Abstract:
BACKGROUND:An insidious risk with the use of muscle perforator flaps is the possibility of venous outflow compromise. Congestion in deep inferior epigastric perforator (DIEP) flaps in particular is not infrequent. On an empiric basis, their salvage has been accomplished by augmenting venous drainage through alternative outflow tracts. The validity of this clinical maneuver can now best be tested in a rat DIEP flap model. METHODS:The rat DIEP flap is a modification of the rat ventral abdomen flap. Flap perfusion can be based on a single rectus abdominis musculocutaneous perforator. No muscle is included with the flap. Three groups of five male Sprague-Dawley rats each were used. The conventional DIEP flap group had only a solitary perforator artery and venae comitantes and served as the control. The contralateral superficial inferior epigastric vein was included with the flap in the other two groups as a distinctly separate venous outflow tract. The latter two groups differed in that the perforator venae comitantes were either retained or deleted. RESULTS:Mean flap survival in the control DIEP flap group was 80.8 +/- 16.3 percent. Retention of the contralateral superficial inferior epigastric vein resulted in a statistically significant enhancement in flap viability (p < 0.027) whether the perforator venae comitantes were left intact (99.8 +/- 0.4 percent) or had been intentionally ablated (99.6 +/- 0.5 percent). CONCLUSIONS:Venous supercharging of the rat DIEP flap ensures greater flap survival. As a corollary, this supports the efficacy of prior anecdotal experiences in which an alternative venous outflow tract, preferably from the superficial system, had been used to overcome venous congestion. It is advisable for any muscle perforator flap to always try to retain a second outflow source to allow the potential for venous supercharging, if later indicated.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Hallock GG,Rice DCdoi
10.1097/01.prs.0000172889.62564.e1subject
Has Abstractpub_date
2005-08-01 00:00:00pages
551-5; discussion 556issue
2eissn
0032-1052issn
1529-4242pii
00006534-200508000-00035journal_volume
116pub_type
杂志文章abstract::Vasospasm in revascularized tissue can compromise tissue perfusion even though the microsurgical anastomoses remain patent. Circulating catecholamine stimulates peripheral vasoconstriction. Chemical vasospasm was induced by the intraarterial administration of norepinephrine to denervated rat hind limbs. Heel pad blood...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198502000-00016
更新日期:1985-02-01 00:00:00
abstract::Vascularized and conventional autogenous rib grafts were used to reconstruct 6-cm ulnar defects in the forelegs of the nine dogs. Each dog served as its own control. Biomechanical torsional testing of the grafted ulnas showed that vascularized grafts were 234 percent stronger than the conventional grafts. Bone toughne...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198403000-00007
更新日期:1984-03-01 00:00:00
abstract::Tumors involving the submandibular gland are rare. However, the incidence of malignancy is much higher than in the parotid (approaching 50 percent). In addition, the 5-year survival rate in patients with malignant tumors of the submandibular gland is much poorer in our series--28 percent versus 71.8 percent for the pa...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/00006534-197802000-00007
更新日期:1978-02-01 00:00:00
abstract::We report a major modification of technique for the transverse abdominal island flap, namely, taking the anterior rectus fascia with the muscle. We believe that this protects the fine vascular network supplying the flap. This has resulted in a more reliable flap, confirmed by increased fluorescein uptake, and signific...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198311000-00031
更新日期:1983-11-01 00:00:00
abstract::Contemporary studies and observations have left no doubt that occlusive dressings are superior to open treatment after laser resurfacing. The currently available occlusive dressings, however, are time-consuming to apply, often dislodge shortly after application, and most require reapplication. The authors report a cro...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000021884.52700.B2
更新日期:2002-09-15 00:00:00
abstract::Two cases of toxic shock syndrome following chemical face peel are reported. Toxic shock syndrome is a severe toxin-mediated multisystem disease. The major signs are fever, rash, desquamation, and hypotension. It can occur in males as well as females and is not necessarily related to menstruation. The surgical wound d...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198707000-00020
更新日期:1987-07-01 00:00:00
abstract:BACKGROUND:Venous thromboembolism, including deep venous thrombosis and pulmonary embolism, is a morbid and costly complication following surgical procedures. The authors aim to assess the added risk of venous thromboembolism in patients undergoing immediate breast reconstruction. METHODS:The 2005 to 2011 American Col...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000438062.53914.22
更新日期:2014-03-01 00:00:00
abstract::A study of the anatomy and transplantation of the musculus obliquus internus abdominis with a neurovascular pedicle transfer for facial reanimation in one stage is presented. Eleven adult cadavers (22 face sides) were dissected to observe the shape, thickness, innervation, and blood supply of the musculus obliquus int...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000029809.71845.04
更新日期:2002-11-01 00:00:00
abstract::To study radiation effect separate from the microcirculation, fibroblasts were cultured from four patients with radiation wounds. Cells could be grown from irradiated tissue near the ulcer and from control normal tissue, but no cells could be cultured from the ulcers. The ability of radiation-treated fibroblasts to at...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198810000-00019
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:The traditional method of teaching in surgery is known as "see one, do one, teach one." However, many have argued that this method is no longer applicable, mainly because of concerns for patient safety. The purpose of this article is to show that the basis of the traditional teaching method is still valid in...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e318287a0b3
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Health care reforms aimed at bundling payments attempt to contain costs. Uncovering variation in spending provides one strategy for decreasing expenditure. This study aims to investigate interhospital cost variation for thumb replantation. METHODS:A retrospective cross-sectional analysis of patients undergo...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006022
