Complications of 278 consecutive abdominoplasties

Stewart, Kenneth J.; Stewart, David A.; Coghlan, Brian; Harrison, Douglas H.; Jones, Barry M.; Waterhouse, N.

doi:10.1016/j.bjps.2005.12.060

Cited by 193 publications

(95 citation statements)

References 9 publications

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“…Despite advances in surgical techniques, patients may still suffer from wound breakdown and ischemic necrosis. 16,17 The associated morbidity and mortality represents a considerable health-care issue. 18,19 The aim of this study was to evaluate the NO-dependent effect of systemic EPO administration starting before surgical induction of acute persistent ischemia in musculocutaneous tissue of mice.…”

mentioning

confidence: 99%

Erythropoietin-induced upregulation of endothelial nitric oxide synthase but not vascular endothelial growth factor prevents musculocutaneous tissue from ischemic damage

Rezaeian

Wettstein

Egger

et al. 2010

Laboratory Investigation

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Recent findings have attested the protective effects of erythropoietin (EPO) in ischemically challenged organs. We therefore aimed at elaborating the underlying mechanism of EPO-mediated protection in musculocutaneous tissue undergoing persistent ischemia after acute injury. Mice were assigned to five experimental groups equipped with a randomly perfused flap fixed in a dorsal skinfold chamber, whereas the sixth group did not undergo flap preparation: EPO, L-Name, EPO and L-Name, EPO and bevacizumab, untreated flap, and nonischemic chamber (control). Intravital fluorescence microscopic analysis of microhemodynamics, apoptotic cell death, macromolecular leakage and angiogenesis was carried out over a 10-day period. Further, immunohistochemical analysis was used to study the protein expression of endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor (VEGF). Increased expression of eNOS in EPO-administered mice correlated with significant arteriolar dilation and thus increased blood flow resulting in a maintained functional capillary density (FCD) at day 10. In addition, EPO induced a VEGF upregulation, which was associated with newly formed capillaries. In addition, EPO was able to reduce ischemia-induced apoptotic cell death and finally to significantly reduce flap necrosis. In contrast, coadministration of L-Name abolished EPO-mediated tissue protection by abrogating the dilatory effect resulting in reduced FCD and tissue survival, without counteracting angiogenesis and apoptotic cell death, whereas additional administration of bevacizumab did not influence the beneficial effect of EPO on flap survival despite abrogating angiogenesis. Macromolecular leakage was found to be increased in all treatment groups. This study shows that EPO administration prevents musculocutaneous tissue from ischemic necrosis as a consequence of an eNOS-dependent arteriolar hyperperfusion maintaining capillary perfusion, thus representing a promising approach to pharmacologically protect ischemically challenged tissue.

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mentioning

confidence: 99%

Erythropoietin-induced upregulation of endothelial nitric oxide synthase but not vascular endothelial growth factor prevents musculocutaneous tissue from ischemic damage

Rezaeian

Wettstein

Egger

et al. 2010

Laboratory Investigation

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“…18 They found late complications including dog ears, localized fatty excess, and unsatisfactory scars in 25 % of patients and 24 % patients underwent revision surgery. A stretched scar indicates tension at closure and lack of proper deep closure so scar revision gives a better aesthetic outcome.…”

Section: Discussionmentioning

confidence: 97%

The correlation of histopathological subcutaneous adipose tissue changes with post bariatric wound healing complications

Sakka¹,

Elaskandrany

2016

Int Surg J

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“…In breast and plastic surgery procedures, usually S. aureus is responsible for the wound infection (2,6,7,10,11,15,19,20). In axillary region procedures, obese patients prone to maceration, procedures at sweating areas P. aeruginosa, Serratia marcescens, Enterobacteriaceae including E. coli and gram-negatives like Klebsiella can be isolated (20, 21).…”

Section: Microorganismsmentioning

confidence: 99%

“…The risk of wound infection is below 5% in surgical procedures including breast reduction and reconstruction surgery, in a patient without additional risk factors for infection (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). In addition to patient specific conditions that are known to increase the risk of infection in all kinds of surgical wounds in general, the use of implants in breast surgery (13) and preoperative radiotherapy application (14,15) further increase the risk of wound infection.…”

Section: Introductionmentioning

confidence: 99%

Guideline for Antimicrobial Prophylaxis in Breast Surgery

Baghaki¹,

Soybir²,

Soran³

2014

J Breasth Health

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Antimicrobial prophylaxis has an important role in reducing surgical wound infection rates. Besides prophylaxis; basic infection control mechanisms implemented in the clinic (17), the surgeon's experience and technique, duration of operation, hospital and operating room conditions, instrumentation, preoperative preparation including body-washing, skin antisepsis and shaving, peri-operative management of temperature and blood glucose regulation, and the patient's existing co-morbidities all play an important role (16,18). Patient-related risk factors for surgical wound infections are advanced age, negative nutritional status, obesity, diabetes mellitus, cigarette smoking, presence of infection, immunodeficiency or immunosuppressive use, steroid use, recent surgery, long preoperative hospitalization and colonization with microorganisms. MicroorganismsIn breast and plastic surgery procedures, usually S. aureus is responsible for the wound infection (2,6,7,10,11,15,19,20). In axillary region procedures, obese patients prone to maceration, procedures at sweating areas P. aeruginosa, Serratia marcescens, Enterobacteriaceae including E. coli and gram-negatives like Klebsiella can be isolated (20, 21). . Pages 582-667 of this book contain the section:"Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery". This section includes current clinical developments, evidence and recommendations on the application of standard and effective antimicrobial prophylaxis in adult and pediatric patients, and has significant differences compared to the previous 1999 edition. On pages 632-633, antimicrobial prophylaxis in breast and plastic surgery practice is addressed in detail. This article contains a summary of the recommendations made in ASHP 2012/2013 Report regarding the antimicrobial prophylaxis in breast and plastic surgery applications.

show abstract

Complications of 278 consecutive abdominoplasties

Cited by 193 publications

References 9 publications

Erythropoietin-induced upregulation of endothelial nitric oxide synthase but not vascular endothelial growth factor prevents musculocutaneous tissue from ischemic damage

Erythropoietin-induced upregulation of endothelial nitric oxide synthase but not vascular endothelial growth factor prevents musculocutaneous tissue from ischemic damage

The correlation of histopathological subcutaneous adipose tissue changes with post bariatric wound healing complications

Guideline for Antimicrobial Prophylaxis in Breast Surgery

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