Abstract:
BACKGROUND:Limb-sparing surgery, consisting of wide-margin tumor resection and preoperative or postoperative radiotherapy/chemotherapy, has become the surgical treatment of choice for extremity sarcomas. However, adequate tumor resection can sometimes compromise crucial limb function, necessitating functional restoration surgery. The purpose of this study was to determine the cost impact and functional outcomes of such procedures. METHODS:Patients receiving either functional restoration surgery or soft-tissue-only reconstruction following extremity soft-tissue sarcoma excision were identified. Patients were then compared along several dimensions: overall length of stay and its subdivisions, surgical time, and total charges and its subdivisions. Patients' functional outcomes were assessed with the Toronto Extremity Salvage Score. RESULTS:Sixty-seven patients who underwent 69 limb-sparing procedures were identified. Fifteen of these procedures (eight upper extremity, seven lower extremity) required functional restoration surgery; 54 of these procedures (13 upper extremity, 41 lower extremity) required only soft-tissue coverage. In the upper extremity, there was a statistically significant increase in overall length of stay (2.8 days) and its subdivisions, surgical time (3.7 hours), and total charges (12,484 dollars) and its subdivisions associated with performing functional restoration surgery. In lower extremity cases, statistically significant increases were determined in only the total charges (9190 dollars) and medical supply charges (13,204 dollars) following functional restoration. Patients who underwent functional restoration surgery had better postoperative function (mean Toronto Extremity Salvage Score, 82 versus 80), but this difference was not statistically significant. CONCLUSION:Although functional restoration surgery is more costly than soft-tissue reconstruction alone, the authors believe that the associated better functional outcome justifies its performance.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Nelson AA,Frassica FJ,Gordon TA,Deune EGdoi
10.1097/01.prs.0000187140.83705.cfsubject
Has Abstractpub_date
2006-01-01 00:00:00pages
277-83issue
1eissn
0032-1052issn
1529-4242pii
00006534-200601000-00043journal_volume
117pub_type
杂志文章abstract::Lymphangioma circumscriptum of the penis and scrotum is an unusual entity that may be indistinguishable from genital warts. After confirmation of the diagnosis, a treatment plan consisting of wide excision should be outlined. To lower the chance of recurrence, not only the affected skin but all the subjacent subcutane...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199901000-00028
更新日期:1999-01-01 00:00:00
abstract::Use of the open rhinoplasty technique (ORT) in certain nasal and septal deformities has proven to be an invaluable asset in the rhinoplasty armamentarium of the authors. Primarily owing to the markedly increased exposure with this technique, more accurate assessment of the deformities is possible and additional or imp...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198812000-00006
更新日期:1988-12-01 00:00:00
abstract::A very rare case of congenital skin tube pedicle with congenital constriction band syndrome was presented. Only one report concerning this bizarre abnormality could be found in the available literature, and no consideration of its etiology has previously been published. In our case, the skin tube was accompanied by th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199204000-00029
更新日期:1992-04-01 00:00:00
abstract::Retrobulbar hemorrhage is a rare complication of orbital trauma or surgery. Although the process is usually self-limiting, infrequently visual impairment may result. Various methods for relieving the associated intraocular hypertension (caused by the extraocular compression posteriorly) have been suggested. The effect...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197701000-00007
更新日期:1977-01-01 00:00:00
abstract::EXECUTIVE SUMMARY: 1. Foot infections in patients with diabetes cause substantial morbidity and frequent visits to health care professionals and may lead to amputation of a lower extremity. 2. Diabetic foot infections require attention to local (foot) and systemic (metabolic) issues and coordinated management, prefera...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000222737.09322.77
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Previous studies have determined specific factors influencing patients with rheumatoid arthritis to choose to undergo reconstructive hand surgery. However, little is known about how rheumatoid arthritis patients are counseled by physicians regarding surgical options and the concerns that cause patients to de...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/PRS.0000000000002083
更新日期:2016-05-01 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::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::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::Patients with severe maxillary hypoplasia secondary to congenital facial clefting present numerous challenging problems for the reconstructive surgeon. Traditional surgical/orthodontic approaches for these patients often fall short of expectations, especially for achieving normal facial aesthetics and proportions. The...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract::The posterior interosseous cutaneous flap is characterized by its thinness and the adjustable length of its vascular pedicle. This flap can be used both as a free and reversed vascular pedicled flap. We applied the free flap mostly for reconstruction of the digits, and the reversed vascular pedicled flap for soft-tiss...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199703000-00028
更新日期:1997-03-01 00:00:00
abstract::Breast reconstruction after a radical mastectomy using the temporary subcutaneous tissue expander is described. The main principle of this method is recovery of the amount of lost tissue through expansion of the remaining chest skin to large proportions and filling of the breast envelope with a smaller permanent mamma...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198202000-00001