更新日期:2019-10-01 00:00:00
abstract::Increasing numbers of plastic surgery procedures are performed in diverse environments, including traditional hospital operating rooms, outpatient surgery centers, and private offices. Just as plastic surgeons develop areas of specialization to better care for their patients, anesthesiologists have specialized in outp...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181c2a268
更新日期:2010-01-01 00:00:00
abstract:SUMMARY:Management of the breast following massive weight loss for both reconstructive and aesthetic reasons poses unique challenges that are often inadequately addressed with traditional techniques. The breast mound is often unstable and deflated, with a loose inelastic skin envelope and ill-defined boundaries that bl...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e3181e60580
更新日期:2010-09-01 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: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::Bone grafts are used to lengthen the dorsum and elevate the tip of the nose in patients with Binder's syndrome. Disappointing long-term results in some patients generally have been assumed to be a result of resorption and/or displacement of the grafts. Treatment outcome was studied in 11 patients with the use of seria...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199802000-00005
更新日期:1998-02-01 00:00:00
abstract::Traditional microsurgery involves the use of bulky and expensive stereo microscopes that have limited portability. Recent advances in video technology have enabled the exploration of alternative visualization methods. The purpose of this study was to evaluate standard laparoscopic equipment for microvascular anastomos...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200109150-00008
更新日期:2001-09-15 00:00:00
abstract::Treatment of nasal deformity and obstruction requires analysis, planning, and precise execution of rhinoplasty techniques. When performed well, rhinoplasty is a powerful tool for achieving appealing nasal morphology and optimizing function. This article aims to highlight an open approach to septorhinoplasty using a nu...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006687
更新日期:2020-04-01 00:00:00
abstract::The abdominal muscles not only constitute a multidirectional cinch that holds the abdominal contents in place, but they also determine the flexion and rotational movements of the trunk. The rectus is mainly responsible for flexion and the obliques are responsible for rotating the trunk. It is therefore important to ma...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198510000-00013
更新日期:1985-10-01 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::The history and current status of suture techniques to correct a broad or bulbous nasal tip are reviewed. General principles for suture techniques to control tip shape are discussed; they include leaving an approximately 6-mm-wide lateral crus. The algorithm presented includes four sutures, all of which are not necess...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000033873.20163.61
更新日期:2002-12-01 00:00:00
abstract::Restoration of sensibility in the paraplegic patient is the optimal therapy for the management and prevention of debilitating pressure sores. In patients with an absence of sensibility below the L3 spinal level, a locally transposed arterialized neuromyocutaneous gracilis flap may be uniquely utilized for ischial rest...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::Deficiency of the free border of the lip is frequently encountered in secondary cleft lip deformities. The free border of the lip consists of the orbicularis oris marginalis muscle and its overlying subcutaneous tissue, vermilion, and mucosa. The pathology may involve any or all of these components. When there is an a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract::In a blind, randomized study, two groups, each of seven rabbits, were treated with either a very low dose of human melanoma cell line-derived tissue-type plasminogen activator (t-PA) or isotonic saline. t-PA (0.067 mg/kg of body weight) was administered intraaortically, 20 percent being given as a 30-second "bolus" in...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1992-08-01 00:00:00
abstract::The cessation of cervical nerve root pain following modified SMAS rhytidectomy is reported. CAT scans and radiographs demonstrating substantial changes in the intervertebral relationships are documented. No previous report exists demonstrating the biomechanical response to platysma muscle surgery. The potential for al...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198804000-00019
更新日期:1988-04-01 00:00:00
abstract:BACKGROUND:Bibliometric indices are proposed measures to quantitatively and qualitatively evaluate scholarly output within academic medicine. The authors sought to validate bibliometric indices as an indicator of academic productivity within plastic surgery and their association with promotion of faculty surgeons in ac...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000594
更新日期:2014-11-01 00:00:00
abstract::The hypothesis that incomplete resorption of osteons in an autogenous cortical bone graft may limit its replacement by new bone regeneration was explored by implanting a hydroxyapatite replica of a coral skeletal structure into bone gaps. This implant contained channels and interconnections similar to those in osteon-...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197905000-00004
更新日期:1979-05-01 00:00:00
abstract:BACKGROUND:Perforator flaps based on the integument of the trunk have been well described in the literature; however, the anatomy of many donor sites has yet to be adequately documented. The integument of the lateral lumbar region of the trunk is supplied by a number of source arteries (lower posterior intercostal, lum...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000161464.11134.c1
更新日期:2005-05-01 00:00:00
abstract::The submental artery island flap is a versatile option in head and neck reconstruction. This flap may be used for the coverage of perioral, intraoral, and other facial defects, leaving a relatively acceptable donor-site scar. In this study, the submental region of 13 formalin-fixed cadavers was dissected bilaterally. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000142479.52061.7d
更新日期:2004-12-01 00:00:00
abstract::Toe-to-hand transfer was performed in 28 patients, involving 33 fingers, using microvascular technique. Of this number, 26 patients (31 fingers) had experienced trauma, and the remaining 2 patients (2 fingers) had a congenital deformity. The toew used for grafting were the great toe (1), the second tow (30), and thir...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198007000-00015
更新日期:1980-07-01 00:00:00