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 mortality. METHODS:The authors undertook a retrospective review of all patients with necrotizing fasciitis treated in three tertiary care hospitals in Ontario, Canada, between January of 1994 and June of 2001. Demographic, comorbid illness, and disease-specific data were collated and analyzed for associations with outcome. Using logistic regression analysis, probability estimates for the prediction of mortality were developed, based on three contributing independent factors. RESULTS:Ninety-nine patients satisfied the inclusion criteria. Overall mortality was 20 percent. Sixteen patients suffered from amputation or organ loss. The most common comorbidities were diabetes (30 percent), immunocompromised status (17 percent), and chickenpox (11 percent). Advanced age (odds ratio, 1.04; 95 percent confidence interval, 1.01 to 1.08; p = 0.012), streptococcal toxic shock syndrome (odds ratio, 10.54; 95 percent confidence interval, 2.80 to 39.44; p < 0.001), and immunocompromised status (odds ratio, 3.97; 95 percent confidence interval, 1.04 to 15.19; p = 0.044) were independent predictors of mortality and were used to design a formula for the probability of mortality. CONCLUSIONS:Age, streptococcal toxic shock syndrome, and immune status are significant determinants of mortality and can predict the probability of death from necrotizing fasciitis soon after admission. This objective information can guide clinicians in communication with patients and in making clinical decisions.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Golger A,Ching S,Goldsmith CH,Pennie RA,Bain JRdoi
10.1097/01.prs.0000259040.71478.27subject
Has Abstractpub_date
2007-05-01 00:00:00pages
1803-1807issue
6eissn
0032-1052issn
1529-4242pii
00006534-200705000-00026journal_volume
119pub_type
杂志文章abstract:BACKGROUND:Incisions made perpendicular to the hair follicles during anterior frontal hairline brow lifts or forehead shortening procedures help produce an inconspicuous forehead scar. The success of this "hidden" incision relies on the anteriorly directed frontal hairline follicles and their growth vector. The authors...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000259191.59277.7a
更新日期:2007-05-01 00:00:00
abstract::The role of the plastic surgeon in the diagnosis and management of congenital anomalies is often a complicated one that involves the integration of input from numerous specialists into the evaluation process. Diastematomyelia is a serious neurosurgical problem that often presents with cutaneous findings in a neurologi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Acellular dermal matrix for implant-based breast reconstruction appears to cause higher early complication rates, but long-term outcomes are perceived to be superior. This dichotomy is the subject of considerable debate. The authors hypothesized that patient characteristics and operative variables would have...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000001327
更新日期:2015-07-01 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::Standard photographic technique in plastic surgery is an important topic that has been stressed in the discipline over the past several years. Clinical photographs should always be taken with the same camera lens, lens setting, lighting, film, and patient position to ensure reproducibility and to enable valid pre- and...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199808000-00045
更新日期:1998-08-01 00:00:00
abstract::Active mobilization of repaired flexor tendons requires sufficient suture strength. This study was designed to investigate the suitability of four newly developed and comparatively strong tendon sutures for flexor tendon repair with active digital mobilization. Fifty fresh flexor digitorum profundus tendons were rando...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200103000-00014
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Limited follow-up data on aesthetic outcome and survival after microsurgical reconstruction of complex scalp and forehead defects are available. These data are important to improve reconstruction quality and patient counseling. The purpose of this study was to evaluate surgical, aesthetic, and oncologic outc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181de2260
更新日期:2010-08-01 00:00:00
abstract::The hybrid version of the radial forearm free flap provides an alternative method for reconstruction in the head and neck. It is versatile and has certain theoretical and practical advantages, including high-flow venous drainage, long venous pedicle, lymphatic drainage, and the avoidance of venous anastomosis or venou...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199909040-00026
更新日期:1999-09-01 00:00:00
abstract::Multiple occurrences of pilomatrixoma are rare. Although it has been known as a benign lesion, there are reports of some tumors that have histopathologic features of malignancy. A case of a 68-year-old Caucasian women with multiple pilomatrixoma is presented. She was operated on to remove three other pilomatrixomas on...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199609000-00024
更新日期:1996-09-01 00:00:00
abstract::The soft-tissue composition of the eyelid varies from lateral to medial, in that the orbicularis area (in square millimeters) is greatest medially and least laterally, whereas the reverse is true for the preauricularis and postorbicularis fat. The purpose of this study was to describe the relative contribution of tiss...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005833
更新日期:2019-08-01 00:00:00
abstract::Thoracoabdominal ectopia cordis is a congenital malposition of the heart and abdominal viscera, which are externally situated, carrying an extremely poor prognosis. We report a case of a complete thoracoabdominal ectopia cordis that had undergone successful coverage over the exposed heart and abdominal contents. A few...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199501000-00026
更新日期:1995-01-01 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:Complete corrugator supercilii muscle resection is important for the surgical treatment of migraine headaches and may help prevent postoperative abnormalities in surgical forehead rejuvenation. Specific topographic analysis of corrugator supercilii muscle dimensions and its detailed association with the supr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000282725.61640.e1
