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Grant Walter Carlson: Influence Statistics

PURPOSE: The concept of virtual surgery uses surgical simulation rather than relying exclusively on intraoperative manual approximation of facial reconstruction. The purpose of this study was to evaluate the degree to which surgical outcomes in free fibula mandibular reconstructions planned with virtual surgery and carried out with prefabricated surgical plate templates and cutting guides correlated to the virtual surgical plan in a series of 11 patients.

MATERIALS AND METHODS: This ...

Recent trends in breast reconstruction have transitioned toward the skin-sparing type of mastectomy and immediate reconstruction using autologous tissue. This study was designed to document trends in the management of patients with unilateral breast cancer and to determine how they influence management of the contralateral breast. All patients who underwent unilateral breast reconstruction at Emory University Hospitals from January of 1975 to December of 1999 were reviewed. The cohort ...

BACKGROUND: The head and neck have a rich lymphatic drainage and complex anatomy, which complicate sentinel lymph node (SLN) biopsy for melanoma. The incidence of regional recurrence after a negative SLN biopsy has been shown to be higher than that at other sites. Compounding factors in this scenario were analyzed to determine their impact on both SLN status and survival.

METHODS: A retrospective review of a prospective database of 315 patients who underwent SLN biopsy for head and neck ...

Sentinel lymph node biopsy has revolutionized the surgical management of primary malignant melanoma. Most series on sentinel lymph node mapping have concentrated on extremity and truncal melanomas. The head and neck region has a rich and unpredictable lymphatic system. The use of sentinel lymph node mapping in the management of head and neck melanoma is evaluated. The authors conducted a retrospective review of patients treated for clinical stage I and stage II malignant melanoma of the ...

OBJECTIVE: The purpose of the study is to define those patient variables that contribute to morbidity and mortality of median sternotomy wound infection and the results of treatment by debridement and closure by muscle flaps.

BACKGROUND: Infection of the median sternotomy wound after open heart surgery is a devastating complication associated with significant mortality. Twenty years ago, these wounds were treated with either open packing or antibiotic irrigation, with a mortality ...

Completion lymph node dissection (CLND) is routinely performed after metastatic melanoma is detected at sentinel lymph node (SLN) biopsy. Nonsentinel lymph node (NSLN) involvement is found in less than one-third of the cases. Possible predictors of NSLN involvement are examined. A retrospective review of 70 patients with a positive SLN biopsy for melanoma and drainage to one lymphatic basin was performed. The size of metastatic deposits was defined as macrometastases (>2 mm), ...

OBJECTIVE: To examine donor-site complications after omental harvest for the reconstruction of extraperitoneal wounds and defects.

SUMMARY BACKGROUND DATA: The omentum, with its immunologic and angiogenic properties, is a versatile organ with well-documented utility in the reconstruction of complex wounds and defects. However, the need for laparotomy and the potential for intraabdominal complications have been cited as relative contraindications to the use of the omentum as a ...

BACKGROUND: The skin sparing mastectomy continues to allow improvement in the esthetic outcome after immediate autologous breast reconstruction. However, native skin flap necrosis does occur and can significantly jeopardize the result. The purpose of this series was to evaluate objectively the utility of fluorescein dye as a tool to assist with evaluation of eventual flap viability or flap necrosis.

METHODS: Fifty consecutive periareolar mastectomy flaps were evaluated after autologous ...

Autologous fat grafting has become a common technique for revisional breast surgery. The purpose of this series is to review our experience with fat grafting for the correction of acquired breast deformities. A retrospective review was performed on 107 patients with a history of breast cancer between 1996 and 2010, who had autologous fat grafting at the time of secondary breast reconstruction. The indications were for improvement in contour, shape, and volume of the breast following ...

BACKGROUND: A recent survey of plastic surgeons showed that the majority prescribed prophylactic antibiotics after hospital discharge for breast reconstruction. There is no clinical evidence that this practice reduces surgical site infection (SSI) after immediate tissue expander breast reconstruction. Furthermore, multiple studies have suggested that current antibiotic choices may not be appropriately covering the causative organisms of SSI.

METHODS: An institutional breast ...

Background: The amount of metastatic disease in the sentinel lymph node (SLN) is examined as a prognostic factor in malignant melanoma.Methods: SLN mapping was performed on 592 patients with stage I and II malignant melanoma from March 1, 1994, through December 31, 1999. One hundred four patients were found to have 134 sentinel SLNs containing metastatic melanoma. The slides were reviewed, and the size of the metastatic melanoma in each SLN was measured. The size of the metastatic ...

BackgroundCompletion lymph node dissection (CLND) is considered the standard of care in melanoma patients found to have sentinel lymph node (SLN) metastasis. However, the therapeutic utility of CLND is not known. The natural history of patients with positive SLNs who do not undergo CLND is undefined. This multi-institutional study was undertaken to characterize patterns of failure and survival rates in these patients and to compare results with those of positive-SLN patients who ...

OBJECTIVE: Sentinel lymph node (SLN) biopsy has shown great utility in the management of melanoma. An analysis of regional recurrence in previously mapped negative SLN basins as the first site of relapse is performed.

METHODS: A retrospective query of a prospective melanoma database from 1994 to 2006 identified 1287 patients who underwent successful SLN biopsy. One thousand sixty patients (82.4%) were SLN negative and 227 (17.6%) patients SLN positive. Clinical variables were examined ...

A subgroup of mastectomy patients receives adjuvant radiation therapy after autogenous breast reconstruction for locoregional control of cancer. The effects of radiation therapy on pedicled transverse rectus abdominis musculocutaneous (TRAM) flaps were determined to evaluate complication rates and aesthetic results. Nineteen patients from 1981 to 1994 receiving radiation therapy after a pedicled TRAM flap reconstruction were compared with 108 patients who received radiation prior to ...