Abstract:
BACKGROUND:Since the inception of microvascular free tissue transfer, flap monitoring has been based on clinical signs. Color, capillary refill, and handheld Doppler have been used for monitoring in the postoperative period; however, subjective clinical examination may delay recognition of flap compromise. Tissue oximeter monitoring offers an objective method for detecting vascular compromise with the measurement of tissue oxygen saturation and real-time flap perfusion. METHODS:The authors reviewed 614 consecutive microsurgical flaps for breast reconstruction from 2004 to 2010. The authors' first 380 patients underwent clinical flap postoperative monitoring. Starting in June of 2008, the authors used tissue oximetry as an adjunct on 234 consecutive patients. Flap reexploration, flap loss, salvage rate, fat necrosis, and characteristics of vascular compromise were analyzed. RESULTS:There were 26 instances of flap reexploration (6.8 percent) and 11 flap losses (2.9 percent) before use of tissue oximetry. After tissue oximetry was used, there were 16 instances of flap reexploration (6.8 percent) and one flap loss. The rate of flap reexploration was not statistically significant between groups, but the difference between the flap failure rates is significant (p = 0.025). The flap salvage rate was previously 57.7 percent; after tissue oximetry monitoring, the flap salvage rate was 93.75 percent (p = 0.015). CONCLUSIONS:The use of tissue oximetry has decreased the authors' flap loss rate and improved the flap salvage rate in microsurgical breast reconstruction. This device is a useful adjunct in flap monitoring during the postoperative period, as it may help decrease flap loss by detecting impending vascular compromise before it becomes clinically evident.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Lin SJ,Nguyen MD,Chen C,Colakoglu S,Curtis MS,Tobias AM,Lee BTdoi
10.1097/PRS.0b013e31820436cbsubject
Has Abstractpub_date
2011-03-01 00:00:00pages
1080-1085issue
3eissn
0032-1052issn
1529-4242pii
00006534-201103000-00007journal_volume
127pub_type
杂志文章abstract:BACKGROUND:Despite a revived interest in fat grafting procedures, clinicians still fail to demonstrate clearly the in vivo behavior of fat grafts as a dynamic tissue substitute. However, the basic principles in cellular biology teach us that cells can survive and develop, provided that a structural matrix exists that d...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181ebe224
更新日期:2010-10-01 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::Twenty-one vascular malformations located in the facial area, 11 high-flow arteriovenous malformations and 10 slow-flow malformations, underwent combined treatment by embolization and later surgery. Embolization was performed simultaneously with superselective angiography of the branches of the external carotid artery...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1990-10-01 00:00:00
abstract:LEARNING OBJECTIVES:Learning Objectives: After reading this article, the participant should be able to: 1. Examine a nasal defect to determine its true dimension and outline and plan the appropriate timing of reconstruction. 2. Develop a surgical plan to restore normal dimension, volume, symmetry, and outline. 3. Deter...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182827bb3
更新日期:2013-04-01 00:00:00
abstract::Of four patients with rheumatoid arthritis and Dupuytren's contracture, two were not aware of the presence of Dupuytren's contracture. When both diseases coexist, the presence of rheumatoid hand deformities, especially flexion and ulnar deviation of the metacarpophalangeal joints, may mask the flexion deformity caused...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198801000-00010
更新日期:1988-01-01 00:00:00
abstract::An experimental animal study was undertaken to evaluate the potential use of HTR polymer as a craniomaxillofacial reconstructive material. Its properties of marked hydrophilicity, a negative surface charge, and extensive porosity combined with a calcium graft coating suggested favorable osteoconductive properties. Fou...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199012000-00006
更新日期:1990-12-01 00:00:00
abstract::Open rhinoplasty has unquestionably become more popular during the past two decades because of the putative diagnostic and technical advantages that direct transcolumellar access offers. To test the hypothesis that patients initially treated by the opened or closed approaches differed in the secondary deformities that...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200205000-00048
更新日期:2002-05-01 00:00:00
abstract::Nine patients with complex extremity injuries were treated with emergency free-flap transfers over a 3 1/2-year period. The transferred emergency free flaps were performed to cover exposed vital structures. All flaps survived without infection. Complete and careful assessment of the systemic condition of the patient a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1992-05-01 00:00:00
abstract::This article describes the results of segmental bone and cartilage reconstruction of significant nasal dorsal defects. Solid bone graft reconstructions frequently lead to an unnatural hardness of the nasal tip. Rib cartilage reconstructions are pliable and soft but are a problem because they easily undergo warpage. Th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200007000-00032
更新日期:2000-07-01 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::Microsurgical transfer of the superficial and deep temporal fascia based on the superficial temporal vessels has been documented. This article analyzes the functional recovery when each layer of this facial flap is placed on either side of reconstructed or repaired tendons, to recreate a gliding environment. This fasc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200111000-00031
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:Vascular complications resulting from intravascular filler injection and embolism are major safety concerns for facial filler injection. It is essential to systematically screen full-face arterial variations and help design evidence-based safe filler injection protocols. METHODS:The carotid arteries of 22 c...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004834
更新日期:2018-11-01 00:00:00
abstract::A description is presented of an anterior approach to the treatment of prominent ears with Kaye's method but with a few modifications to simplify it. Confirmation of the method's advantages is discussed. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199702000-00042
更新日期:1997-02-01 00:00:00
