Abstract:
BACKGROUND:The purpose of this study was to (1) understand national variation in delay of emergency procedures in patients with open tibial fracture at the hospital level and (2) compare length of stay and cost in patients cared for at the best- and worst-performing hospitals for delay. METHODS:The authors retrospectively analyzed the 2003 to 2009 Nationwide Inpatient Sample. Adult patients with open tibial fracture were included. Hospital probability of delay in performing emergency procedures beyond the day of admission was calculated. Multilevel linear regression random-effects models were created to evaluate the relationship between the treating hospital's tendency for delay (in quartiles) and the log-transformed outcomes of length of stay and cost. RESULTS:The final sample included 7029 patients from 332 hospitals. Patients treated at hospitals in the fourth (worst) quartile for delay were estimated to have 12 percent (95 percent CI, 2 to 21 percent) higher cost compared with patients treated at hospitals in the first quartile. In addition, patients treated at hospitals in the fourth quartile had an estimated 11 percent (95 percent CI, 4 to 17 percent) longer length of stay compared with patients treated at hospitals in the first quartile. CONCLUSIONS:Patients with open tibial fracture treated at hospitals with more timely initiation of surgical care had lower cost and shorter length of stay than patients treated at hospitals with less timely initiation of care. Policies directed toward mitigating variation in care may reduce unnecessary waste.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Sears ED,Burke JF,Davis MM,Chung KCdoi
10.1097/PRS.0b013e31827c6efcsubject
Has Abstractpub_date
2013-03-01 00:00:00pages
553-563issue
3eissn
0032-1052issn
1529-4242pii
00006534-201303000-00019journal_volume
131pub_type
杂志文章abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Describe the goals of nasal reconstruction as they apply to extensive, complex defects that may also involve the adjacent lip or cheeks. 2. Understand the advantages and disadvantages of different options for reconstruction of lining...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000298113.56554.c3
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:To plan abdominal perforator-based microsurgical breast reconstruction, duplex ultrasound is often employed to preoperatively identify the location of abdominal wall perforating vessels. Recently, several groups have published the use of computed tomography angiography for preoperative planning in perforator...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/PRS.0b013e3181c82d24
更新日期:2010-02-01 00:00:00
abstract::We describe a case of congenital popliteal pterygium in conjunction with other specific congenital malformations. This syndrome has been called the quadruple syndrome. The literature is reviewed. A rationale for more aggressive treatment of this deformity is discussed. One child who has undergone major multiple nerve ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197509000-00020
更新日期:1975-09-01 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 authors studied residency applicant attitudes toward rank list creation, communication with programs, and the impact of these factors on their performance in the Match. METHODS:An anonymous, 26-question, multiple-choice, online survey was distributed to the program coordinators of every Accreditation Co...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31829ad2bb
更新日期:2013-09-01 00:00:00
abstract::Resource costs, which are the costs to the hospital of providing a service, were measured for 154 patients who underwent mastectomy and immediate breast reconstruction with TRAM flaps. Unilateral and bilateral reconstructions were evaluated separately. The resource costs required to perform mastectomy and reconstructi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199607000-00011
更新日期:1996-07-01 00:00:00
abstract::Soft-tissue injuries involving the dorsum of the hand and foot continue to pose complex reconstructive challenges in terms of function and contour. Requirements for coverage include thin, vascularized tissue that supports skin grafts and at the same time provides a gliding surface for tendon excursion. This article re...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200008000-00013
更新日期:2000-08-01 00:00:00
abstract::Skin-sparing mastectomy by definition describes the procedure of mastectomy, either simple or modified radical, with a minimum amount of skin excision. The surgical skin excision must: (1) include the nipple-areola complex, (2) include the biopsy site, and (3) allow for access to the axilla for possible dissection. In...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND:The purpose of the present study was to determine the locations of the infraorbital foramen and mental foramen based on soft-tissue landmarks to facilitate prediction of the locations of these structures during facial surgery. METHODS:Fifty embalmed cadavers (100 sides) of Koreans were dissected to expose t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000279558.86727.5a
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:In an era of increasing drug resistance, immunotherapy is a desirable treatment against Pseudomonas aeruginosa infections. The flagellum, which is an important pseudomonal virulence factor, was targeted for immunotherapy. The aim of the study was to evaluate the efficacy of polyclonal immunotherapy targeted ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000218768.34429.e0
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Greater provider volume is associated with better outcomes. There is, however, a paucity of evidence on volume-outcome associations for surgical complications and 30-day all-cause rehospitalization after free tissue transfer or free flap surgery. Surgical complications and frequent rehospitalization are impo...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/PRS.0000000000003515
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Autologous fat transplantation (or lipofilling) is an excellent technique for correction of cosmetic defects. The success of the procedure relies strongly on the techniques of harvesting and transferring viable adipocytes. The purpose of this study was to evaluate effects of two harvesting methods and coenzy...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000258395.81926.d8
更新日期:2007-04-01 00:00:00
abstract::Blasius was a famous teacher and surgeon. Apart from his own writings on surgery and his new methods for reconstructions, such as the replacement of nose, lips, and eyelids, some theses were also inspired by him. His main work is his three-volume Handbuch der Akiurgie, to which he added an excellent atlas, from which ...
