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ABSTRACT: BACKGROUND: Cranioplasty using alternate alloplastic bone substitutes instead of autologous bone grafting is inevitable in the clinical field. The authors present their experiences with cranial reshaping using methyl methacrylate (MMA) and describe technical tips that are keys to a successful procedure. METHODS: A retrospective chart review of patients who underwent cranioplasty with MMA between April 2007 and July 2010 was performed. For 20 patients, MMA was used for cranioplasty after craniofacial trauma (n = 16), tumor resection (n = 2), and a vascular procedure (n = 2). The patients were divided into two groups. In group 1, MMA was used in full-thickness inlay fashion (n = 3), and in group 2, MMA was applied in partial-thickness onlay fashion (n = 17). The locations of reconstruction included the frontotemporal region (n = 5), the frontoparietotemporal region (n = 5), the frontal region (n = 9), and the vertex region (n = 1). The size of cranioplasty varied from 30 to 144 cm(2). RESULTS: The amount of MMA used ranged from 20 to 70 g. This biomaterial was applied without difficulty, and no intraoperative complications were linked to the applied material. The patients were followed for 6 months to 4 years (mean, 2 years) after MMA implantation. None of the patients showed any evidence of implant infection, exposure, or extrusion. Moreover, the construct appeared to be structurally stable over time in all the patients. CONCLUSIONS: Methyl methacrylate is a useful adjunct for treating deficiencies of the cranial skeleton. It provides rapid and reliable correction of bony defects and contour deformities. Although MMA is alloplastic, appropriate surgical procedures can avoid problems such as infection and extrusion. An acceptable overlying soft tissue envelope should be maintained together with minimal contamination of the operative site. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Aesthetic Plastic Surgery 04/2013; · 1.41 Impact Factor
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ABSTRACT: The pedicled thoracodorsal artery perforator flap has been shown to be an effective option for reconstruction of various regions, including the breast, axilla, upper arm, lateral chest, and shoulder area. However, the original length of the pedicle limits the flap's reach to remote locations. We devised a technique that involves microsurgical lengthening of the pedicle to extend the arc of rotation of the pedicled perforator flap. After exposure of the subscapular vascular tree, we divided the thoracodorsal vessel at the point of bifurcation to the serratus branch and then the pedicle was reconnected to the distal end of the serratus branch. Here, we present 2 cases in which this technique was effectively applied to reconstruct a defect of the elbow using a thoracodorsal artery perforator flap with a pedicle lengthening procedure.
Annals of plastic surgery 03/2013; · 1.29 Impact Factor
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ABSTRACT: : Using an internal mammary artery as the recipient vessel in a free flap autologous breast reconstruction is common practice, but this vessel is often sacrificed for end-to-end anastomosis and is typically assessed by removing a costal cartilage segment. The authors studied the reliability of the end-to-side arterial anastomosis using a rib-sparing approach by comparing it with end-to-end anastomosis.
: The authors analyzed 100 consecutive medical records of patients who underwent autologous breast reconstruction with a free deep inferior epigastric artery perforator flap in which the internal mammary vessels were assessed using a rib-sparing technique. The study compared the complications between the two groups of end-to-side arterial anastomosis (50 cases) and end-to-end arterial anastomosis (50 cases).
: Exposure of the internal mammary artery using a rib-sparing technique was performed successfully in all 100 flaps. The second and third intercostal spaces were used in 46 and 54 cases, respectively. The mean width of the used intercostal space was 18.3 ± 2.4 mm in the end-to-side group and 18.3 ± 2.9 mm in the end-to-end group (p = 0.923). All flaps survived without partial or total necrosis. One case of venous insufficiency that required exploration occurred in the end-to-side group; the flap was totally saved with venous revision. There was no significant statistical difference between the end-to-side and end-to-end groups in all other variables, including mean flap ischemic time (p = 0.431) and fat necrosis (p = 0.339).