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:The authors present their experience using an established chemotherapeutic agent as a scarless treatment for vascular birthmarks. One hundred sixty-four of more than 600 patients seen in the authors' center received intralesional bleomycin injection over 5 years. METHODS:Patient demographics, clinical respo...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31820e923c
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:It has been stated that height of the lateral lip is difficult to obtain with the rotation advancement repair only when the lateral lip is short in both its vertical and horizontal dimensions. The authors studied preoperative cleft lip anthropometry to determine the frequency of the "geometrically unfavorabl...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318200aa2e
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Neurofibromatosis type 1 is a genetic and ubiquitous disease, with an estimated incidence of one in 3000 live births. Neurofibromas, defined as various benign tumors, are hallmarks of the disease. Facial plexiform or diffuse neurofibromas usually occur unilaterally and can induce facial hemihypertrophy. Surg...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181d180e9
更新日期:2010-04-01 00:00:00
abstract::This study of suction lipectomy aspirates from 15 consecutive patients was undertaken to biochemically quantitate the blood-to-fat ratios of the aspirates. A wide variation in the blood-to-fat ratios (8 to 54 percent) was noted, but the authors failed to demonstrate any relationship between the blood-to-fat ratios and...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198678060-00009
更新日期:1986-12-01 00:00:00
abstract::The authors tested the hypothesis that certain maneuvers (neck flexion/extension and head protrusion/retrusion) alter the appearance of the submental area, jawline, and melolabial groove. They used a questionnaire survey of 20 naïve judges who assessed a standardized photograph album of three subjects. The subjects' f...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000127791.31526.e2
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Tibial resection in children presents a unique reconstructive challenge because of technical demands, future growth potential, and repetitive loading of the lower extremity. Positioned in a tibial defect, the free fibula undergoes primary bone healing while maintaining intrinsic resistance to infection and t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318230e463
更新日期:2012-01-01 00:00:00
abstract::We describe the use of a fascial flap for covering the framework in ear reconstruction. When covered in turn with a skin graft, this fascial flap provides an abundant amount of a thin, tough, vascular, hairless cover of good quality in all cases except those where injuries in the auricular area have been deep enough t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1977-09-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to compare the local recurrence and distant metastasis of postmastectomy radiotherapy for breast cancer patients with and without immediate transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction. METHODS:Between March of 1997 and October of 2001, 191 breast can...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000220527.35442.44
更新日期:2006-10-01 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::The subperiosteal endoscopic laser forehead lift is shown to be an effective tool for plastic surgeons. By combining the use of the carbon dioxide laser with the already established technique of endoscopic forehead lift, improved results are achieved. The technique of endoscopic forehead lifting lends itself to new ad...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199808000-00034
更新日期:1998-08-01 00:00:00
abstract::A simple method for measuring circumduction of the thumb, by using a ratio of the range of motion to the length of the first metacarpal, is described. This method can be of value in assessing many aspects of thumb function, especially the improvement in function after opponensplasty. The improved ability to position t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197908000-00012
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:The authors evaluated the use of national databases to track surgical complications among abdominoplasty and breast augmentation patients. METHODS:Their study population included all patients with abdominoplasty or breast augmentation in the Tracking Operations and Outcomes for Plastic Surgeons (TOPS) and C...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181bf8378
更新日期:2009-12-01 00:00:00
abstract::We have devised a new method for secondary commissuroplasty after reconstruction of the lower lip using Estlander's method with both aesthetically and functionally satisfactory results. This method consists of forming two equilaterally triangular mucosal flaps on the vermilion and a small triangular skin flap in the n...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199210000-00025
更新日期:1992-10-01 00:00:00
abstract::Just as everyone has a different learning style, teachers too approach the task from different perspectives. There are five basic teaching perspectives or styles: transmission, apprenticeship, developmental, nurturing, and social justice. The acronym BIAS is useful to describe the beliefs, intentions, assessments, and...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318252f182
更新日期:2012-06-01 00:00:00
abstract::The case is presented of a primary toe-to-thumb transfer by microvascular anastomosis for reconstruction of an acute degloving amputation of the thumb. This approach is not recommended as the standard practice for this type injury, however, there were certain advantages in this patient: (1) one stage procedure, (2) re...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1981-02-01 00:00:00
abstract::Amputated rat hindlimbs were subjected to either normothermic (26 degrees C) or hypothermic (4 degrees C) ischemia. Experimental limbs had their microcirculation washed out (either before or after the ischemic insult) with a physiologic acellular plasma substitute previously reported to enhance flap survival following...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198710000-00020
更新日期:1987-10-01 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