Abstract:
BACKGROUND:Despite a 12 to 82 percent pressure ulcer recurrence rate, no standard protocol exists for postoperative management. The authors reviewed a single surgeon's experience using a standard protocol: surgery and immediate reconstruction regardless of nutrition, intraoperative bone culture guiding postoperative antibiotic use, and hospital admission for 3 weeks of flat bedrest before graduated sitting. METHODS:A 5-year retrospective chart review was performed on consecutive surgically treated pressure ulcers. A search of billing records identified 101 patients with 179 ulcers. Data abstracted included demographics, comorbidities, location and stage of ulcers, treatment history with outcomes, and laboratory data. RESULTS:Seventy-nine percent of the patients were men with a mean age of 49.4 years. Of 179 ulcers, 49.7 percent were ischial, 26.8 percent were sacral, and 19 percent were trochanteric; 87.7 percent of ulcers were stage 4. Primary closure was performed on 45.8 percent; others underwent flap closure. There was no correlation between positive bone cultures and recurrence or complications. The overall recurrence rate was 16.8 percent at a mean period of 435.9 days. New ulcer occurrence was 14.5 percent and the complication rate was 17.3 percent. Admission prealbumin and albumin did not correlate with recurrence or complication. Mean follow-up was 629 days. CONCLUSIONS:A standard clinical pathway for pressure ulcer treatment improves long-term outcomes; the authors' protocol's validity is supported by low recurrence and complication rates. Nutritional data do not predict outcome. Intraoperative bone cultures are the most valid method of diagnosing osteomyelitis; results should not delay definitive treatment. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Larson DL,Hudak KA,Waring WP,Orr MR,Simonelic Kdoi
10.1097/PRS.0b013e3182442197subject
Has Abstractpub_date
2012-04-01 00:00:00pages
897-904issue
4eissn
0032-1052issn
1529-4242pii
00006534-201204000-00020journal_volume
129pub_type
杂志文章abstract:BACKGROUND:Oronasal fistulas are a frequent complication after cleft palate surgery. Numerous repair methods have been described, but wound-healing problems occur often. The authors investigated, for the first time, the suitability of multilayered amniotic membrane allograft for fistula repair in a laboratory experimen...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182910b50
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Breast reduction is a very common procedure within the field of plastic surgery, with many techniques. These techniques include differences in the location of the pedicles and of the scars. Another variation on the technique for breast reduction relates to preoperative infiltration of an epinephrine solution...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181823755
更新日期:2008-09-01 00:00:00
abstract::Dimpling of the skin of the thighs and buttocks is commonly referred to as cellulite, and it afflicts women much more frequently than men. Whereas many therapies that presume cellulite is caused by an abnormality of adipose tissue have gained recent popularity, the basic pathophysiology of cellulite has not been clear...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199806000-00025
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:Gender disparities in academic plastic surgery are known; however, recently, professional societies have endorsed a culture of gender diversification. This study aims to evaluate the effects of these changes at faculty and leadership positions. METHODS:A cross-sectional study was conducted in June of 2018 t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006086
更新日期:2019-10-01 00:00:00
abstract::The anterolateral thigh flap is currently the frontline choice for head and neck reconstruction. The authors used a chimeric anterolateral thigh flap for reconstruction of a through-and-through oropharyngeal defect. Because of the absence of suitable recipient vessels in the proximity of the defect, the authors recrui...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182879f32
更新日期:2013-05-01 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::The venous architecture of the integument and the underlying deep tissues was studied in six total-body human fresh cadavers and a series of isolated regional studies of the limbs and torso. A radiopaque lead oxide mixture was injected, and the integument and deep tissues were dissected and radiographed. The sites of ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199008000-00001
更新日期:1990-08-01 00:00:00
abstract::Choking is a serious problem in pharyngoesophageal reconstruction, which may occur following tumor ablation of the pharynx or following corrosive injury involving the epiglottis and other parts of the upper airway. To prevent choking and the risk of severe pulmonary complications, patients have to give up oral intake ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000083377.41505.BB
更新日期:2003-11-01 00:00:00
abstract::The safety of lidocaine dosing in the tumescent technique has been well documented, but there is little evidence regarding the safety of combining tumescent lidocaine infiltration with subcutaneous lidocaine infiltration required in other aesthetic surgery. The safety of lidocaine and epinephrine dosing was investigat...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199606000-00009
更新日期:1996-06-01 00:00:00
abstract::Low-energy lasers are currently being used in the therapy of rheumatoid arthritis, chronic pain, muscle strain, and the promotion of wound healing in human and veterinary medicine. This study examined the effects of low-energy laser on skin-flap survival in a controlled interspecies study using the rat and porcine mod...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199202000-00017
更新日期:1992-02-01 00:00:00
abstract::The coverage of defects of the Achilles tendon, malleoli, and heel remains a challenge to reconstructive surgeons. The distally based superficial sural artery island flap is vascularized by the median superficial sural artery, posterolateral septal perforators originating from the peroneal artery, neurovascular arteri...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199812000-00013
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:Simulation has gained notable recognition for its role as an effective training and assessment modality in the present era of competency-based medical education. Despite the well-documented efficacy of both live and cadaveric animal models, several ethical, financial, and accessibility issues persist with th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005990
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Peripheral neuropathy is highly prevalent among patients with diabetes mellitus and demonstrates well-established consequences of limb loss following lower extremity ulceration, infection, and amputation and upper extremity loss of function. Symptomatic neuropathy is recognized by neuropathic pain, paresthes...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e31820063d4
