Abstract:
:The present study describes the techniques available for single-stage sarcoma resection, soft-tissue reconstruction, and radiotherapy for limb preservation in patients who are unable to undergo primary wound closure after a complete soft-tissue resection of their primary sarcoma. From 1989 to 1994, 19 patients (age range, 18-79 years; mean, 51.2 years) underwent radical resection of extremity sarcomas followed by immediate reconstruction. Seven patients had tumors in the upper extremity and 12 patients had tumors in the lower extremity. There were 13 primary tumors and 6 recurrent tumors. Fifteen patients (79%) received radiation therapy, 7 patients by external beam and 8 patients by brachytherapy. Reconstruction included 16 regional flaps in 13 patients and 7 free tissue transfers in 6 patients. Commonly used flaps included the rectus abdominis (N = 5), the latissimus dorsi (N = 4), the anterolateral thigh (N = 4), the reverse-flow radial forearm (N = 2), and the gastrocnemius (N = 2) flaps. Complications included wound breakdown (N = 2), partial skin graft failure (N = 1), hematoma requiring operative evacuation (N = 1), and partial flap necrosis (N = 1). There were no operative mortalities. Eight patients underwent wide local excision, flap closure, and brachytherapy. Mean length of hospital stay for this group was 12.3 days compared with 13.8 days for the remaining 11 patients. There was one complication (13%) in this group and four complications in the remaining patients (4 of 11; 36%). Our study confirms the utility of soft-tissue reconstruction to permit wide local excision with clear margins as well as the delivery of postoperative radiotherapy. It demonstrates the ability of pedicled flaps and free tissue transfers to remain viable and provide sufficient wound coverage in the setting of early postoperative brachytherapy. In addition, this series illustrates the efficacy of a team approach and one-stage therapy for extremity soft-tissue sarcomas that includes excision, reconstruction, and early postoperative brachytherapy in a single hospitalization.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Abramson DL,Orgill DP,Singer S,Gibstein LA,Pribaz JJdoi
10.1097/00000637-199711000-00003subject
Has Abstractpub_date
1997-11-01 00:00:00pages
454-60issue
5eissn
0148-7043issn
1536-3708journal_volume
39pub_type
杂志文章abstract:UNLABELLED:Periprosthetic infections of oncologic reconstructions have an amputation rate between 37% and 87%. Eleven patients with an infected knee reconstruction following limb salvage surgery for cancer were treated with the staged protocol. All patients underwent prosthetic removal and implantation of an antibiotic...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000203990.08414.ad
更新日期:2006-05-01 00:00:00
abstract::Reconstruction of the nose after severe burn injury is a challenging problem. There are usually associated facial burns, which limits the availability of local flaps. Reconstruction with unburned distant tissue is often not appropriate because of the resulting mismatch in color and texture. Successful nasal reconstruc...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31817d87ed
更新日期:2009-02-01 00:00:00
abstract::Finding an appropriate soft-tissue grafting material to close a wound located over the distal phalanx of the thumb, especially the pulp region, can be a difficult task. A sensate first dorsal metacarpal artery flap, mobilized from the dorsum of the adjacent index finger and used as an island pedicle skin flap, can be ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000137134.15728.dd
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Breast capsular contracture (BCC) is a commonly adverse event postmammoplastly characterized by an immune response mediated by cytokines and transforming growth factor (TGF)-β1 resulting in excessive synthesis and deposit of extracellular matrix around the breast implant. Presence of TGF-β1 polymorphisms has...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31822284f4
更新日期:2013-01-01 00:00:00
abstract::Disciplines using human body surface dimensions require accurate, repeatable measurements. This study presents a design for the analysis of repeatability, precision, and validation of a new anthropometric device. This model enables estimation of the proportion of the total variation attributable to each level of data ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199504000-00004
更新日期:1995-04-01 00:00:00
abstract::A random-pattern cutaneous flap with its base at the highly vascularized dorsal web space has been designed to decrease donor site deformity and to increase securely flap mobilization in contractures involving more than 1 adjacent proximal phalanx base. Rectangular flaps facing each other on the lateral sides of adjac...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000141941.62650.59
更新日期:2005-01-01 00:00:00