: The rib-sparing and internal mammary artery-preserving free deep inferior epigastric artery perforator flap transfer is an efficient and safe technique for microsurgical breast reconstruction.
: Therapeutic, III.
Plastic and reconstructive surgery 03/2013; 131(3):327e-34e. · 2.74 Impact Factor
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ABSTRACT: The pedicled, descending-branch muscle-sparing latissimus dorsi (MSLD) flap has been widely used for breast reconstruction following total mastectomy. However, the superiority of the MSLD flap compared to the extended latissimus dorsi (ELD) flap has not yet been described. This study compares morbidities following pedicled MSLD flap and ELD flap breast reconstruction. A total of 36 women with pedicled MSLD flaps were compared with 37 women with ELD flap breast reconstruction. The medical records were reviewed for complications and demographic data. The authors compared morbidity including donor-site seroma, limitation of shoulder movement and aesthetic contour of the donor site following MSLD flap and ELD flap breast reconstruction. The authors compared the identified parameters and set the level of significance at the 0.05 alpha level. The demographic data of the two groups were not significantly different statistically. Donor-site seroma occurred in two MSLD patients (5.6%) and in 23 ELD patients (62.2%) (p = 0.0001). Limitation of shoulder movement occurred in nine MSLD patients (25%) and in 28 ELD patients (75.7%) (p = 0.0001). Back asymmetry occurred less frequently in the MSLD group (p = 0.0297). The pedicled, descending-branch MSLD flap, with its low complication rate and associated with minimal functional and aesthetic deficits of the donor site, can be a good option for breast reconstruction. LEVEL OF EVIDENCE: Therapeutic, III.
Journal of Plastic Reconstructive & Aesthetic Surgery 02/2013; · 1.49 Impact Factor
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ABSTRACT: BACKGROUND: The current trend in minimally invasive surgery is to make a small surgical incision. However, the excessive tensile stress applied by the retractors to the skin surrounding the incision often results in a long wound healing time and extensive scarring. To minimize these types of wound problems, the authors evaluated a simple and cost-effective method to minimize surgical incision scars based on the use of a latex surgical glove. METHODS: The tunnel-shaped part of a powder-free latex surgical glove was applied to the incision and the dissection plane. It was fixed to the full layer of the dissection plane with sutures. The glove on the skin surface then was sealed with Ioban (3 M Health Care, St. Paul, MN, USA) to prevent movement. The operation proceeded as usual, with the retractor running through the tunnel of the latex glove. RESULTS: It was possible to complete the operation without any disturbance of the visual field by the surgical glove, and the glove was neither torn nor separated by the retractors. The retractors caused traction and friction during the operation, but the extent of damage to the postoperative skin incision margin was remarkably less than when the operation was performed without a glove. CONCLUSION: This simple and cost-effective method is based on the use of a latex surgical glove to protect the surgical skin incision site and improve the appearance of the postoperative scar. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Aesthetic Plastic Surgery 01/2013; · 1.41 Impact Factor
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ABSTRACT: PURPOSE: Recently, there has been increasing interest in system-based approaches to improve patient safety, including the concern of the risks of after-hours surgery. Although several studies have demonstrated worse outcomes associated with night surgery, little is known regarding the effects of after-hours surgery on microsurgery fields. Here, we evaluated the hypothesis that after-hours microsurgery could increase the risk of postoperative complications. METHODS: A retrospective case-control study was performed of patients who underwent elective microsurgical reconstruction between January 2004 and March 2012. Patients were categorised into an after-hours group defined as an operation starting between 4 pm and 7 am or a daytime group defined as an operation starting between 7 am and 4 pm. RESULTS: A total of 454 patients were included, with 345 patients in the daytime group and 109 patients in the after-hours group. Flap-compromised complications were observed in 24 patients (5.3%), including 13 (2.9%) total losses and 11 (2.4%) partial losses. After-hours surgery was associated with a higher risk of total flap loss (p = 0.011) and re-exploration (p = 0.004), which remained significant in multivariate analysis (p = 0.018; p = 0.002). Total flap salvage was possible in 18 of 31 (58.1%) of re-explorations, and a significantly higher success rate was observed in the daytime group (p = 0.027). Total length of hospital stay was significantly longer in the after-hours group (p = 0.039). Minor complication rates did not show significant differences between the groups. CONCLUSIONS: After-hours performance of elective free flap surgery was demonstrated to be associated with increased risk of flap-related complications.