journal_title:Plastic and reconstructive surgery
pub_type: 传,历史文章,杂志文章
doi:10.1097/00006534-198410000-00020
更新日期:1984-10-01 00:00:00
abstract::After a very cautious dissection, the crossing of cartilages is going to produce a "spring effect" which, in pushing them to the right position, will consequently correct the pinch. This is a simple procedure, indicated only for nose tips or, if associated with other techniques, to correct secondary rhinoplasty patien...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
abstract::Several authors have cited renal disease as a risk factor for free flap failure. The authors performed a retrospective analysis of all patients who underwent free tissue transfer with concomitant renal disease, including acute renal failure, end-stage renal disease, chronic renal insufficiency, and functional kidney t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000122214.55090.16
更新日期:2004-06-01 00:00:00
abstract::Understanding wound healing today involves much more than simply stating that there are three phases: inflammation, proliferation, and maturation. Wound healing is a complex series of reactions and interactions among cells and "mediators." Each year, new mediators are discovered and our understanding of inflammatory m...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000222562.60260.f9
更新日期:2006-06-01 00:00:00
abstract::The high incidence of complications during tissue expansion may be related to overexpansion with subsequent tissue necrosis and implant extrusion. Subjective parameters such as pain or capillary fill may be poor guidelines for determining the end point of a given session of expansion. In an attempt to rectify this pro...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00006534-198603000-00013
更新日期:1986-03-01 00:00:00
abstract::Prophylactic bilateral mastectomy is an option for women who are at an increased risk of developing breast cancer. Prophylactic mastectomy is often performed with immediate reconstruction (i.e., at the same time and under the same anesthetic as the mastectomy). Satisfaction with reconstruction has been described previ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000131877.52740.0e
更新日期:2004-08-01 00:00:00
abstract::As we have gained experience with the extended superficial musculoaponeurotic system (SMAS) technique in face lifting, refinements in our procedure have led to increased consistency in results. The important factors that have led to our technical modifications include the following: (1) the significance of the retaini...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200001000-00046
更新日期:2000-01-01 00:00:00
abstract::The use of nonpenetrating clips to accomplish wound closure as an alternative to suture in the repair of simulated cleft lips in partially exteriorized fetuses has been described previously. In this study, the fetus is approached endoscopically, and clipped (n = 8) and sutured (n = 4) intrauterine endoscopic repairs i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199807000-00001
更新日期:1998-07-01 00:00:00
abstract::Recent evidence supports the use of end-to-side neurorrhaphy for the treatment of certain peripheral nerve disorders. However, the mechanism by which nerves regenerate following this procedure is still unclear. To address this question, the authors designed a new end-to-side coaptation model in rats in which the donor...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000129075.96217.92
更新日期:2004-07-01 00:00:00
abstract::The purpose of this Special Topic article is to present the current state of scientific evidence related to the safety of silicone breast implants. There is presently overwhelming evidence to support the safety of silicone breast implants. Ultimately, the decision to obtain, keep, or remove breast implants is the choi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000005710
更新日期:2019-07-01 00:00:00
abstract::Cigarette smoke, and specifically nicotine, has been shown to reduce skin-flap survival. The purpose of this study was to determine if the preoperative administration of pentoxifylline can counteract the deleterious effects of nicotine on skin-flap survival in the rat. Sixty rats were distributed into four groups (n =...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199707000-00011
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:Outcomes for a continuously applied alveolar bone grafting protocol, established in 1982, are reported and compared to previously published outcomes from the authors' unit and elsewhere. METHODS:A descriptive, retrospective cohort study of alveolar bone grafting outcomes at a tertiary referral cleft center ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006494
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:"Disruptive physician" is a term appearing more frequently in many hospital bylaws. It has significant negative implications that can lead to loss of privileges for plastic surgeons. METHODS:Exploring the various definitions of disruptive physician reveals palpable differences between those of the Joint Com...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31819348bd
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Capsular contracture remains the most common complication following breast augmentation surgery, and evidence suggests that bacterial biofilm on the implant surface is responsible. The authors investigated whether the interaction of bacterial biofilm with implants independently determines progression to caps...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000020
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Facial contour augmentation is an entity often encountered by reconstructive surgeons. To date, very different autologous tissues such as fat, dermofat, dermal fascia, muscle, cartilage, and bone in the manner of grafts or flaps according to the requirements of the defect have been used for facial augmentati...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000252002.76466.cf
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Composite defects of the oral cavity are often the result of trauma or advanced-stage tumor extirpation. The resultant deformity frequently requires a three-dimensional reconstruction of bone and soft-tissue. The fibula free flap is the preferred method of reconstruction, with various modifications focused o...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000216
更新日期:2014-06-01 00:00:00
abstract::This paper discusses a case of congenital leukemia cutis of lymphoblastic type presenting as a solitary frontonasal tumor. The presentation is unusual when compared with other reported cases of neonatal leukemia and represents the only reported case with comparable presenting features to the authors' knowledge. The di...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199712000-00026
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:The debate over the legitimacy of silicone as a safe tool for soft-tissue augmentation has spanned well over half a century. Proponents concede that injections of questionable purity and/or of massive quantities have produced unfavorable outcomes. They assert that in experienced hands with "injectable-grade"...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000267580.92163.33
更新日期:2007-12-01 00:00:00