Abstract:
BACKGROUND:The management of postoperative deep sternal wound infection varies widely based on the discretion of the cardiovascular surgeon and the plastic surgeon. METHODS:Analysis of patients with deep sternal wound infection undergoing one-step radical sternal débridement and muscle flap reconstruction by a single plastic surgeon from 1986 to 2008 was conducted. Two groups of patients were identified. The immediate group was referred soon after diagnosis of sternal wound infection and without any débridement. The delayed group was referred much later after undergoing an extended management by their cardiovascular surgeon. Retrospective review was performed to compare morbidity, mortality, and length of stay between the two groups. RESULTS:There were a total of 583 patients with deep sternal wound infection. Of the 497 patients referred immediately, 22 (4.4 percent) patients required mechanical ventilation for an average of 4 days, eight (1.6 percent) required tracheotomy, 13 (2.6 percent) developed stage III/IV pressure sores, 24 (4.8 percent) developed major wound dehiscence, zero (0 percent) required skin grafting, average length of stay was 4.7 days, and five died (1 percent). Of the 86 patients with a delayed referral, 40 (46.5 percent) required mechanical ventilation for an average of 18.3 days, 31 (36 percent) required tracheotomy, 20 (23.3 percent) developed stage III/IV pressure sores, 12 (14 percent) developed major wound dehiscence, nine (10.5 percent) required skin grafts, the average length of stay was 19.3 days, and four died (4.7 percent). CONCLUSION:Patients with deep sternal wound infection following sternotomy benefit from one-step radical sternal débridement and muscle flap(s) reconstruction, as it results in a significant decrease in morbidity, mortality, and length of stay.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Cabbabe EB,Cabbabe SWdoi
10.1097/PRS.0b013e3181a205f9subject
Has Abstractpub_date
2009-05-01 00:00:00pages
1490-1494issue
5eissn
0032-1052issn
1529-4242pii
00006534-200905000-00012journal_volume
123pub_type
杂志文章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 umbilicus offers no functional importance to the adult human but remains a key aesthetic landmark of the anterior abdominal wall, and its absence can be a cause for concern in aesthetic and reconstructive patients. Umbilical reconstruction or transposition for abdominoplasty and abdominally based flap operations i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000007292
更新日期:2020-11-01 00:00:00
abstract::The purpose of this study was to develop a methodology to quantify osseous, ocular, and periocular fat changes caused by correction of orbital hypertelorism to test the hypothesis that there is a quantitatively predictable relationship between the movement of the osseous orbit and that of the ocular globe. A retrospec...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1999-07-01 00:00:00
abstract::A case is reported of bilateral rupture of inflatable implants from a closed capsulotomy, with ingrowth of fibrous tissue through the inflation valves. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197706000-00023
更新日期:1977-06-01 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::As the inclusion criteria for breast conservation therapy have continued to evolve to include lower quadrant tumors, very large breasts, and central tumors, the potential for significant disfigurement after breast conservation therapy has also increased. This has led some centers to develop coordinated oncology-plasti...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000046491.87997.40
更新日期:2003-03-01 00:00:00
abstract::Twenty patients with microvascular fibula flap reconstruction of oromandibular defects were selected for implant-retained prosthodontic rehabilitation. A total of 71 osseointegrated implants were placed within the grafted fibulas. Four patients had immediate implant placement at the time of their reconstructive surger...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00006534-199702000-00008
更新日期:1997-02-01 00:00:00
abstract::Forty-three nonconsecutive patients presenting with dentofacial deformity underwent surgical procedures designed intentionally to create skeletal disproportion in the sagittal and/or vertical dimensions. This was accomplished through expansion (enlargement) of the facial skeleton beyond normative standards. At the tim...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199205000-00004
更新日期:1992-05-01 00:00:00
abstract::Real-time ultrasonography in pregnancy can accurately detect gestational age, position of the fetus, position of the placenta, sex of the fetus, and many congenital anomalies before birth. To date, however, there has been no report of detection of a cleft lip-palate deformity by ultrasound. Two cases, in approximately...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198112000-00002
更新日期:1981-12-01 00:00:00
abstract::Our experience with 20 full-thickness cheek reconstruction in 17 patients over the past 27 years is presented. The evolution of techniques for management of full-thickness cheek defects reflects our gradual appreciation of the longitudinal artery concept within axial and musculocutaneous flap units. During the 1950s, ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198209000-00004
更新日期:1982-09-01 00:00:00
abstract::Lymphedema is a chronic disorder that, in developed countries, occurs most commonly after lymph node dissection for cancer treatment. Although the pathophysiology of lymphedema is unknown, the disease is characterized histologically by fibrosis and abnormal adipose deposition. Clinical studies have provided evidence t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000000268
更新日期:2014-07-01 00:00:00
abstract::Chemosurgical peel is a technique that has been used widely by plastic surgeons and dermatologists to remove fine and deep wrinkles of the skin. However, the reaction of elastic tissue to the cutaneous application of commonly used chemical peeling agents has not been defined. This study comparatively assessed the alte...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199708000-00035
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:In reconstructive and aesthetic surgery, several autogenous graft materials and biomaterials are available for soft-tissue augmentation, but none has all the properties of the ideal filler material. The common problem is that heterogeneous material is reactive, and the problem for the autogenous grafts is re...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000156152.97672.31
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:The free fibular flap has become the workhorse flap for composite mandibular defect reconstruction. As advancements in microsurgery have improved flap survival, greater interest has shifted toward flap refinements to avert donor-site morbidities. METHODS:A total of 27 free fibular flaps used for mandible re...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318218fc70
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Negative-pressure wound therapy with instillation is increasingly utilized as an adjunct therapy for a wide variety of wounds. Despite its growing popularity, there is a paucity of evidence and lack of guidance to provide effective use of this therapy. METHODS:A panel of experts was convened to provide guid...
