Background: Current efficacy data supporting the routine use of acellular dermal matrices in postmastectomy tissue expander/implant reconstruction are limited. A multicenter, blinded, randomized controlled study was designed to evaluate effectiveness matrix setting reconstruction. The primary objective determine whether would decrease patient-reported postoperative pain. secondary its accelerate rate expansion. Methods: trial conducted at two U.S. centers from 2008 2011. Immediately...

Although breast-conserving surgery is oncologically safe for women with early-stage breast cancer, mastectomy rates are increasing. The objective of this study was to examine the role reconstruction in surgical management unilateral cancer.A retrospective cohort diagnosed cancer (1998 2011) identified National Cancer Data Base conducted. Rates surgery, and bilateral contralateral prophylactic procedures (per 1000 cases) were measured relation reconstruction. association between treatment...

There has been a trend toward limiting perioperative prophylactic antibiotics, based on research not conducted in plastic surgery patients. The authors' university hospital instituted antibiotic prescribing guidelines the Surgical Care Improvement Project. An increased rate of surgical-site infections was noted breast reconstruction authors sought to determine whether change prophylaxis regimen affected rates infections.A retrospective study compared patients undergoing who received...

Restoration of form and function after burn injury remains challenging, but emerging laser pulsed light technologies now offer hope for patients with hypertrophic scars, which may be associated persistent hyperemia, chronic folliculitis, intense pruritis, neuropathic pain. In addition to impairing body image, these scars limit functional recovery, compromise activities daily living, prevent return work. Three different platforms are poised alter our reconstructive algorithm: (1)...

Background: Fat transfer is an increasingly popular method for refining postmastectomy breast reconstructions. However, concern persists that fat may promote disease recurrence. Adipocytes are derived from adipose-derived stem cells and express adipocytokines can facilitate active cancer in laboratory models. The authors sought to evaluate the association between reconstructed recurrence patients diagnosed with local or regional invasive cancers. Methods: A multicenter, case-cohort study was...

Objective: To evaluate a web-based breast reconstruction decision aid, BREASTChoice . Summary and Background Data: Although postmastectomy can restore quality of life body image, its morbidity remains substantial. Many patients lack adequate knowledge to make informed choices. Decisions are often discordant with patients’ preferences. Methods: Adult women stages 0–III cancer considering no previous were randomized or enhanced usual care (EUC). Results: Three hundred seventy-six screened; 120...

Women diagnosed with early stage (I or II) breast cancer face a highly challenging decision - whether not to undergo adjuvant chemotherapy. We developed quality instrument for chemotherapy and sought evaluate its performance.Cross-sectional, mailed survey of recent survivors, providers, healthy controls retest survivors. The includes questions on knowledge personal goals. It results in score concordance score, which reflects the percentage patients who received treatments that match their...

Women with early-stage breast cancer face a multitude of decisions. The quality decision can be measured by the extent to which treatment reflects what is most important an informed patient. Reliable and valid measures patients' knowledge their goals concerns related treatments are needed assess quality.To identify set key facts relevant each three decisions (surgery, reconstruction adjuvant chemotherapy hormone therapy) evaluate validity methods used them.Candidate were chosen based on...

Decisions about breast reconstruction after mastectomy are some of the most difficult decisions a cancer patient makes. To make good decision, should have adequate knowledge specific facts related to and treatment chosen be consistent with patient's personal preferences or goals. We sought identify important goals for mastectomy, compare patients' providers' perspectives. conducted cross-sectional survey survivors providers. Participants rated ranked importance goals/concerns mastectomy....

Variation in rates of breast reconstruction after mastectomy has raised concerns about the quality decisions reconstruction. The authors sought to evaluate patient decision making reconstruction, using a validated measure knowledge and preferences related reconstruction.A cross-sectional survey early-stage cancer survivors from four university medical centers was conducted. included measures specific facts, personal goals concerns, involvement making. A multivariable linear regression model...

What do patients want when looking for an aesthetic surgeon? When faced with attributes like reputation, years in practice, testimonials, photos, and pricing, which is more valuable? Moreover, are procedure-specific? Currently, inadequate evidence exists on most important to patients, our knowledge, none procedure-specific preferences. First, determine the breast augmentation, combined breast/abdominal surgery, facelift using conjoint analysis. Second, test internet crowdsourcing service...

From MalawiBreast cancer burden is high in low-resource countries.From 1980 to 2010, new breast cases increased by more than 50% worldwide. 1Disease even rapidly low-and middle-income countries (LMICs), where half of now occur.Moreover, disproportionately affects young women LMICs, such that 23% occur among age 15 49 years LMICs versus 10% high-income countries. 1

This study assesses the usefulness of omentum in reconstruction complex perineal defects, following abdominoperineal resection or pelvic exenteration, for anorectal malignancy. Between 2000 and 2008, 70 patients (mean age: 59 years) with malignancy underwent (n = 57) exenteration 13) were reconstructed by primary repair alone 13), 16), myocutaneous flap 28), 13). Patients without omental flaps compared Student t test chi2 analysis. Omental based on a single pedicle, tunneled retrocolic plane...

Discussions about breast reconstruction should include factual information and consideration of the patient's personal concerns. Providers are familiar with relevant facts but may not know which concerns important to patients. Experience cancer patients has found that providers frequently do their patients' treatment preferences. To help reconstructive surgeons discuss preferences patients, we sought identify women's key related reconstruction. We employed a qualitative design convened...

Road traffic injuries are a major cause of preventable death in sub-Saharan Africa. Accurate epidemiologic data scarce and under-reporting from primary sources is common. Our objectives were to estimate the incidence road deaths Malawi using capture-recapture statistical analysis determine what future efforts will best improve upon this estimate. model combined both police hospital-based registries over one year period (July 2008 June 2009). The mortality incidences 0.075 0.051 deaths/1000...

Shared decision-making (SDM) is a process through which patients and providers collaborate to select treatment option that aligns with patients' preferences clinical context. SDM can improve decision quality satisfaction. However, vulnerable populations face barriers participation in SDM, exacerbates disparities quality. This perspective article discusses patients, using examples from who made decisions about postmastectomy breast reconstruction. We offer several strategies for practice,...

Background: Approximately 20% of patients report inadequate discussions with their providers about reconstructive options, an increased frequency reported in non-White women. Eliciting treatment preferences adaptive choice-based conjoint (ACBC) analysis can improve our understanding what patients’ value. We aimed to determine African American (AA) value when considering breast reconstruction options. Methods: Cross-sectional ACBC AA women recruited through community partnerships and academic...