Abstract:
BACKGROUND:Skin is the most immunogenic component of a composite tissue allograft. Topical immunotherapy is an attractive therapeutic modality with which to provide local immunosuppression, with minimal systemic toxicity. The present study was performed to investigate the potential of topical tacrolimus to prolong survival of the skin component of a composite tissue allograft. METHODS:Wistar Furth-to-Lewis rat orthotopic hind limb transplants were performed. Group I consisted of rats treated with topical tacrolimus; group II, antilymphocyte serum plus 21 days cyclosporine; and group III, antilymphocyte serum plus 21 days of cyclosporine plus topical tacrolimus. In group IV, tacrolimus levels in blood, skin, and muscle were measured in an autograft control group. RESULTS:All animals in group I (n = 8) developed grade III clinical rejection by postoperative day 9. In group II (n = 9), the median onset of grade III rejection was postoperative day 40 (range, postoperative days 34 to 44). In group III (n = 6), two animals developed focal grade III rejection on postoperative days 35 and 56. The remaining four animals reached the 100-day endpoint without grade III rejection. In group IV, tacrolimus levels were low or undetectable in blood, whereas skin levels were 100-fold higher than underlying muscle. CONCLUSIONS:Topical tacrolimus therapy has the potential to prevent skin rejection in a composite tissue allograft. Preoperative depletion of T cells with antilymphocyte serum, along with a short course of systemic immunosuppression, prevents acute rejection, whereas topical tacrolimus inhibits immune cell function in the skin. Concentrations of tacrolimus are substantially higher in skin compared with underlying muscle and peripheral blood. Topical immunotherapy could reduce the morbidity associated with systemic immunosuppression in clinical composite tissue allografts.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Solari MG,Washington KM,Sacks JM,Hautz T,Unadkat JV,Horibe EK,Venkataramanan R,Larregina AT,Thomson AW,Lee WPAdoi
10.1097/PRS.0b013e318191bcbdsubject
Has Abstractpub_date
2009-02-01 00:00:00pages
17S-25Sissue
2 Suppleissn
0032-1052issn
1529-4242pii
00006534-200902001-00005journal_volume
123pub_type
杂志文章abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Discuss the critical anatomic structures of the nose that are affected in naso-orbital ethmoid fractures. 2. Discuss the advantages of early, complete nasal reconstruction of these fractures. 3. Apply a clinical algorithm to such nas...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000195081.39771.57
更新日期:2006-01-01 00:00:00
abstract::Seventy-four patients were referred to the senior author because of presumed velopharyngeal incompetence without cleft palate. As a result of an extensive preoperative evaluation that included assessment of articulation patterns, nasal emission, oronasal resonance, and general speech intelligibility, 57 of the 74 pati...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198402000-00010
更新日期:1984-02-01 00:00:00
abstract:SUMMARY:The multidisciplinary approach to lower extremity function preservation is well established and is globally considered the standard of care. Every member of the team contributes their unique skills and knowledge to patient care. The effective integration of negative-pressure wound therapy with instillation (NPW...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000007608
更新日期:2021-01-01 00:00:00
abstract::Tissue factor pathway inhibitor is a naturally occurring protein inhibitor of factor X and the tissue factor-factor VII complex of the extrinsic pathway of coagulation. The potential of tissue factor pathway inhibitor as a topical antithrombotic agent was evaluated in a rabbit model of thrombosis that combined intimal...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199603000-00015
更新日期:1996-03-01 00:00:00
abstract::Closure of plantar defects with local rotation flaps was studied in 10 patients with 11 plantar defects. Ages ranged from 15 to 66 years, and the average defect was 3.0 X 3.6 cm. Two patients were diabetics. Etiology was variable and included trauma, tumors, and breakdown in patients with anesthetic plantar surfaces. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198611000-00012
更新日期:1986-11-01 00:00:00
abstract::A study of the source of the blood supply to the anterolateral femoral flap was carried out on 42 lower limbs of adult cadavers (among them 35 cadavers with injection of red latex and 1 with india ink into the arteries and 6 vascular cast specimens), and the surface locations of the vascular pedicle were detected on 5...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND:Capsular contracture remains a major problem following prosthetic breast implantation, especially in patients undergoing irradiation. Recent studies suggest that such radiation injuries are a cascading process of cytokine activation, with transforming growth factor (TGF)-β acting as the "master switch." Beca...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182131bea
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Immediate reconstruction of composite head and neck defects using free tissue transfer is an accepted treatment standard. There remains, however, ongoing debate on whether the costs associated with this reconstructive approach merit its selection, especially considering poor patient prognoses and the high co...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000260591.82762.b5
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to observe bony healing in the hard palate after cleft palate repair and to discuss the factors affecting it. METHODS:Fifty-two patients with repaired cleft palate were examined at least 1 year postoperatively by means of computed tomographic scanning. The incidence of bone reg...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000156777.99552.1d
更新日期:2005-04-15 00:00:00
abstract:BACKGROUND:Enhanced recovery after surgery (ERAS) protocols have known benefits in the inpatient setting, but little is known about their impact in the subsequent outpatient setting. On discharge, multimodal analgesia has been discontinued, nerve blocks and pain pumps have worn off, and patients enter a substantially d...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006546
更新日期:2020-03-01 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:BACKGROUND:Bariatric surgery, particularly the Roux-en-Y gastric bypass, is currently the most effective method of sustainable weight loss for the morbidly obese patient population. Unfortunately, the nutritional adequacy of the postoperative diet has frequently been overlooked, and in the months to years that follow, ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e31817d6023
更新日期:2008-08-01 00:00:00
abstract::An adjustable vertical marking is described for vertical mammaplasty in mild and moderate hypertrophy or ptosis of the breast. A vertical rectangular flap with the pedicle supported at the inframammary fold provides fullness for the upper or the lower pole of the breast. It is fixed over the pectoralis aponeurosis alo...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000100811.71958.A5