Journal of Plastic Reconstructive & Aesthetic Surgery 01/2013; · 1.49 Impact Factor
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ABSTRACT: BACKGROUND: There are several methods that may be used to confirm the status of rib cartilage, such as physical examinations or chest radiography, for subjects with microtia. However, these methods are limited because of clinicians' inability to gain accurate information about the rib cartilage. We performed 3-dimensional chest computed tomography to preoperatively evaluate the accuracy of rib cartilage imaging. METHODS: A total of 37 patients preparing for auricular reconstruction using a rib cartilage graft underwent preoperative 3-dimensional rib cage computed tomography (3-D rib CT). The 3-D rib CT was performed in cases of secondary revisional reconstruction, those with a history of surgery using rib cartilage, in those with a history of trauma related to the rib cage, older patients with question of calcification of rib cartilage, or those with a suspected rib cartilage anomaly on physical examination. Preoperatively, the appropriateness of using the rib cartilage were evaluated. RESULTS: With the aid of the 3-D rib CT, successful autogenous auricular reconstruction was achieved in 36 patients. Framework fabrication in combination with a porous polyethylene implant and autogenous rib cartilage was performed in the remaining patient as planned preoperatively. By analyzing the 3-D rib CT image preoperatively, auricular reconstruction using a recycled rib cartilage graft with newly harvested rib cartilage was performed successfully in 13 of 14 secondary revisional cases. Based on preoperative CT images, modified surgical planning in terms of cartilage harvest and framework fabrication was needed in 8 of 11 patients who had a history of operation using rib cartilage and in 3 of 5 subjects with suspected rib cage anomalies on physical examination. Successful reconstruction was achieved using the modified surgical plan. CONCLUSIONS: A preoperative 3-D rib CT helps in surgical planning for autogenous auricular reconstruction for microtia, especially in patients with suspicious rib cartilage status.
Annals of plastic surgery 12/2012; · 1.29 Impact Factor
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ABSTRACT: Endoscopic excision is a growing treatment option for benign facial tumors; however, its outcome has not been reported in a large series with long-term follow-up. The purpose of this study was to present the outcome of our decade-long experience with endoscopic excision, compared with direct excision.We retrospectively reviewed patients who underwent surgical treatment using either the endoscopic or direct approach for benign facial tumors from January 2001 to January 2012. Patient demographics, complications, recurrence, and pathological results were collected. Patient satisfaction was assessed using survey questionnaires. The results of endoscopic excision and direct excision were compared.Endoscopic excision was performed for 152 patients consisting of 77 lipomas (50.7%), 45 osteomas (29.6%), 24 dermoid cysts (15.8%), and 6 others (3.9%). The masses were located on the forehead in 138 patients (90.8%) and on the cheeks in 14 patients (9.2%). Direct excision was performed for 123 patients composed of 62 lipomas (50.4%), 46 dermoid cysts (37.4%), 11 osteomas (8.9%), and 4 others (3.3%). The mean follow-up period was 4.6 years. In the endoscopic excision group, hematomas developed in 2 and wound dehiscence in 1 patient. In the direct excision group, 1 hematoma and 1 wound dehiscence occurred. There were 4 recurrent cases in the endoscopic excision group and 1 recurrent case in the direct excision group, but there was no statistically significant difference in the recurrence rate between the 2 groups (2.6% vs 0.8%, P = 0.258). Patient satisfaction was higher in the endoscopic excision group than in the direct excision group (satisfaction for aesthetics, 92.98 vs 71.71%, P < 0.001; satisfaction for procedure, 89.9 vs 76.15%, P = 0.001).Compared with direct excision, endoscopic excision provided a comparable recurrence rate and higher patient satisfaction in this decade-long study. Endoscopic excision is a safe and valuable treatment option for selected benign tumors on the forehead and cheek.
