Use of Autologous and Microsurgical Breast Reconstruction by U.S. Plastic Surgeons

Kulkarni, Ashish; Sears, Erika D.; Atisha, Dunya; Alderman, Amy K.

doi:10.1097/prs.0b013e31829ae03e

Cited by 62 publications

(58 citation statements)

References 22 publications

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“…For example, a recent survey of U.S. plastic surgeons reports financial reimbursement as a major obstacle to autologous reconstruction. 10 Furthermore, Medicare physician payments from 1998 to 2008 have declined by only 4 percent for implants, whereas they have decreased by 11 percent for autologous tissue transfers. 11 These effects are magnified by the adoption of lengthier microsurgical techniques, particularly in the setting of bilateral mastectomy defects.…”

mentioning

confidence: 99%

Cost-Effectiveness Analysis of Implants versus Autologous Perforator Flaps Using the BREAST-Q

Matros

Albornoz

Razdan

et al. 2015

Plastic and Reconstructive Surgery

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mentioning

confidence: 99%

Cost-Effectiveness Analysis of Implants versus Autologous Perforator Flaps Using the BREAST-Q

Matros

Albornoz

Razdan

et al. 2015

Plastic and Reconstructive Surgery

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“…In the survey by Kulkarni et al, 7 a substantial decrease was noted in the proportion of plastic surgeons performing > 20 cases/year compared with the 2010 survey. There was also a discernible increase in the percentage of plastic surgeons performing 1–20 cases/year in the 2012 survey compared with the 2010 survey 8 (Table 2).…”

Section: Discussionmentioning

confidence: 93%

“…In the study by Kulkarni et al, 7 the average response by procedure was 79% for tissue expander/implant-based reconstructions (Table 2). Surgeons with a low volume of BR (<5 cases/year) performed implant-based reconstruction (IBR) for more than 90% of their patients.…”

Section: Discussionmentioning

confidence: 95%

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A Comparative Analysis of 2 National Breast Reconstruction Surveys

Gürünlüoğlu

Bronsert²

2014

Plastic and Reconstructive Surgery Global Open

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Background:Pertinent findings of two national breast reconstruction (BR) surveys from two different institutions at two separate times (2012 vs 2010) were analyzed for comparison.Methods:An appraisal of sampling methodology, sample demographics, years of practice, practice affiliation, BR type, and annual volume between the two studies was conducted using statistical analysis.Results:Proper sampling technique and adequate sample size were used in both surveys to represent the typical population of general US plastic surgeons practicing BR. There were no differences in mean age or years of practice between the sample population in both studies. The percentage of plastic surgeons with academic affiliation was higher in the 2012 survey compared to the 2010 survey (28% vs 18%, P<0.05). Implant-based BR was the predominant method among surveyed plastic surgeons in both surveys. There was a substantial decrease in the proportion of plastic surgeons performing >20 cases per year in the 2012 survey compared to the 2010 survey (P<0.05). A high volume of BR, defined as >60 cases per year in the 2010 survey and >20 cases per year in the 2012 survey, correlated significantly with academic practice and multidisciplinary cancer centers, respectively (P<0.05). There was a significant decline in the percentage of plastic surgeons performing microsurgical BR from 2010 to 2012 (35% vs 25%, P<0.05).Conclusions:Comparative data suggest that there are fewer high volume BR cases being performed by US plastic surgeons and that there has been a reduction among plastic surgeons in the use of microsurgical BR from 2010 to 2012. We believe that these findings may indicate early signs of the changes in BR trends in the US.

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“…The enumerated anatomic zones possess a common structure component, the carcass which is different depending on its location, stiffness, configuration and thickness. Reconstruction of such formations involves complex surgical methods including autogenous tissue complex transplantation; duration of such surgery is long and the procedure is multiphase [1,2]. At the current stage of reconstructive surgery the need for creating and implementing synthetic and composite tissue replacement materials is becoming more and more apparent.…”

Section: Introductionmentioning

confidence: 99%

Composite implants coated with biodegradable polymers prevent stimulating tumor progression

Litviakov

Tverdokhlebov

Perelmuter

et al. 2016

AIP Conference Proceedings

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Abstract. In this experiment we studied oncologic safety of model implants created using the solution blow spinning method with the use of the PURASORB PL-38 polylactic acid polymer and organic mineral filler which was obtained via laser ablation of a solid target made of dibasic calcium phosphate dihydrate. For this purpose the implant was introduced into the area of Wistar rats' iliums, and on day 17 after the surgery the Walker sarcoma was transplanted into the area of the implant. We evaluated the implant's influence on the primary tumor growth, hematogenous and lymphogenous metastasis of the Walker sarcoma. In comparison with sham operated animals the implant group demonstrated significant inhibition of hematogenous metastasis on day 34 after the surgery. The metastasis inhibition index (MII) equaled 94% and the metastases growth inhibition index (MGII) equaled 83%. The metastasis frequency of the Walker sarcoma in para aortic lymph nodes in the implant group was not statistically different from the control frequency; there was also no influence of the implant on the primary tumor growth noted. In case of the Walker sarcoma transplantation into the calf and the palmar pad of the ipsilateral limb to the one with the implant in the ilium, we could not note any attraction of tumor cells to the implant area, i.e. stimulation of the Walker sarcoma relapse by the implant. Thus, the research concluded that the studied implant meets the requirements of oncologic safety.

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Use of Autologous and Microsurgical Breast Reconstruction by U.S. Plastic Surgeons

Cited by 62 publications

References 22 publications

Cost-Effectiveness Analysis of Implants versus Autologous Perforator Flaps Using the BREAST-Q

Cost-Effectiveness Analysis of Implants versus Autologous Perforator Flaps Using the BREAST-Q

A Comparative Analysis of 2 National Breast Reconstruction Surveys

Composite implants coated with biodegradable polymers prevent stimulating tumor progression

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