abstract:SUMMARY:Optimal management of the mandible fracture is directly dependent on thorough evaluation, correct injury assessment, and timely initiation of appropriate therapy. As the mandible is a complex three-dimensional bone, significant structural differences in mandibular regions must be appreciated. While the small cr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e318195668e
更新日期:2009-02-01 00:00:00
abstract::Relationships between physicians and industry, whether it be pharmaceutical companies, medical device manufacturers, or purveyors of medical technology, contain both an element of potential for good and a potential for harm. Certainly, the potential for good is realized when the collaboration results in improved plast...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000788
更新日期:2015-04-01 00:00:00
abstract::We retrospectively reviewed 119 consecutive patients who underwent cleft palate repair at the Mayo Clinic to determine the incidence of postoperative fistula formation, to assess possible contributing factors, and to review the methods of surgical management. Fistulas of the secondary palate were included, but nasal-a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:The deep inferior epigastric perforator (DIEP) flap, which is a modification of the muscle-sparing free transverse rectus abdominis musculocutaneous (TRAM) flap, is being more frequently used in an effort to reduce postoperative abdominal morbidity. However, there is no consensus as to which of these flaps i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003843
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:A thin skin flap is often required for optimal resurfacing of particular areas of the body. An anterolateral thigh perforator flap can be thinned to an extent to which it is vascularized by the subdermal plexus only. This study presents a novel flap thinning technique and its application for resurfacing the ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000200615.77678.f1
更新日期:2006-03-01 00:00:00
abstract:UNLABELLED:Fibular osteotomy remains a challenging aspect of mandibular microsurgical reconstruction, dependent largely on surgeon experience, intraoperative judgment, and technical speed. Virtual surgical planning and stereolithographic modeling is a relatively new technique that can allow for reduction in the learnin...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31822b6723
更新日期:2011-11-01 00:00:00
abstract::To determine the best method for treating deep second- and third-degree burned hands in our institution, a prospective study comparing early excision and grafting with nonsurgical treatment was undertaken. The patients were randomly assigned to two groups, and the hands in the first group were excised and grafted with...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00006534-198204000-00017
更新日期:1982-04-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199303000-00026
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abstract:BACKGROUND:Perforator free flaps from the buttock serve as an alternative to abdominally based flaps in autologous breast reconstruction. Microsurgeons often opt to harvest tissue from the gluteal donor site because of a lack of abdominal volume and/or quality. The authors examined the experience of a single surgeon wi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318230c2d8
更新日期:2011-12-01 00:00:00
abstract::Correcting facial asymmetry is a difficult problem for plastic surgeons. From 1991 to 1996, the authors treated 53 cases of mandibular angle resection, 13 of which were of patients with an asymmetrical lower face. On the basis of these experiences, the authors highlight two important points in dealing with the asymmet...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract::As part of forehead rejuvenation and surgical treatment of migraine headaches, the mass of the corrugator supercilii, the procerus, and the depressor supercilii muscles is replaced with fat for optimal aesthetic contouring of this region and to help prevent recurrence of the glabellar lines. The authors propose a new ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000128825.62390.73
更新日期:2004-07-01 00:00:00
abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Identify clinical situations in which hand sonography can result in the detection of partial extensor tendon tears. 2. Identify the limitations of magnetic resonance imaging in diagnosing extensor tendon tears. 3. Understand the vari...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000345599.95343.2a
更新日期:2009-02-01 00:00:00
abstract::The quantity of soft tissue overlying the symphysis menti affords an important attribute that can aid in determination of the correct surgical approach for optimal facial harmony. Xerograms of the facial profile of 100 patients with normal occlusion were analyzed by accepted radiographic cephalometric techniques. The ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract::The objective of this retrospective follow-up study was to evaluate the outcome of patients with soft-tissue sarcoma treated by the authors' protocol, which consists of a selective combination of conservative surgery and radiotherapy. Patients who relapsed were especially evaluated to improve treatment results. The au...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000095946.90511.1D
更新日期:2004-01-01 00:00:00
abstract::A microform cleft lip has three major components: (1) a minor defect of the upper vermilion border with loss of the mucocutaneous ridge; (2) a narrow ridge of tissue, resembling an exaggerated philtral column extending to the nostril sill; and (3) a deformity of the nostril. To attain the muscle continuity without an ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000135336.43513.17
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Keloids and hypertrophic scars are the result of abnormal healing responses and dermal tissue proliferation; current surgical procedures can give rise to exuberant scarring and permanent functional loss or disfigurement. Considering the promising results reported when treating keloids and hypertrophic scars ...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/PRS.0b013e3182a053c8
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Composite tissue allotransplantation is fraught with complexities similar to those of solid organ transplantation, including donor-related cytomegalovirus transmission. With this in mind, the authors' objective was to (1) report their team's experience with infections and donor-related cytomegalovirus transm...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318208d03c
更新日期:2011-04-01 00:00:00