Annals of plastic surgery 12/2012; · 1.29 Impact Factor
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ABSTRACT: PURPOSE: The plantar region presents unique challenges for reconstructive surgeons. Reconstruction using a thoracodorsal artery perforator (TDAP) flap yields favourable results in various fields of microsurgical reconstruction, but reports on the reconstruction of plantar defects are sparse. Here, the authors present their experience in the reconstruction of various defects in the plantar region using free TDAP flaps. METHODS: From January 2005 to July 2011, 40 free TDAP flaps were transferred for reconstructive purposes to restore skin and soft-tissue defects in the plantar region. Hospital and outpatient records were reviewed independently for all patients. A patient questionnaire including five questions was administered to subjectively evaluate reconstructive results. RESULTS: A total of 24 male and 16 female patients were enrolled in this study. The mean age was 47.8 years and ranged from 7 to 77 years. The most common cause of defect was oncology related (n = 21), followed by trauma-related (n = 11), diabetes-related (n = 6) and other causes. The average flap size was 63.7 cm(2) and ranged from 25 to 212 cm.(2) All flaps survived except for one, resulting in a below-knee amputation. The mean follow-up period was 20.4 months. Four patients underwent secondary revisional procedures, including simple defatting in two patients and excision of redundant skin due to flap instability in two patients. The satisfaction surveys were completed by 34 (85%) patients. Patients reported high levels of satisfaction in terms of pain, limitation of daily activities, donor site satisfaction and overall satisfaction. Most patients were satisfied and reported that they would recommend the procedure to others. CONCLUSION: An appropriately thinned free TDAP flap with thick skin provided favourable outcomes with high patient satisfaction and is a valuable option for the restoration of skin and soft-tissue defects in the plantar region.
Journal of Plastic Reconstructive & Aesthetic Surgery 11/2012; · 1.49 Impact Factor
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ABSTRACT: PURPOSE: Fat tissue can be injured by ischaemia in free flap surgeries, leading to the development of fat necrosis. The aim of this study was to evaluate the association between ischaemic time and fat necrosis in microsurgical breast reconstruction using a deep inferior epigastric perforator (DIEP) flap. METHODS: A retrospective chart review was performed for patients who underwent breast reconstruction with free DIEP flaps between June 2009 and November 2011. Data regarding patient demographics, potential risk factors and fat necrosis were collected. Fat necrosis was diagnosed with ultrasound imaging between 3 and 6 months postoperatively. Univariate and multivariate analyses were used to assess the correlation between ischaemic time and fat necrosis rate. Receiver operating characteristic curve analysis was used to determine a cut-off value for the ischaemic time at which differential fat necrosis rates were maximal. RESULTS: A total of 86 patients were included in this study. The mean ischaemic time was 89 min, and fat necrosis was diagnosed in 15 patients (17.4%). A significant association was found between ischaemic time and fat necrosis rate on univariate (p-value = 0.001) and multivariate analyses (p-value = 0.017). The trend analysis of ischaemic time as a categorical variable relative to fat necrosis rate was also significant (p-value <0.001). A threshold value was found whereby patients with an ischaemic time longer than 99.5 min appeared to experience a significantly higher fat necrosis rate than patients with shorter times (p-value = 0.005, odds ratio = 9.449). CONCLUSION: Ischaemic time appears to be significantly associated with increased fat necrosis rate in breast reconstruction using DIEP flaps. A long ischaemia time may be a risk factor for the development of fat necrosis.