更新日期:2004-02-01 00:00:00
abstract::Free-tissue transfer in the elderly has received increasing attention in the literature. Existing reports are limited by small samples or inadequate definition of the term elderly. This study reviewed 5 years' experience with free-tissue transfer in a geriatric population (mean age 75 years, range 70 to 83 years). For...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00006534-199612000-00018
更新日期:1996-12-01 00:00:00
abstract::A new computerized suction aspirator monitor is described. This device offers the benefits of instantaneous and concurrent scientifically accurate readout of aspirate contents in five separate bodily areas. Thus knowledge of amounts of blood versus fat can be immediately known without resorting to guess, estimate, or ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198811000-00029
更新日期:1988-11-01 00:00:00
abstract:BACKGROUND:Secondary lymphedema is often observed in postmalignancy treatment of the breast and the gynecologic organs, but effective therapies have not been established in chronic cases even with advanced physiologic operations. Currently, reconstructive surgery with novel approaches has been attempted. METHODS:The h...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003110
更新日期:2017-03-01 00:00:00
abstract::The authors present their experience with 25 hard palate mucosa grafts used as lining material in the reconstruction of full-thickness alar defects. Good "take" was obtained in 22 grafts; the other three grafts incurred necrosis of the overriding skin flaps and postoperative infection. Degree of shrinkage was 11 to 15...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200005000-00004
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Conventional palatoplasty relies on extensive mucosal incisions and isolation of flaps on the palatine vessels to facilitate midline closure and velar reconstruction. This introduces substantial scarring, which has adverse effects on vascularity and growth. The authors have developed a minimally invasive pal...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000280
更新日期:2014-07-01 00:00:00
abstract::Using a simplified pressure-measuring device, we determined the pressures under 4 anatomical sites in 11 human subjects to compare 3 commercially available sleeping surfaces. The 3 surfaces tested were a water mattress, a water bed, and our standard hospital bed. There were no significant differences in the recorded p...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197710000-00016
更新日期:1977-10-01 00:00:00
abstract::Cyclo-oxygenase inhibitors and free-radical scavengers protect the skin against necrosis induced by frostbite. However, the tissue component(s) that determine the evolution of skin necrosis and the mechanism of this pharmacologic protection are not precisely defined. We have studied freezing injury to rabbit ears by s...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198901000-00012
更新日期:1989-01-01 00:00:00
abstract::Use of anabolic steroids is one of many possible causes for gynecomastia. Optimal surgical treatment for this entity involves a combination of liposuction and direct excision. A series of 20 patients treated for anabolic steroid-induced gynecomastia presented. Postoperative complications included two hematomas, one se...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200101000-00039
更新日期:2001-01-01 00:00:00
abstract::This article presents a method for passing a cerclage suture around the nasal tip complex to narrow it. The method does not require elevation of the skin from the lower lateral cartilages. The method requires a double-pointed straight needle with the suture swaged on in the center. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Nipple-sparing mastectomy is a controversial option for breast cancer treatment due to locoregional recurrence and distant metastasis. In addition to these oncologic factors, technical factors such as ideal incision type or reconstructive options are also debatable. This systematic review examines current tr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e3182a48b8a
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Previous studies have proposed that the frontal branch of the superficial temporal artery could be used to determine the course of the temporal branch of the facial nerve; however, these studies have not documented this relationship. The objective of this study was to thoroughly examine the courses of the fr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000174001.95115.9e
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Treatment of macrogenia can be a challenging problem. In this article, the authors provide novel insights for treatment of a previously poorly treated problem. The authors have developed anatomical insights that facilitate the subtly difficult preoperative evaluation of the large chin and, when applied appro...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000267636.25672.81
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:There are many approaches to the medial orbital wall. However, most of them have problems with limitation of exposure, scarring, and postoperative inflammatory symptoms related to the eye. The authors used an upper eyelid crease approach to overcome these problems and investigate the usefulness of this appro...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318262f3d9
更新日期:2012-10-01 00:00:00
abstract::Rheumatoid arthritis affects approximately 1 percent of the adult population. Bilateral symmetric involvement of the wrist occurs in 85 percent of these patients, with recurrent flares and relentless progression. Anatomic changes consist of radiocarpal, intercarpal, and radioulnar subluxation and joint destruction. Fo...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199912000-00018
更新日期:1999-12-01 00:00:00
abstract::The widespread use of bioprosthetic mesh in breast reconstruction has revealed an increased risk of seroma and infection, and a high financial cost. This study introduces a technique that mitigates these shortcomings using an autologous dermal graft (Autoderm). Indications, operative technique, and 1-year outcomes are...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182865af3
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Body dysmorphic disorder may negatively affect self-perception of body shape and lead patients to seek cosmetic surgery. This study estimates the level of body dissatisfaction and prevalence of body dysmorphic disorder symptoms in candidates for three plastic surgical procedures. METHODS:Three hundred patie...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000475753.33215.8f
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:The field of scar assessment lacks a standard methodology. Previous methods have focused on a wide range of scar types, resulting in poorer sensitivity and diminishing their discriminatory effectiveness. METHODS:As part of a clinical trial investigating the scar-improving efficacy of transforming growth fac...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.prs.0000232378.88776.b0
更新日期:2006-09-15 00:00:00