更新日期:1982-02-01 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:BACKGROUND:The major drawback of adipose grafting is its clinical unpredictability, which leads to surgeon and patient dissatisfaction. The mechanisms underlying angiogenesis and regeneration of the graft tissue are still unclear. METHODS:Mouse adipose tissue was processed using two different methods (fragmental and i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000965
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Anaphylaxis and anaphylactic-like reactions in the perioperative period are a significant concern for anesthesiologists and surgeons. With an incidence as high as one in 3500 and a mortality rate of 3 to 6 percent, proper management of these reactions is essential. The available surgical literature provides ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318254b2b8
更新日期:2012-07-01 00:00:00
abstract::Dynamic skeletal muscle flaps are designed to perform a specific functional task through contraction and relaxation of their muscle fibers. The most commonly used dynamic skeletal flaps today are for cardiomyoplasty and anal or urinary myoplasty. Low-frequency chronic stimulation of these flaps enables them to use the...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000034921.49695.3D
更新日期:2003-01-01 00:00:00
abstract::Unilateral coronal synostosis is the common appellation for premature, one-sided fusion of the frontoparietal suture-the most common cause of synostotic frontal plagiocephaly. However, frontal asymmetry can also result from isolated fusion across the anterior cranial base without involvement of the frontoparietal sutu...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000021308.37931.18
更新日期:2002-09-15 00:00:00
abstract::Based on the 14 free flap transfers we present with full survival, we recommend peroperative magnification angiography of both the recipient and donor sites. In our hands, this type of preoperative assessment seems to increase the margin of safety. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197910000-00007
更新日期:1979-10-01 00:00:00
abstract::Some new variations are described for partial and total ear reconstructions, eyebrow reconstructions, and sideburn reconstructions in burned patients. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1975-03-01 00:00:00
abstract::The median facial dysplasia group of patients is a unique, distinct, definable group characterized by mid-line facial deficiencies in the presence of a unilateral or bilateral cleft lip with or without cleft palate and without clinically detectable anomalies of the brain. This group of patients comprised 2 percent of ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-05-01 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::Auricular pseudocyst is an asymptomatic cystic swelling of the upper portion of the auricle. Various therapeutic approaches have been employed with variable success. We report our results with nine patients treated by needle aspiration and bolstered pressure sutures applied over both aspects of the cyst for 1 week. Tr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199104000-00030
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND:The pedicled descending branch muscle-sparing latissimus dorsi flap with a transversely oriented skin paddle presents distinct advantages in breast reconstruction, including reduced donor-site morbidity and greater freedom of orientation of the skin paddle. This study reports the anatomical basis, surgical t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181934838
更新日期:2009-01-01 00:00:00
abstract::One-hundred forty-eight operative procedures for flexion contractures of the finger(s) following burn injury in children have been studied in detail with follow-up from 6 months to 8 years. Intramedullary K-wires, used for 53 procedures where a graft was done, were associated with a significantly worse long-term resul...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198108000-00016
更新日期:1981-08-01 00:00:00
abstract::The incidence of free-flap failure is reported at 4 to 5 percent. Often, these failures are attributed to postoperative venous thrombosis with salvage rates reported at 42 percent. The use of thrombolytics has been effective in laboratory protocols; however, there have been only case reports to substantiate their use ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199811000-00021
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:The presence of epicanthal folds and the absence of supratarsal folds are unique features in the eyelids of Asians. The resulting appearance leads many to seek cosmetic improvement in the medial canthal area. Although many techniques have been described for the elimination of epicanthal folds, scarring and d...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000246713.59153.bb
更新日期:2007-02-01 00:00:00
abstract::Soft-tissue injuries involving the dorsum of the hand and foot continue to pose complex reconstructive challenges in terms of function and contour. Requirements for coverage include thin, vascularized tissue that supports skin grafts and at the same time provides a gliding surface for tendon excursion. This article re...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200008000-00013
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Patients with palatal clefts are predisposed to developing speech and language abnormalities. Emerging evidence indicates that children with cleft lip and/or cleft palate have higher rates of learning disabilities than the general population and differences in brain morphology. METHODS:Magnetic resonance im...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181881f54
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Insufficient soft-tissue coverage following total knee arthroplasty jeopardizes prosthesis retention and may lead to significant complications. The aim of this study was to evaluate the natural history of total knee arthroplasty following flap reconstruction of soft-tissue defects. METHODS:A retrospective r...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000001929
更新日期:2016-01-01 00:00:00
abstract::This study demonstrates the feasibility of acute extraluminal expansion to elongate arteries intraoperatively in order to overcome defects too large to be repaired primarily. Twenty Sprague-Dawley rats were divided into two groups: an expander-elongation group and a nonexpanded control group of 10 rats each. Arterial ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199209000-00016
更新日期:1992-09-01 00:00:00