Journal of Plastic Reconstructive & Aesthetic Surgery 10/2012; · 1.49 Impact Factor
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Plastic and reconstructive surgery 10/2012; 130(4):619e-20e. · 2.74 Impact Factor
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ABSTRACT: Several researches have shown that negative-pressure wound dressings can secure split-thickness skin grafts and improve graft survival. However, in anatomically difficult body regions such as the perineum it is questionable whether these dressings have similar beneficial effects. In this study, we evaluated the effects of negative-pressure wound dressings on split-thickness skin grafts in the perineum by comparing wound healing rate and complication rate with that of tie-over dressings. A retrospective chart review was performed for the patients who underwent a split-thickness skin graft to reconstruct perineal skin defects between January 2007 and December 2011. After grafting, the surgeon selected patients to receive either a negative-pressure dressing or a tie-over dressing. In both groups, the initial dressing was left unchanged for 5 days, then changed to conventional wet gauze dressing. Graft success was assessed 2 weeks after surgery by a single clinician. A total of 26 patients were included in this study. The mean age was 56·6 years and the mean wound size was 273·1 cm(2) . Among them 14 received negative-pressure dressings and 12 received tie-over dressings. Negative-pressure dressing group had higher graft taken rate (P = 0·036) and took shorter time to complete healing (P = 0·01) than tie-over dressing group. The patients with negative-pressure dressings had a higher rate of graft success and shorter time to complete healing, which has statistical significance. Negative-pressure wound dressing can be a good option for effective management of skin grafts in the perineum.
International Wound Journal 09/2012; · 1.46 Impact Factor
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ABSTRACT: Computed tomographic angiography is widely used for obtaining vascular information about the abdominal donor site for microsurgical breast reconstruction. The purpose of this study is to report the authors' experience using preoperative computed tomographic angiography of both donor and recipient sites for a series of microsurgical breast reconstruction procedures.
A total of 71 patients preparing for autologous breast reconstruction with deep inferior epigastric artery perforator (DIEP) flaps underwent preoperative computed tomographic angiography with scanned fields ranging from the clavicle to the pubic symphysis. Preoperative evaluation included computed tomography-based anatomy of the intercostal space, the internal mammary artery and vein, and the internal mammary artery perforator to determine which intercostal space was to be approached. The volume of the breast and the volume of the abdominal flap were calculated using computed tomography-based volumetry.
In 67 patients, the internal mammary vessel was exposed expeditiously at the preoperatively designated intercostal space by the rib-sparing technique. The design of flaps, including vascular pedicles, was accomplished with the aid of the computed tomography-based volumetric ratio (mean, 0.64) between the breast and abdominal flaps of patients. The volumetric ratio ultimately correlated with the ratio of the weight of the actual flap inset to the harvested flap weight (mean, 0.63).
Preoperative computed tomographic angiography of both donor and recipient sites provides valuable information for planning and executing microsurgical breast reconstruction. Computed tomography-based anatomy and volumetry facilitate the approach to recipient vessels and harvest of free DIEP flaps.
Diagnostic, IV.
Plastic and reconstructive surgery 07/2012; 130(1):11e-20e. · 2.74 Impact Factor
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ABSTRACT: For more precise and rapid notification of free flap status between staff members after surgery, the authors used a smartphone and mobile messenger application including multimedia during the initial postoperative period and analyzed the influence of this method for the re-exploration time and survival rate of the flap before and after use. From April of 2010 to September of 2011, 123 consecutive free flaps were reviewed. The authors increased the flap survival rate from 96.2 to 100 percent and increased the threatened flap salvage rate from 50 to 100 percent with this method. The time interval between the first notification of flap compromise and the start of re-exploration was significantly shortened (4.0 versus 1.4 hours). This method not only provided better communication and comprehensive information but also allowed early diagnosis of flap compromise to be actualized at early re-exploration, ultimately increasing flap survival. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
Plastic and reconstructive surgery 07/2012; 130(1):125-9. · 2.74 Impact Factor
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ABSTRACT: The objective of this study was to estimate the outcomes of surgical treatment for patients with venous malformations (VMs).
