Abstract:
:The literature regarding reconstruction of large scalp wounds with free tissue transfer consists mostly of case reports and small series, and none of the published reports focus on the particular problems of the oncology patient. Here the authors describe their experience with 37 flaps in 32 patients, all of whom required scalp reconstruction with free tissue transfer after tumor extirpation. Twenty-seven free flaps were performed at the time of the initial surgery and 10 were performed after a prior reconstruction failed. The authors describe the characteristics of the patients and procedures, including tumor type, wound size and complexity, flaps and recipient vessels used, preoperative and postoperative radiation therapy, and complications. Most (72 percent) of the tumors were recurrent or persistent. The free tissue transfer was successful in all patients. There was a 59 percent overall complication rate with 32 percent of patients requiring a secondary surgical procedure. Most of the complications were wound-healing complications. Although there were two cases of vein thrombosis, these were salvaged by revision, and no flaps were lost. Nine patients underwent postoperative radiation therapy that was well tolerated. Only four patients underwent cranioplasty at the time of the initial operation, and no secondary cranial reconstructions were performed. The authors conclude that preoperative and postoperative radiation therapies as well as the need for expedient tumor resection and immediate flap coverage are issues that make free tissue transfer attractive for the oncology patient who needs scalp reconstruction. Although the complication rate is relatively high and a significant percentage of patients require a secondary procedure, free flap coverage was efficacious for all patients in this group. Cranioplasty is not usually required but, if needed, alloplastic or autologous cranial reconstruction does not appreciably increase morbidity in the selected patient.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Hussussian CJ,Reece GPdoi
10.1097/00006534-200205000-00008subject
Has Abstractpub_date
2002-05-01 00:00:00pages
1828-34issue
6eissn
0032-1052issn
1529-4242journal_volume
109pub_type
杂志文章abstract::Composite tissue defects may involve skin, mucosa, muscle, and bone together or in combinations of two or three of these tissues. Defects involving bone and skin are frequently encountered. Osteocutaneous flaps may be used to reconstruct these composite tissue defects. Sometimes, it is not possible to obtain a vascula...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000101062.00227.4F
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to (1) understand national variation in delay of emergency procedures in patients with open tibial fracture at the hospital level and (2) compare length of stay and cost in patients cared for at the best- and worst-performing hospitals for delay. METHODS:The authors retrospecti...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31827c6efc
更新日期:2013-03-01 00:00:00
abstract::Our experience with the use of cartilage grafts in 430 primary rhinoplasties is presented. We find grafts indicated when operating on small noses with thick skin to increase and define the dorsum, to add projection and angularity to the tip, to project the columella, and to correct the acute nasolabial angle. The proc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198105000-00003
更新日期:1981-05-01 00:00:00
abstract:BACKGROUND:Attempted separation of craniopagus twins has continued to be associated with devastating results since the first partially successful separation with one surviving twin in 1952. To understand the factors that contribute to successful separation in the modern era of neuroimaging and modern surgical technique...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000002269
更新日期:2016-07-01 00:00:00
abstract::This study questions previous reports of the presence of micrometer-sized areas of crystalline silica in pathologic tissue sections that are based exclusively on polarized-light microscopy. By using optical principles, it can be argued that it is impossible to identify unambiguously or to detect the birefringence of c...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199904040-00028
更新日期:1999-04-01 00:00:00
abstract::The midface of a full-term stillborn infant with a right complete unilateral cleft lip and palate was studied with plain-film radiography and tomography, xeroradiography, and computerized axial tomography. Gross skeletal and soft-tissue deficiencies on the cleft side were evident as compared to the noncleft side and i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198608000-00018
更新日期:1986-08-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to define the anatomical boundaries, transformation in the aging face, and clinical implications of the Ristow space. The authors propose a title of deep pyriform space for anatomical continuity. METHODS:The deep pyriform space was dissected in 12 hemifacial fresh cadaver disse...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002262
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:To determine the overall complication rates associated with brachioplasty, a retrospective review was performed of all brachioplasty procedures performed at the authors' institution over a 16-year period. METHODS:Hospital charts were reviewed for patient demographics. Ten fresh frozen cadaveric arm dissecti...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000218707.95410.47
更新日期:2006-06-01 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::The 47-kDa heat shock protein (HSP47) is a molecular chaperone specifically targeting the processing and quality control of collagen molecules. This study was performed to investigate whether antisense therapy preventing HSP47 expression might affect the scar formation occurring during wound healing of skin. In wound ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000054844.41243.F2
更新日期:2003-05-01 00:00:00
abstract::Best evidence has no bearing on quality of life if it is not implemented in clinical practice. The authors introduce knowledge translation as a theoretical framework for closing the gap between evidence and practice in plastic surgery. The current state of published evidence in plastic surgery is reviewed and evaluate...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000004891
更新日期:2018-11-01 00:00:00
abstract::There has been considerable disagreement in descriptions of the SMAS. Fresh cadaver dissection, combining anatomic dissection done with the aid of the operating microscope and histologic cross section of facial tissues, was performed in 24 facial halves. Histologic preparation was made on tissue macrosections, each 10...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:
更新日期:1993-12-01 00:00:00
abstract::In 37 cadavers of average age 75.5 years, the calvarium was studied. In all, the diploe and outer and inner tables were found to be definite layers. Although the parietal bone thickness did decrease with age in this study, there was no correlation between age and the outer table or diploe thickness. No significant cha...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198907000-00006
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:Vascularized groin lymph node flap transfer is an emerging approach to the treatment of postmastectomy upper limb lymphedema. The authors describe the pertinent flap anatomy, surgical technique including different recipient sites, and outcome of this technique. METHODS:Ten cadaveric dissections were perform...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31828bd3b3
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Open tibia fractures are commonly stratified by the Gustilo classification, an orthopedic grading system that does not incorporate the presence of arterial injury when limb perfusion is intact. In the authors' experience, however, the presence of arterial injury appears to negatively impact microsurgical out...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003766
更新日期:2017-11-01 00:00:00
abstract::The authors have previously described a classification system for earlobe ptosis and have established a criterion for earlobe pseudoptosis. Earlobe heights were characterized based on anatomic landmarks, including the intertragal notch, the otobasion inferius (the most caudal anterior attachment of the earlobe to the ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000101505.66716.DF
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Adipose-derived mesenchymal stem cells are a robust, multipotent cell source. They are easily harvested and exhibit promise in a variety of regenerative applications. The purpose of this study was to evaluate the aging impact on adipose-derived mesenchymal stem cells, relating to morphology, senescent proper...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182729cfc
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Fat grafting is an adjuvant that may improve the quality of radiation-damaged tissue. However, fat grafting for volume restoration in irradiated sites may be less effective because of a poorly vascularized fibrotic recipient bed. External volume expansion has emerged as a potential technique to prepare the r...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006372
更新日期:2020-01-01 00:00:00
abstract::This is a report of a patient who sustained a traumatic avulsion of the hemipelvis and survived this catastrophic challenge. Survival of the patient is dependent on multiple factors of associated injuries, early management, and general health of the patient. Early involvement of the plastic surgical team offers a coor...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198512000-00030
更新日期:1985-12-01 00:00:00
abstract::A case is reported in which a closed compression capsulotomy for fibrous capsular contracture was followed by rupture of the implant bag with the immediate appearance of silicone gel in the axilla. A possible mechanism, analogous to that of high-pressure injection injuries of the hands, is hypothesized. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197812000-00013
更新日期:1978-12-01 00:00:00
abstract::Xeroradiography, because of its unique phenomenon of "edge enhancement," has some advantages for assessing facial fractures. In 17 of the 19 patients in our pilot study group, this technique was as valuable as, or more so than, plain films. The xerogram done prior to laminagraphy is a useful "map" for the radiologist ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197808000-00008
更新日期:1978-08-01 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::A case of removal of a large compound nevus of the leg by serial excision is reported. Failure to perform the initial excision entirely intralesionally led to the appearance of pigmentary deposits within normal skin. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198012000-00008
更新日期:1980-12-01 00:00:00
abstract:BACKGROUND:Most managed care plans use a physician "gatekeeper" to control referrals to hand surgeons. The appropriateness of this model for upper extremity complaints has never been challenged. The purpose of this study was to evaluate the prior management of patients with elective hand disorders who present to a hand...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/PRS.0b013e31829acc74
更新日期:2013-09-01 00:00:00
abstract::This study was undertaken to obtain more insight into the morphologic and functional performance of microvascular polytetrafluoroethylene (PTFE) prostheses. Therefore, both the cellular events of healing (n = 30) and the prostacyclin production (n = 18) of microvascular polytetrafluoroethylene prostheses (length 10 mm...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1988-05-01 00:00:00
abstract:BACKGROUND:Surgical treatment of injuries with loss of skin tissue has improved significantly with the advent of regenerative medicine and tissue bioengineering, and the use of stem cells and dermal substitutes. The success of tissue regeneration depends on optimal local vascularization and the successful integration o...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182547e04
更新日期:2012-07-01 00:00:00
abstract::This study describes the treatment protocol for and the outcome of the management of complex wounds around total knee replacements. An analysis of 28 patients (29 knees) with complex defects who had surgery between January 1, 1986, and July 30, 1996, was performed. A specific management protocol was applied to each kn...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199911000-00012
更新日期:1999-11-01 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::A thick nostril is a disturbing deformity and one for which surgeons and patients may be reluctant to employ the traditional "piece of pie" skin excisions commonly described. As an alternative in selected circumstances, a method of internally thinning the nostril rim using an alar base groove incision known as alar ri...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199604000-00023
更新日期:1996-04-01 00:00:00
abstract::In the vast majority of burned patients, the injury is limited to the skin and superficial subcutaneous tissue, and the vasculature of the deeper fascia is spared. This fact encouraged me to design a flap in which the burned scar tissue is employed. The island fasciocutaneous flap is based only on the proximal septocu...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199709001-00014
更新日期:1997-09-01 00:00:00