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Flaps based on the ulnar artery have never gained the same popularity as the radial forearm flap, despite several potential advantages. In this article, the authors describe a true ulnar artery perforator flap with perforator mapping. METHODS:Thirty-eight consecutive patients who underwent ulnar artery perf...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182362a9c
更新日期:2012-01-01 00:00:00
abstract::The purpose of this study was to gain information which might be helpful in understanding the influence of palate surgery on abnormal maxillary growth. The finding of actin-rich cells in the granulation tissue of palatal wounds supports the hypothesis that one of the functions of those cells is contraction--and the la...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197809000-00015
更新日期:1978-09-01 00:00:00
abstract::The objective of this study was to compare two noninvasive techniques, laser Doppler and optical spectroscopy, for monitoring hemodynamic changes in skin flaps. Animal models for assessing these changes in microvascular free flaps and pedicle flaps were investigated. A 2 x 3-cm free flap model based on the epigastric ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000148415.54546.ca
更新日期:2005-02-01 00:00:00
abstract::Given the short recovery and immediate results, facial fillers have become a popular alternative to surgical rejuvenation of the face. Reported complications arising from facial filler injections include erythema, tissue loss, blindness, stroke, and even death. In this article, the authors describe their anatomically ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003309
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:This study compared overall and breast cancer-specific survival using long-term follow-up data among women diagnosed with invasive breast cancer undergoing mastectomy or breast reconstruction. METHODS:Retrospective study using population-based data from Ontario Cancer Registry (1980 to 1990) including women...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/PRS.0000000000001054
更新日期:2015-03-01 00:00:00
abstract::Poland's syndrome comprises a spectrum of chest-wall deformities affecting, to various degrees, the rib cage, the chest-wall muscles, the neurovascular structures of the ipsilateral arm, and the overlying breast. This study details our experience with nine female Poland's syndrome patients who had chest-wall and breas...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199702000-00017
更新日期:1997-02-01 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::The forehead flap is a reliable means of bringing viable lining to the oral and oropharyngeal cavities after composite resections for cancer in locally radiated areas. We discuss the complications and results of such reconstructions. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197807000-00007
更新日期:1978-07-01 00:00:00
abstract::Subfascial placement of implants was introduced 3 years ago. Collected data reveal very promising short-term and long-term results in comparison with subglandular and subpectoral positioned implants. The clinical experiences of 69 breast augmentations in the subfascial position are reported. The indications for this t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000135906.48388.22
更新日期:2004-10-01 00:00:00
abstract::Breast cancer is the tumor with the highest prevalence and incidence in women. Reduction mammaplasty is one of the most common procedures performed in Brazil by the plastic surgeon, and it is not uncommon for the surgeon to find a breast tumor during the operation or afterward, when the histopathological report is rec...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000152683.62899.50
更新日期:2005-03-01 00:00:00
abstract::Currently, fat transplantation occurs immediately after harvesting procedures. Because low rates of fat graft take are well reported in the literature, many patients require multiple surgical procedures for fat graft harvest. These subsequent procedures lead to increased cost, donor-site morbidity, and patient discomf...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000006699
更新日期:2020-04-01 00:00:00
abstract::The distribution of glucose and lactate within skin flaps was determined in full-thickness guinea pig skin (excluding the panniculus carnosus). The distal end of the flaps had a low glucose content (less than 50 percent of normal) but high lactate level (2 to 3 times normal) during the 3 days after flap elevation. Pro...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197805000-00015
更新日期:1978-05-01 00:00:00
abstract::Approaches advocated for treatment of airway obstruction among neonates with Pierre Robin sequence include positioning, tongue-lip adhesion, mandibular distraction, and tracheostomy, with no established guidelines regarding which modality is appropriate for a specific patient. This report proposes an algorithm for the...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000110323.50084.21
更新日期:2004-04-01 00:00:00
abstract::A review of the literature and case records reflected a need for the development of a clinically applicable assessment scheme and classification system for soft-tissue laceration injuries to the face. Herein, a systematic approach for assessing facial lacerations is proposed based on location, depth of penetration, br...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199904040-00008
更新日期:1999-04-01 00:00:00
abstract::In an attempt to decrease a 10 to 15 percent vascular thrombosis rate leading to graft occlusion, low-dose human-grade heparin was studied to determine if carefully monitored intravenous therapy would increase 7-day patency in a known potent thrombosis model. In New Zealand white rabbits, the type of infusate administ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198809000-00016
更新日期:1988-09-01 00:00:00
abstract::This study was undertaken to obtain more insight into the morphologic and functional performance of microvascular polytetrafluoroethylene (PTFE) prostheses. Therefore, both the cellular events of healing (n = 30) and the prostacyclin production (n = 18) of microvascular polytetrafluoroethylene prostheses (length 10 mm...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1988-05-01 00:00:00
abstract:BACKGROUND:Cell-seeded biomaterial scaffolds have been proposed as a future option for reconstruction of bone tissue. The ability to generate larger, functional volumes of bone has been a challenge that may be addressed through the use of perfusion bioreactors. In this study, the authors investigated use of a tubular p...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005529
更新日期:2019-05-01 00:00:00