Factors associated with 30‐day soft tissue complications following upper extremity sarcoma surgery

2020 ◽  
Author(s):  
Yannick A. J. Hoftiezer ◽  
Jonathan Lans ◽  
Brian B. Freniere ◽  
Kyle R. Eberlin ◽  
Neal C. Chen ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Upper Extremity ◽  
Factors Associated ◽  
Extremity Sarcoma

scholarly journals Factors Associated With 30-day Soft Tissue Complications and Reoperation Following Upper Extremity Sarcoma Surgery

2020 ◽  
Vol 8 (9S) ◽  
pp. 91-92
Author(s):  
Yannick A.J. Hoftiezer ◽  
Jonathan Lans ◽  
Brian B. Freniere ◽  
Kyle R. Eberlin ◽  
Neal C. Chen ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Upper Extremity ◽  
Factors Associated ◽  
Extremity Sarcoma

scholarly journals Factors Associated with Mortality and Amputation Caused by Necrotizing Soft Tissue Infections of the Upper Extremity: A Retrospective Cohort Study

2019 ◽  
Vol 44 (3) ◽  
pp. 730-740 ◽  
Author(s):  
Femke Nawijn ◽  
Svenna H.W.L. Verhiel ◽  
Kiera N. Lunn ◽  
Kyle R. Eberlin ◽  
Falco Hietbrink ◽  
...  
Keyword(s):  
Risk Factor ◽  
Soft Tissue ◽  
Mortality Rate ◽  
Upper Extremity ◽  
Base Deficit ◽  
Amputation Rate ◽  
Soft Tissue Infections ◽  
Factors Associated ◽  
Asa Classification ◽  
Necrotizing Soft Tissue Infections

Abstract Background It is unclear what the exact short-term outcomes of necrotizing soft tissue infections (NSTIs), also known and necrotizing fasciitis of the upper extremity, are and whether these are comparable to other anatomical regions. Therefore, the aim of this study is to assess factors associated with mortality within 30-days and amputation in patients with upper extremity NSTIs. Methods A retrospective study over a 20-year time period of all patients treated for NSTIs of the upper extremity was carried out. The primary outcomes were the 30-day mortality rate and the amputation rate in patients admitted to the hospital for upper extremity NSTIs. Results Within 20 years, 122 patients with NSTIs of the upper extremity were identified. Thirteen patients (11%) died and 17 patients (14%) underwent amputation. Independent risk factors for mortality were an American Society of Anesthesiologists (ASA) classification of 3 or higher (OR 9.26, 95% CI 1.64–52.31) and a base deficit of 3 meq/L or greater (OR 10.53, 95% CI 1.14–96.98). The independent risk factor for amputation was a NSTI of the non-dominant arm (OR 3.78, 95% CI 1.07–13.35). Length of hospital stay was 15 (IQR 9–21) days. Conclusion Upper extremity NSTIs have a relatively low mortality rate, but a relatively high amputation rate compared to studies assessing NSTIs of all anatomical regions. ASA classification and base deficit at admission predict the prognosis of patients with upper extremity NSTIs, while a NSTI of the non-dominant side is a risk factor for limb loss.

Written Prescription for Over-the-Counter Nonopioid Pain Medications Does Not Increase the Likelihood of Use after Ambulatory Hand and Upper Extremity Surgery

2020 ◽  
Author(s):  
Daniel J. Lynch ◽  
James S. Lin ◽  
Kanu S. Goyal
Keyword(s):  
Postoperative Pain ◽  
Soft Tissue ◽  
Upper Extremity ◽  
Pain Control ◽  
Control Program ◽  
Postoperative Pain Control ◽  
Over The Counter ◽  
Unequal Variance ◽  
Pain Medications ◽  
Medication Consumption

