buried free flaps is difficult because the standard methods of clinical examination and surface Doppler monitoring are not possible. Buried free flaps are often monitored using an implantable 20-MHz ultra...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000221113.78244.8c
更新日期:2006-07-01 00:00:00
abstract::Any split-thickness skin graft donor site is obvious to some degree because of pigment alterations and, at the worst, it can develop hypertrophic scarring. A predictably superior aesthetic result is possible if this site is converted to a full-thickness defect followed by primary closure, because a linear scar is the ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199912000-00057
更新日期:1999-12-01 00:00:00
abstract::The Le Fort I osteotomy is a versatile operation for correction of developmental, congenital, and posttraumatic deformities of the lower midface. One of the challenges of the osteotomy is pterygomaxillary separation, with the potential for unfavorable fractures to the orbit/skull base or vascular injury. A modified te...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2020-05-01 00:00:00
abstract::The purpose of this study was to assess the progressive changes of nasal symmetry, growth, and relapse after presurgical nasoalveolar molding and primary cheiloplasty in unilateral complete cleft lip/palate infants. Twenty-five consecutive complete unilateral cleft lip/palate infants were included. All the infants und...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000133027.04252.7a
更新日期:2004-09-15 00:00:00
abstract:LEARNING OBJECTIVES:After reading this article, the participant should be able to: 1. Describe biofilm pathogenesis as it relates to problem wounds. 2. Understand the preclinical and clinical evidence implicating biofilm in problem wounds. 3. Explain the diagnostic and treatment challenges that biofilms create for prob...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003325
更新日期:2017-05-01 00:00:00