abstract::The present article deals with the surgical experience of treating 72 patients for posttraumatic enophthalmos. Patients were divided into the following 4 groups with respect to the type of injury and the time of surgery: Group 1, recent midfacial injuries with orbital floor fractures; Group 2, recent blow-out fracture...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::In an effort to standardize use of the dorsal rat flap model originally described by McFarlane, we determined the following. The effect of delay is readily demonstrated but does not prevent necrosis entirely. Almost all flaps showed some necrosis, but delayed flaps showed approximately 15% less necrosis. Measurement o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198309000-00006
更新日期:1983-09-01 00:00:00
abstract:INTRODUCTION:Breast implant selection is multifactorial and must assess risk profiles of the implants. Textured implants are available in an anatomically shaped form and are thought to have lower rates of capsular contracture. However, evidence is mounting that they carry a significantly higher risk of breast implant a...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001880
更新日期:2019-04-01 00:00:00
abstract::Intracompartmental sepsis (IS) is a rare complication in patients with burns. Intracompartmental sepsis presents in patients with inadequate perfusion of intracompartmental tissues and subsequent ischemic necrosis and infection. Contributing factors include high-volume resuscitation, delayed escharotomies, and previou...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000691
更新日期:2016-03-01 00:00:00
abstract::Technically we can divide full-thickness thoracic reconstruction into 2 parts: providing a rigid support and ensuring well-vascularized coverage. Since 1986, the authors' center has had ample experience with bone banks and the use of cryopreserved bone grafts, which led them to consider the possibility of using these ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000099961.00590.9b
更新日期:2004-01-01 00:00:00
abstract::Many techniques for cleft lip repair have been reported, but these techniques do not consider the contour lines of the upper lip and, in fact, destroy them. The upper lip has complicated contour lines including the vermilion free margin, vermilion border, upper lip horizontal groove (upper lip groove), philtrum (dimpl...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199109000-00008
更新日期:1991-09-01 00:00:00
abstract::This study has demonstrated that microcrystalline collagen is useful for controlling hemorrhage from an area where microvascular anastomoses are being performed, and that microcrystalline collagen does not adversely affect patency rates of microvascular repairs even when applied directly to the anastomosis itself. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198212000-00004
更新日期:1982-12-01 00:00:00
abstract::Extensive wounds of the knee region have previously mandated utilization of a local muscle or free flap to achieve healing. The recent successes of fasciocutaneous flaps in the lower leg region have been extrapolated for use of local, randomly oriented anteromedial or anterolateral knee flaps in addition to previously...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198910000-00004
更新日期:1989-10-01 00:00:00
abstract::Several perforator-based flaps have been developed recently and, although preoperative evaluation of perforator vessels is important, the conventional method using the Doppler flowmeter is still being used. The authors tried to identify perforator vessels in the abdominal region using scanning laser Doppler imaging an...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200206000-00008
更新日期:2002-06-01 00:00:00
abstract::The medial sural MEDIAL GASTROCNEMIUS perforator flap is a potentially large, thin cutaneous flap that encompasses the calf skin territory. Its medial sural vascular pedicle has a long leash of large caliber that simplifies microanastomoses when used as a free flap. Because the identification of the requisite perforat...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000095438.33962.31
更新日期:2004-02-01 00:00:00
abstract::Crushing injuries, including electrical burns on the dorsum of the foot, result in extensive tissue loss and exposure of bone and tendon. Debridement and covering of the wound with richly vascularized tissue are necessary at an early date. Flaps for the dorsum of the foot should be thin and the donor tissue to be sacr...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198509000-00011
更新日期:1985-09-01 00:00:00
abstract::Many surgical procedures to improve mandibular contour have been introduced in East Asia. Despite consensus regarding mandible contouring surgery, surgery which includes angle ostectomy and lateral cortex excision, some patients require only mandibular angle ostectomy. The intraoral approach is a widely used method, b...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000216
更新日期:2016-01-01 00:00:00
