Abstract:
BACKGROUND:Suboptimal pain management is a common, yet largely unrecognized, problem in the postsurgical patient population. Current treatment protocols heavily rely on opioid use and, though generally effective in providing pain relief, are associated with multiple side effects. The present systematic review aims to offer plastic surgeons insight into the current state of literature on prolonged local anesthetic wound infusion regimens, evaluating both their efficacy in lowering pain scores and the potential opioid-sparing effect. METHODS:A comprehensive literature search of the Medline, Embase, and Cochrane Library databases was performed to identify relevant studies published between 1980 and December 2017 evaluating the use of prolonged local anesthetic wound infusion for postoperative pain management in plastic surgery. RESULTS:A total of 28 articles were selected, including 3904 patients. The overall infection rate in all patients treated with postsurgical local anesthetic wound infiltration was 0.28% (7/2536). There were no reported cases of systemic toxicity. An opioid-sparing effect was found in 92% (12/13) of studies when compared to an active comparator and 88% (7/8) of those comparing to placebo. Pain scores were decreased in 90% (9/10) of studies comparing wound infiltration to narcotic-based regimens and in 67% (6/9) of those comparing to placebo. CONCLUSIONS:Continuous or intermittent wound infusion is safe and effective in reducing pain scores and opioid consumption in plastic surgery. Though the overall pain-lowering effect appears to be modest, ease of catheter insertion and patient satisfaction make this technique an alluring alternative to more validated approaches such as neuraxial or peripheral nerve blocks.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Roy CF,Azzi AJ,Davison Pdoi
10.1097/SAP.0000000000001916subject
Has Abstractpub_date
2019-12-01 00:00:00pages
e110-e117issue
6eissn
0148-7043issn
1536-3708journal_volume
83pub_type
杂志文章abstract::Many procedures have been developed to correct the secondary cleft lip nasal deformity, including the depressed nasal tip, flaring nasal aperture, and a very short columella. The forked flap, cartilage graft, or strut and bony graft have been applied for many years. We propose the extended open-tip rhinoplasty with th...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199611000-00005
更新日期:1996-11-01 00:00:00
abstract::Eight patients with large panniculi are described where severe problems with hygiene, immobility, and chronic infection were caused by the lymphedematous, chronically infected pannus. Protracted nonsurgical management of the infected panniculus had failed in all 8 patients. Wedge resection without fat undermining remo...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199205000-00008
更新日期:1992-05-01 00:00:00
abstract::Oculopharyngeal muscular dystrophy is a hereditary, autosomal dominant, slowly progressive disorder with onset that occurs during middle age. Major symptoms are ptosis and dysphagia resulting primarily from selectively involved levator palpebrae and the pharyngeal muscles. Progressive, usually symmetrical blepharoptos...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200210000-00015
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:In this study, we investigated sensory and motor outcomes for different bridging techniques for short nerve gaps. MATERIAL AND METHODS:This study was conducted in the Postdoctoral Department of Burns, Plastic, and Reconstructive Surgery of our institution from August 2014 to May 2017. All patients with post...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001207
更新日期:2017-11-01 00:00:00
abstract:UNLABELLED:Periprosthetic infections of oncologic reconstructions have an amputation rate between 37% and 87%. Eleven patients with an infected knee reconstruction following limb salvage surgery for cancer were treated with the staged protocol. All patients underwent prosthetic removal and implantation of an antibiotic...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000203990.08414.ad
更新日期:2006-05-01 00:00:00
abstract:PURPOSE:This study aims to determine the relationship between race and ischemic complications in women undergoing breast reconstruction with pedicled TRAM (pTRAM) and perforator flaps (DIEP). PATIENTS AND METHODS:A retrospective, cross-sectional study of women who underwent breast reconstruction utilizing either pTRAM...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000102
更新日期:2014-01-01 00:00:00
abstract::A new genioplasty technique has been described and performed on 16 patients since 1995. The technique has been developed to avoid some undesired results of the current osseous genioplasty techniques and to achieve a more natural appearance in advancement genioplasty. According to the authors' technique, a rectangular ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1999-08-01 00:00:00
abstract::Finger pulp loss is often observed in daily practice. When the lateral and dorsal surfaces of the injured digit remain intact, a neurovascular island flap can be designed and raised from that part of the finger for pulp reconstruction. Two types of homodigital lateral-dorsal neurovascular island flaps were used in 17 ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200045060-00008
更新日期:2000-12-01 00:00:00
abstract::Transverse facial clefts (macrostomia) are rare disorders that result when the embryonic mandibular and maxillary processes of the first branchial arch fail to fuse properly to form the corners of the mouth. Macrostomia may be seen alone or in association with other anomalies. It may be unilateral, extending along a l...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181e6cfc1
更新日期:2011-04-01 00:00:00
abstract::Double-breasted closure of the skin is achieved by deepithelialization of 1 edge of a wound and advancement of the opposite edge over this deepithelialized area. Such closure may prevent contamination or exposure of the implant in cases where immediate breast reconstruction with prosthetic material is obtained after s...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000174362.35948.65
更新日期:2005-09-01 00:00:00
abstract::The purpose of this investigation was (1) to determine the incidence of basal cell carcinoma (BCC) recurrence in patients who had microscopic evidence of residual tumor at the margin of resection and (2) to identify morphological characteristics that predispose to recurrence. Twenty-nine patients with margin-positive ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199703000-00008
更新日期:1997-03-01 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:BACKGROUND:This study sought to examine the feasibility and effectiveness of the use of ultrasound (US) as a clinical adjunct in the delivery of botulinum toxin for the treatment of Raynaud disease of the hand. METHODS:One cadaver hand was injected with a colored simulation material using the current traditional surfa...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002303
