ABSTRACT
Reconstructive surgical procedures often take a long time to perform and duration of surgery is frequently cited as a major risk factor for postoperative complications. Whether operative time is an independent risk factor is unknown, as patients undergoing long operations may have numerous other risk factors. From September 1996 to September 1997, we prospectively assessed those patients undergoing reconstructive surgery lasting 6 h or more. A total of 62 patients were studied and they were grouped into three categories: head and neck surgery (n = 23), breast reconstruction (n = 18) and upper and lower limb surgery (n = 21). Postoperative complications were recorded and the results of each group compared. Each of the three patient categories had a similar mean duration of surgery but there were large differences in postoperative morbidity between the three groups, e.g. within the head and neck group postoperative respiratory and wound complications occurred in 43% and 26% of patients, respectively. In the limb surgery group, however, only 5% of patients had respiratory complications and 5% had wound complications. Despite having similar duration of surgery the differences in postoperative complications between the three groups suggest that duration of surgery alone is not a major determinant of postoperative morbidity and that the type of surgery performed and the patient's general health are more important predictors of outcome.
Subject(s)
Plastic Surgery Procedures , Postoperative Complications , Adult , Extremities/surgery , Female , Head and Neck Neoplasms/surgery , Humans , Intraoperative Period , Mammaplasty , Middle Aged , Prospective Studies , Risk Factors , Time FactorsSubject(s)
Radius Fractures/complications , Tendon Injuries/etiology , Thumb/injuries , Adolescent , Humans , Male , RuptureSubject(s)
Adhesives , Skin Transplantation , Surgery, Plastic/methods , Humans , Specimen Handling/methodsSubject(s)
Carcinoma, Basal Cell/surgery , Skin Neoplasms/surgery , Curettage , Electrocoagulation , HumansABSTRACT
A case of xeroderma pigmentosum (XP) is reported whose treatment included sub-total excision of facial skin and resurfacing in aesthetic units with grafts of relatively undamaged buttock skin. The principle of resurfacing is logical and supported by this and other reports which are reviewed. Though control was achieved in the grafted areas, tumours continued to develop in adjacent ungrafted skin. The importance of radical excision of exposed skin in severe cases of XP is emphasised.
Subject(s)
Face/surgery , Skin Neoplasms/surgery , Surgery, Plastic , Xeroderma Pigmentosum/surgery , Adult , Humans , Male , Skin Neoplasms/pathology , Skin Transplantation , Xeroderma Pigmentosum/pathologyABSTRACT
A case of delayed acute hemorrhage complicating tissue expansion of the scalp is presented. The likely mechanism was erosion of an occipital artery by the edge of the expander, and the risk of a similar occurrence should be considered in all patients undergoing tissue expansion.