Abstract Introduction This study looked to determine how providing written prescriptions of nonopioids affected postoperative pain medication usage and pain control. Materials and Methods Patients undergoing hand and upper-extremity surgery (n = 244) were recruited after the implementation of a postoperative pain control program encouraging nonopioids before opioids. Patients were grouped based on procedure type: bone (n = 66) or soft tissue (n = 178). Patients reported postoperative medication consumption and pain control scores. Two-tailed t-tests assuming unequal variance were performed to look for differences in postoperative pain control and medication consumption between those who were and were not given written prescriptions for nonopioids. Results For both soft tissue and bone procedure patients, a written prescription did not significantly affect patients’ postoperative pain control or medication consumption. Regardless of receiving a written prescription, patients who underwent soft tissue procedures consumed significantly more daily nonopioids than opioids. Conclusion Receiving written prescriptions for nonopioids may not have a significant effect on postoperative pain control or medication consumption. Patients undergoing soft tissue hand and upper extremity procedures may be more likely to consume more daily nonopioids than opioids postoperatively compared to bone procedure patients regardless of whether they receive a written prescription for nonopioids.

Versatility of the Posterior Interosseous Artery Flap: Emphasis on Powering Up the Toe Transfer

Hand ◽  
2021 ◽  
pp. 155894472110289
Author(s):  
GiJun Lee ◽  
BumSik Kim ◽  
Neunghan Jeon ◽  
JungSoo Yoon ◽  
Ki Yong Hong ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Upper Extremity ◽  
Reverse Flow ◽  
Donor Site ◽  
Congenital Defects ◽  
Soft Tissue Coverage ◽  
Posterior Interosseous Artery ◽  
Arterial Inflow ◽  
Pedicle Length ◽  
Interosseous Artery

Background: Reverse-flow posterior interosseous artery (rPIA) flap is an excellent tool for restoration of defects in the hand and upper extremity, sparing the main arteries to the hand. Its reliability has been well established. Materials and Methods: Fifty-one cases of rPIA flap involving 49 patients were retrospectively reviewed. The inclusion criteria were age, sex, etiology, size and location of the defect, flap size, number of perforators included, pedicle length, flap inset, donor site coverage, complications, and ancillary procedures. Results: This study included 44 men and 5 women, ranging in age between 10 and 73 years. The subjects had soft tissue defects of the hand and upper extremity mainly due to traumatic injuries, including scar contractures of the first web space in 18 cases, thumb amputations in 6 cases, and congenital defects in 1 case. Among the 51 rPIA flap elevations, 3 cases involved flap failure due to the absence of proper pedicle. A fasciocutaneous pattern was observed in 45 cases and a myocutaneous pattern in 3 cases. In 5 cases of unplantable thumb amputations, the rPIA flap was performed for arterial inflow to the secondary toe-to-thumb transfer. Venous congestion of varying degrees was noted in 7 cases involving partial necrosis in 2 cases. During the mean 17 months of follow-up, patients were generally satisfied with the final outcomes. Conclusion: The rPIA flap can be used not only for soft tissue coverage of the hand and upper extremity but also as a recipient arterial pedicle for a secondary toe-to thumb transfer.

Necrotizing Soft-Tissue Infections in the Feet of Patients With Diabetes: Outcome of Surgical Treatment and Factors Associated With Limb Loss and Mortality

2009 ◽  
Vol 8 (3) ◽  
pp. 141-146 ◽  
Author(s):  
Javier Aragón-Sánchez ◽  
Yurena Quintana-Marrero ◽  
Jose L. Lázaro-Martínez ◽  
Maria J. Hernández-Herrero ◽  
Esther García-Morales ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Limb Loss ◽  
Soft Tissue Infections ◽  
Factors Associated ◽  
Patients With Diabetes ◽  
Necrotizing Soft Tissue Infections ◽  
Diabetes Outcome

scholarly journals Comparison of Fasciocutaneous and Muscle-based Free Flaps for Soft Tissue Reconstruction of the Upper Extremity

2019 ◽  
Vol 7 (12) ◽  
pp. e2543
Author(s):  
Christoph Koepple ◽  
Ann-Katrin Kallenberger ◽  
Lukas Pollmann ◽  
Gabriel Hundeshagen ◽  
Volker J. Schmidt ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Upper Extremity ◽  
Free Flaps ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction
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