更新日期:2020-06-01 00:00:00
abstract::Epicanthus, with its various types, is characterized by an arching fold at the sides of the nose, with a concavity directed laterally. Epicanthus inversus, one of these types, which occurs with varying frequency in all races, is most common among Asians. In epicanthus inversus, the medial canthus is displaced laterall...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200045020-00007
更新日期:2000-08-01 00:00:00
abstract::The purpose of this study was to investigate the efficacy of cilostazol for prevention of thrombosis in microsurgical anastomosis. We used not only a patency test, but also ultrasonography to evaluate the blood flow volume (FV) more accurately and objectivity. In addition, we evaluated the accuracy and sensitivity of ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31819aad6c
更新日期:2010-04-01 00:00:00
abstract::A simple method of grafting around draining abdominal wall fistulas is described. A Silastic sump drain stapled into a doughnut configuration is used. This produces a barrier around the fistula which drains the fluid off as it reaches the perforations of the sump drain. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198312000-00019
更新日期:1983-12-01 00:00:00
abstract:BACKGROUND:Infantile hemangioma (IH) is a common, benign tumor occurring in up to 10% of white infants. Propranolol has emerged as a front-line therapy for IH. The retrospective study examined the response of propranolol therapy on hemangioma size. METHODS:Twenty-seven children (4 to 20 weeks old) with IH were enrolle...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000521
更新日期:2016-03-01 00:00:00
abstract::The etiology of keloid formation is diverse. They are characterized grossly as thick scar tissue that extends beyond the boundaries of the original wound. Histologically, keloids are composed of excessive collagen with an abnormally large number of partially or totally occluded microvessels. This occlusion of keloid m...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199905000-00009
更新日期:1999-05-01 00:00:00
abstract::Currently, 50 cases of craniocarpotarsal dysplasia, or whistling face syndrome (WFS), have been reported, with more than 60 anatomical anomalies involving the head, hands, and feet, in addition to the face. In spite of the fact that there is much information concerning the surgical correction of many of these deformit...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:There is no quantitative evidence supporting one unilateral cleft lip (UCL) repair technique over the other with regard to scarring. We sought to evaluate the difference between the extended Mohler and Millard techniques, using 3 scar assessment scales. METHODS:Postoperative frontal and basal photographs of...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001991
更新日期:2019-12-01 00:00:00
abstract::Sagging of the remaining breast behind the inframammary fold after breast reduction or breast augmentation may necessitate revisional surgery. The authors achieved inframammary fold reconstruction by reconstruction of the inframammary crease ligament through a deepithelialized skin flap that is anchored to the periost...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000037279.69711.53
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Ketorolac tromethamine (Toradol) is an effective a nonsteroidal anti-inflammatory drug and a powerful analgesic for patients undergoing breast surgery. However, the potential for postoperative bleeding has not yet been explored specifically in women undergoing implant-based breast reconstruction. There is co...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001409
更新日期:2018-05-01 00:00:00
abstract:INTRODUCTION:Abdominal wall integrity may be compromised after abdominal flap harvest for breast reconstruction, leading to bulging or herniation due to weakening of the abdominal wall and dissection through the rectus muscle. Mesh can be used to reinforce the abdominal wall to reduce the risk of hernia formation posto...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001468
更新日期:2018-05-01 00:00:00
abstract::One of the surgical goals of phalloplasty is to obtain sufficient rigidity for sexual penetration. This is also important for patients with erectile dysfunction. Different kinds of techniques have described phalloplasty and obtaining rigidity in patients with erectile dysfunction, but there is no good substitute for t...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000044142.17243.8C
更新日期:2003-05-01 00:00:00
abstract:INTRODUCTION:Full-thickness soft tissue defects of the back remain challenging clinical problems for reconstructive surgeons. Among a vast variety of local flap options, perforator-based local flaps gain increasing popularity lately. Because mostly heterogeneous patient cohort comparison of different perforator flaps i...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002439
更新日期:2021-01-01 00:00:00
abstract::Intravascular coagulation is the final common pathway of failure in replanted digits and "free" tissue transfers. To address this clinical problem, a model based upon intimal damage and stasis in the rat femoral vein was developed. The ability of local, intraarterially administered Thrombolysin to achieve "local" clot...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198107000-00006
更新日期:1981-07-01 00:00:00
abstract:BACKGROUND:Complications after immediate breast reconstruction pose a significant challenge to the reconstructive surgeon. Known risk factors include smoking, obesity, age, and adjuvant oncologic therapies. Less is known about the association between axillary lymph node dissection (ALND) and the development of postoper...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000653
更新日期:2016-11-01 00:00:00
abstract::The experiences of the author while an Officer in the South African Medical Corps are related. During the battle of Britain he was attached to the R.A.M.C. and observed the work of pioneers in modern military plastic surgery. On his return to South Africa, he set up the Brenthurst Military Red Cross Hospital for Plast...
journal_title:Annals of plastic surgery
pub_type: 历史文章,杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::Fatty tumors of the peripheral nerves, although rare, occur with sufficient frequency to pose problems in diagnosis and treatment. Moreover, the nomenclature of these tumors has suffered from controversy over their morpological description. These factors have contributed to a misunderstanding about the treatment of th...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197803000-00011
更新日期:1978-03-01 00:00:00
abstract::Current recipient vessels for microvascular breast reconstruction include the internal mammary and the thoracodorsal systems. This review will focus on the advantages of the internal mammary artery and vein and reasons for their preference. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0b013e31821daac3
更新日期:2012-05-01 00:00:00