We retrospectively reviewed the data of 48 patients who underwent surgical management for VMs from 1994 to 2009 at our institute. The 1-year responses to surgeries were classified into three groups based on the results: "remission," "improvement," and "no change."
The indications of surgeries were mass or swelling in 48 patients (100%), intractable pain in 11 (23%), limb length discrepancy in seven (15%), bleeding in three (6%), and limitation of the range of motion in one (2%). The locations of the VMs were head and neck in 17 patients (35%), abdomen and pelvis in one (2%), perineum and genitalia in three (6%), upper extremities in 12 (25%), and lower extremities or buttocks in 15 (31%). Of the 48 surgeries for radical excision and debulking, 25 (52%) resulted in remission, 11 (23%) in improvement, and 12 (25%) in no change. During follow-up (mean: 44.8 ± 36.6 months, range: 0-111 months), recurrence after radical excision occurred in 10% (3 of 31) of the patients, and size increase after debulking surgery in 24% (4 of 17) of the patients.
Surgical treatment can be an option in patients with VMs, especially with symptoms that cannot be managed with conservative therapy or sclerotherapy. After excisional or debulking surgery in patient with VMs, remission or improvement can be observed in 75%.
Annals of Vascular Surgery 07/2012; 26(5):665-73. · 1.03 Impact Factor
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ABSTRACT: The aim of this study was to assess the impact of immediate breast reconstruction (IBR) with autologous tissue on the development of post-mastectomy lymphedema in patients undergoing modified radical mastectomy (MRM). A retrospective chart review was performed for early-stage breast cancer patients who underwent MRM between January 2001 and December 2009. Patients were categorized into two groups based on whether or not they underwent IBR. The incidence of lymphedema was assessed and compared. A total of 712 patients underwent MRM, which included 117 patients undergoing IRB. There were no significant differences between two groups except for a lower body mass index in the reconstruction group. Comparing the incidence of lymphedema using multivariate logistic regression analysis, the reconstruction group had a significantly lower incidence of lymphedema (p-value = 0.023). Breast cancer patients who underwent MRM with IBR had a significantly lower incidence of lymphedema than those in the non-reconstruction group.
Breast (Edinburgh, Scotland) 05/2012; · 2.09 Impact Factor
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ABSTRACT: Though there are reports regarding congenital microtia in various populations, few studies have focused on patients in South Korea. The objectives of the present study were to investigate the characteristics of microtia in South Korea and demonstrate the contribution of environmental risk factors to the occurrence of microtia.
We performed a retrospective chart review of congenital microtia patients who presented to our institution between January 2002 and December 2010. A case-control study was performed in 169 microtia patients and 128 controls to investigate the impact of environmental and prenatal factors on the development of congenital microtia. The data were gathered by personal interviews and detailed questionnaires filled out by the patients' parents.
A total of 374 microtia patients were included in the present study. Most cases were sporadic, and most were male. Unilateral microtia was more common, especially on the right side, while bilateral microtia occurred in only 25 patients. Two hundred forty-three patients had isolated microtia with no other congenital anomalies. In subgroups divided by type, lobule-type microtia was more common than concha-type microtia, and patients with anotia were the least common. Risk factors analyzed using multivariate regression models between groups, resident area during pregnancy, threatened abortion history, rubella vaccination, medication history during the first trimester, and alcohol consumption during the first trimester had significant impacts on the development of isolated microtia.
The characteristics of congenital microtia in South Korea are similar to those in other populations, including the predominance of sporadic occurrence, male gender, lobule type, and isolated microtia. Several environmental risk factors can have significant impacts on the development of microtia.