abstract::A common unsatisfactory long-term outcome of otoplasty is undercorrection and residual deformity. Aggressive scoring with a scalpel blade can cause unattractive and painful ridging, especially in older patients with stiffer cartilage. We developed an ex vivo pig ear model to compare the effectiveness of bipolar diathe...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000237684.42771.10
更新日期:2007-03-01 00:00:00
abstract::Improvements were made by us in several distally based pedicled flaps of the nutrient vessels of the saphenous nerve with lower rotation points. However, these flaps are still insufficient for trauma complicated by bone defects. Accordingly, we conducted a systematic study of the anatomic theory on distally based pedi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318188b958
更新日期:2009-07-01 00:00:00
abstract::We present the results of a pilot study conducted to evaluate the effectiveness of palatal tomography in patients suspected of having palatal defects not detectable by other methods. Twelve patients were involved in the projects, ranging in age from 3 to 11 years. There were 8 boys and 4 girls. Each patient was evalua...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197903000-00009
更新日期:1979-03-01 00:00:00
abstract::Infected femoral shaft fractures and femoral nonunions are difficult to manage. In the presence of associated segmental bony defects, limb length discrepancy, or complex deformities, Ilizarov techniques seem to be the ideal choice for management. We would like to describe small case series of 3 patients managed using ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3182a795f0
更新日期:2013-11-01 00:00:00
abstract::The morphology of macrostomia and a method of myoplasty and commissuroplasty are described. The important operative considerations are accurate commissure positioning, muscle reconstruction, obliteration of the lateral subdermal groove, placement of a vermilion flap across the commissure, and Z-plasty of skin in the n...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198108000-00010
更新日期:1981-08-01 00:00:00
abstract:BACKGROUND:Long-term postoperative splinting plays a role in the prevention of contracture of the grafted skin after a second-stage ear reconstruction. The scar retraction could lead to an unfavorable aesthetic outcome. Splinting could play a role to overcome or prevent the loss of projection and the obliteration of th...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001212
更新日期:2018-04-01 00:00:00
abstract::The use of external devices for cranial suspension or immobilization may facilitate the transfer of skin grafts or flaps needed for scalp coverage. Skull tongs are readily available in any trauma center. Following composite tissue transfer to the skull, skull tongs can prevent compromise of the microanastomoses or the...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198901000-00015
更新日期:1989-01-01 00:00:00
abstract::Fatty tumors of the peripheral nerves, although rare, occur with sufficient frequency to pose problems in diagnosis and treatment. Moreover, the nomenclature of these tumors has suffered from controversy over their morpological description. These factors have contributed to a misunderstanding about the treatment of th...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197803000-00011
更新日期:1978-03-01 00:00:00
abstract::One of the most common complications of double eyelid operations is asymmetry. To reduce asymmetry, we fixed the dermis to the tarsal plate at the same level as the skin incision, and objectively evaluated the symmetry of the height using photogrammetry.Of 30 patients who had double eyelid operations by the intratarsa...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181b022e3
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Despite the recent surge in rates of immediate breast reconstruction, there is a paucity of large multicenter studies to compare differences in morbidity after immediate versus delayed breast reconstruction. This study used the National Surgical Quality Improvement Program (NSQIP) to study the association be...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002590
更新日期:2020-11-17 00:00:00
abstract::Congenital segmental amputations are difficult to correct. Free interposition bone grafts with growth centers were tried experimentally by many investigators even at the beginning of this century. Attempts at clinical application of this principle, however, were mostly failures. More recently, with the advent of micro...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199210000-00010
更新日期:1992-10-01 00:00:00
abstract::A review of the English medical literature over the last 20 years reporting on flexor profundus lacerations revealed only 55 reported cases of zone I flexor profundus lacerations in children. The standard repair technique in young children (5-10 years of age) has been either tendon reinsertion into bone (usually Bunne...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31820e0e19
更新日期:2012-01-01 00:00:00