Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 4 de 4
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Ann Plast Surg ; 85(6): 601-607, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32332388

RESUMO

BACKGROUND: Oncoplastic breast-conserving surgery (OBCS) is most commonly performed using established or modified mastopexy/breast reduction techniques. Although the comparative complication profiles of Wise-pattern mastopexy/breast reduction techniques compared with vertical scar techniques are well understood, outcomes in the setting of OBCS are unknown. METHODS: A retrospective study was conducted of all patients that underwent OBCS using mastopexy/breast reduction techniques at a single center over a 6-year period. Patients who underwent Wise-pattern techniques were compared with those who underwent vertical scar techniques. Demographic, treatment, and outcomes data were collected. Descriptive statistics were used, and multivariate analysis was performed to evaluate the relationship between these multiple variables and complications. RESULTS: Of 413 eligible patients, 278 patients (67.3%) received a Wise-pattern technique and 135 (32.7%) underwent a vertical scar technique. The overall complication rate was significantly higher in the Wise-pattern than in the vertical scar group (30.6% vs 18.5%, respectively; P = 0.012), as was the major complication rate (11.9% vs 4.4%; P = 0.011) including need for additional surgery for complications (6.8% vs 1.5%; P = 0.029). Complications resulted in a delay to any adjuvant therapy in 20 patients (4.8%); however, the difference between the groups was not significant (6.1% for Wise pattern vs 2.2% for vertical scar; P = 0.098). In a multivariable logistic model, use of a Wise-pattern technique (odds ratio, 0.37 [95% confidence interval, 0.14-0.99]; P = 0.049) was a significant predictor of major complications. CONCLUSIONS: The Wise-pattern mastopexy/breast reduction OBCS technique was associated with a significantly higher complication and major complication rate than vertical scar techniques. The findings should be considered during choice of surgical technique in oncoplastic breast conservation.


Assuntos
Neoplasias da Mama , Mamoplastia , Neoplasias da Mama/cirurgia , Cicatriz/etiologia , Humanos , Mastectomia Segmentar , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos
2.
Plast Reconstr Surg ; 145(5): 1134-1142, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32332525

RESUMO

BACKGROUND: Oncoplastic breast-conserving surgery expands the indications for breast conservation. When performed using modified mastopexy/breast reduction techniques, the optimal timing of the contralateral symmetrizing mastopexy/breast reduction remains unclear. This study examined the effect of the timing of symmetrizing mastopexy/breast reduction on oncoplastic breast-conserving surgery outcomes. METHODS: A retrospective study was conducted of all patients who underwent oncoplastic breast-conserving surgery using mastopexy/breast reduction techniques at a single center from 2010 to 2016. Patients who received synchronous (immediate) contralateral breast symmetrizing mastopexy were compared with those who underwent a delayed symmetrizing mastopexy procedure. Demographic, treatment, and outcome data were collected. Descriptive statistics were used and multivariate analysis was performed to evaluate the various relationships. RESULTS: There were 429 patients (713 breasts) included in the study; of these, 284 patients (568 breasts) underwent oncoplastic breast-conserving surgery involving mastopexy/breast reduction techniques and immediate symmetrizing mastopexy, and 145 patients underwent delayed contralateral symmetrizing mastopexy. The overall complication rate was similar between the immediate and delayed groups (25.4 percent versus 26.9 percent, respectively; p = 0.82), as was the major complication rate (10.6 percent versus 6.2 percent; p = 0.16). Complications resulted in a delay in adjuvant therapy in 18 patients (4.2 percent); in two patients (0.7 percent), this delay resulted from a complication in the contralateral symmetrizing mastopexy breast. Immediate contralateral symmetrizing mastopexy was not associated with increased risk of complications per breast (p = 0.82) or delay to adjuvant therapy (p = 0.6). CONCLUSION: Contralateral mastopexy/breast reduction for symmetry can be performed at the time of oncoplastic breast-conserving surgery in carefully selected patients without significantly increasing the risk of complications or delay to adjuvant radiation therapy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.


Assuntos
Neoplasias da Mama/cirurgia , Mamoplastia/métodos , Mastectomia Segmentar/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Tempo para o Tratamento , Adulto , Idoso , Mama/anatomia & histologia , Mama/cirurgia , Estética , Feminino , Seguimentos , Humanos , Mamoplastia/efeitos adversos , Mastectomia Segmentar/métodos , Pessoa de Meia-Idade , Satisfação do Paciente , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
3.
Wounds ; 28(9): 306-316, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27701126

RESUMO

Open wounds of the distal third of the leg and foot with an exposed tendon present a challenge in wound management and in attaining stable, durable coverage. The mobility of the tendon often leads to chronic inflammation that impedes wound closure, while the desiccation of the exposed tendon leads to progressive tendon necrosis. For the authors' cases, the ability of extracellular matrix (ECM) products to modulate wound bed inflammation and facilitate constructive remodeling of a wound seemed a reasonable approach in treating these wounds, especially in patients who are often poor surgical candidates for more advanced reconstructive procedures. METHODS: The authors reviewed 13 patients who had open wounds of the distal third of the leg and/or foot that had associated tendon involvement in the wound (Achilles, 6; tibialis anterior, 6; and peroneal, 1). Patients' wounds were treated to total closure. The clinical course and patient management is reviewed herein. RESULTS: The authors found newer ECM products can provide a more optimal method of management of patients with exposed tendons, as compared to prolonged negative pressure wound therapy. CONCLUSION: Furthermore, the authors conclude the use of newer ECM products yields a more stable, less scarred, reconstructed wound that more closely resembles normal foot and ankle appearance compared to other more complex reconstructive operative procedures.


Assuntos
Matriz Extracelular/metabolismo , Extremidade Inferior/irrigação sanguínea , Procedimentos de Cirurgia Plástica/métodos , Medicina Regenerativa , Transplante de Pele/métodos , Lesões dos Tecidos Moles/terapia , Tendões/irrigação sanguínea , Bexiga Urinária/transplante , Adulto , Animais , Matriz Extracelular/transplante , Feminino , Humanos , Masculino , Tratamento de Ferimentos com Pressão Negativa , Estudos Retrospectivos , Retalhos Cirúrgicos/irrigação sanguínea , Suínos , Tendões/patologia , Resultado do Tratamento , Bexiga Urinária/citologia , Cicatrização
4.
Clin Plast Surg ; 42(4): 465-79, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26408437

RESUMO

The breast is appreciated aesthetically and clinically for its shape, projection, and volume. Surgical techniques have evolved to manipulate the breast skin envelope, soft tissues, and chest wall anatomy, with and without prosthetic devices. The pectoralis major specifically is altered for pocket dissection and implant coverage. Both the aesthetic and reconstructive surgeons are aware of its relationship to the chest wall and the breast soft tissues. Both are able to achieve outstanding outcomes; however, the authors present an alternative appreciation of the pectoralis and its relationship to the breast.


Assuntos
Mama/anatomia & histologia , Mamoplastia/métodos , Músculos Peitorais/anatomia & histologia , Parede Torácica/anatomia & histologia , Mama/cirurgia , Implante Mamário , Dissecação , Estética , Feminino , Humanos , Músculos Peitorais/cirurgia , Parede Torácica/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...