International journal of pediatric otorhinolaryngology 03/2012; 76(3):357-61. · 0.85 Impact Factor
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ABSTRACT: Lymphedema is a common complication after mastectomy in breast cancer patients. Many treatment options are available, but no treatment results in a complete cure. We report a case of lymphedema that occurred after modified radical mastectomy in a breast cancer patient who showed objective improvement after delayed breast reconstruction with an latissimus dorsi myocutaneous flap. A 41-year-old female patient with left breast cancer had undergone modified radical mastectomy with axillary lymph node dissection and postoperative radiotherapy 12 years previously. Four years after surgery, lymphedema developed and increased in aggravation despite conservative treatment. Eight years after the first operation, the patient underwent delayed breast reconstruction using the extended latissimus dorsi myocutaneous flap method. After reconstruction, the patient's lymphedema symptoms showed dramatic improvement by subjective measures including tissue softness and feeling of lightness, and by objective measures of about 7 mL per a week, resulting in near normal ranges of volume. At a postoperative follow-up after 3 years, no recurrence was observed. Delayed breast reconstruction with extended latissimus dorsi myocutaneous flaps may be helpful to patients with lymphedema after mastectomy. This may be a good option for patients who are worried about the possibility of the occurrence or aggravation of secondary lymphedema.
Archives of plastic surgery. 03/2012; 39(2):154-7.
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ABSTRACT: Ketorolac is commonly prescribed for relieving postoperative pain and is known to have an anticoagulation effect, though this has not been studied in a clinical series. The aim of this study was to evaluate the effects of ketorolac on microvascular thrombosis in lower extremity reconstruction.
A retrospective chart review was performed for patients who underwent lower limb reconstruction with a free flap between January of 2005 and September of 2011. Patients were categorized into two groups based on the administration of ketorolac for postoperative pain relief. Complications were assessed, and the two groups were compared for vascular insufficiency, total or partial flap loss, and hematoma formation.
A total of 128 patients underwent microsurgical flap transfer, including 111 thoracodorsal artery perforator flaps, four latissimus dorsi myocutaneous flaps, seven deep inferior epigastric artery perforator flaps, and six anterolateral thigh flaps. Eighty patients were administrated ketorolac, and 48 patients were not. The nonketorolac group had significantly higher rates of vascular-related complications, and the difference remained significant after adjusting for confounding factors on multivariate logistic regression analysis. There was a correlation between the duration of ketorolac administration and complication rates, for which longer periods of ketorolac administration yielded lower complication rates.
Ketorolac administration has a protective effect against the development of microvascular thrombosis and can be a preferred analgesic in free tissue transfer.
Therapeutic, III.
Plastic and reconstructive surgery 02/2012; 129(6):1322-7. · 2.74 Impact Factor
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ABSTRACT: The purpose of our study was to analyze scientific papers published by South Korean plastic surgeons in journals included in the Science Citation Index Expanded (SCIE), and to evaluate the publication and research activities of Korean plastic surgeon.
We conducted a survey of SCIE papers in the field of plastic surgery published by South Korean authors between 2001 and 2010 using Web of Science software. We further analyzed these results according to the number of publications per year, journals, institution, and type of papers. We also compared the total number of citations to published scientific papers. We analyzed the rank of South Korea among other countries in representative journals.
Overall, 667 papers were published by South Korean authors between 2001 and 2010. The number of publications increased dramatically from 2003 (n=31) to 2010 (n=139). Subsequently, the ten most productive Korean medical colleges were identified. All published papers received 2,311 citations and the citation to paper ratio was 3.49. The rank of Korea among other countries in terms of the number of published papers remained in the top 10 during the recent 10 years.
Publication output of Korean plastic surgeon over the last 10 years showed a remarkable growth in terms of quantity and quality. Currently, Korea is among the top six countries in representative plastic surgery journals. Korean plastic surgeons have played a central role in this progress, and it is anticipated that they will continue to do so in the future.
Archives of plastic surgery. 01/2012; 39(1):46-50.