journal_title:Plastic and reconstructive surgery
pub_type: 共识发展会议,杂志文章
doi:10.1097/PRS.0b013e3182a80586
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:The occipitocervicopectoral flap has a local skin pedicle in the occipital region, with the distal portion of the flap in the pectoral region. One disadvantage of the occipitocervicopectoral flap is its limited flap length. To overcome this disadvantage, a perforator supercharging technique was applied to en...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318244230b
更新日期:2012-04-01 00:00:00
abstract::Effective methods to identify novel genes in complicated dynamic tissue processes are needed in molecular biology research. Traditional techniques primarily target known genes and are inefficient in the pursuit of unknown genes. Here we describe the use of a modified differential display polymerase chain reaction (DD-...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200209010-00011
更新日期:2002-09-01 00:00:00
abstract::A graphic and written anatomic data sheet (ADS) for facial aesthetic surgery and body contour surgery is presented as a tool for: (1) analyzing surgical maneuvers and their effect on final outcome; (2) recording individual anatomic variations; (3) communicating data between office personnel and colleagues; (4) aiding ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199304000-00030
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Free tissue transfer has not been fully adopted as the primary mode of treating foot and ankle defects in potentially indicated patients, partly because of the lack of sizable vessels and the potential in the long term of differential growth in the flap and the recipient site. Also lacking are long-term outc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000219133.72059.71
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Trapeziectomy with ligament reconstruction and tendon interposition is currently the most popular technique for operative treatment of trapeziometacarpal osteoarthritis. Based on the evidence, however, it is uncertain whether the addition of ligament reconstruction and tendon interposition to trapeziectomy c...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e318217435a
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Photoaging is generally treated by ablative procedures that injure the epidermis and basal membrane and lead to fibrosis of the papillary dermis. Damaging the epidermis significantly can cause potential adverse effects such as dyspigmentation. It was recently shown in clinical trials that percutaneous collag...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318188245e
更新日期:2008-11-01 00:00:00
abstract::The use of the island rotation flap for the repair of small and medium-sized partial-thickness defects of the nasal tip and soft triangle has led to extremely favorable aesthetic results far superior to that of full-thickness skin grafts. The color and thickness match have been excellent, and the complication rate was...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00006534-199612000-00030
更新日期:1996-12-01 00:00:00
abstract::This study reviews 21 microvascular free flaps to the diabetic foot in 19 patients over a 65-month period. All flaps were either to the plantar surface of the foot or to cover exposed Achilles tendon. Twenty of the flaps survived. The operations required a long, costly hospitalization with frequent recipient- and dono...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199411000-00013
更新日期:1994-11-01 00:00:00
abstract::Congenital double-lip deformity is an infrequent developmental abnormality affecting the lips, more commonly the upper lip. We report seven cases of double lip, all in males, of which six were in the upper lip and one in the lower lip. It was quite interesting to observe that in the upper lip, the buccal portion of th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198909000-00006
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:The prognostic factors that determine outcome in patients with necrotizing fasciitis remain poorly understood. The aim of this study was to analyze the variables that affect the mortality and morbidity of patients with necrotizing fasciitis and to create a simple method for estimating the probability of mort...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000259040.71478.27
更新日期:2007-05-01 00:00:00
abstract::To develop new types of surgical flaps that utilize portions of the skin and subcutaneous tissue (e.g., a thin flap or an adipofascial flap), three-dimensional investigation of the vasculature in the skin and subcutaneous tissue has been anticipated. In the present study, total-body arterial injection and three-dimens...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199809030-00020
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Cranial particulate bone graft heals inlay calvarial defects and can be harvested as early as infancy. The purpose of this study was to test the hypothesis that particulate bone promotes ossification primarily by osteogenesis. METHODS:Freshly harvested particulate bone, devitalized particulate bone, and hig...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31824a2bdd
更新日期:2012-05-01 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:BACKGROUND:This study evaluated patients who underwent primary breast surgery within a single group practice from 1994 to 2009. Reoperations were divided by reoperation reason into total reoperations and implant-specific reoperations. The authors hypothesized that the implant-specific reoperation rate will provide the ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318205f41b
更新日期:2011-03-01 00:00:00
abstract::Injectable bovine collagen has proven to be safe and effective for the treatment of contour defects for more than 20 years. After intradermal exposure to bovine collagen, the most commonly reported side effect is hypersensitivity (incidence of approximately 3 percent to test and approximately 1 to 2 percent to subsequ...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/01.prs.0000105649.69434.ef
更新日期:2004-03-01 00:00:00