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Biomedical subjects

Don A Hudson

Publications and source records attributed to Don A Hudson.

5 recordsLinked to original sources
PubMed2003

Influence of vascular delay on abdominal wall complications in unipedicled TRAM flap breast reconstruction.

Surgically delaying a unipedicled lower abdominal transverse rectus abdominis musculocutaneous (TRAM) flap has been shown to improve flow within the flap. This delay, however, also affects blood supply and drainage of the entire anterior abdominal wall. The purpose of this study was to compare the abdominal complications between surgically delayed and nondelayed TRAM flaps. A retrospective case review of lower abdominal TRAM flap breast reconstructions was performed. A total of 35 patients were included in the study, of whom 15 had undergone delay and 20 had not. The patients were found to be matched by age and body mass index. There was a higher incidence of smokers (past or present) in the delayed series. Despite this, no abdominal flap complications were experienced in those who underwent delay. In the nondelayed series, however, three patients (15%) experienced delayed healing, and two flaps (10%) underwent severe necrosis (p = 0.047, chi-squared test). In the delayed series, one patient (7%) was found to have an abdominal bulge. No hernias were encountered. In contrast, two bulges (10%) and four hernias (20%) were identified in patients in the nonndelayed series (p = 0.6 and 0.09, respectively, chi-squared test). These data suggest that a preliminary delay procedure leads to a reduction in the incidence of abdominal wall complications in unipedicled lower abdominal TRAM flaps.

Abdominal Wall↗
PubMed2003

A study of the patient factors affecting reconstruction after mastectomy for breast carcinoma.

Breast shape may be retained after surgery for breast cancer with either wide local excision (WLE) and radiotherapy or mastectomy (M) and immediate reconstruction (M+R). We determined the proportions of patients who would be suitable for these options, would accept them, and if they declined M+R their reasons for doing so. Over a 10-month period 177 women were assessed at a combined breast clinic by general and plastic surgeons and by radiation oncologists. A prospective record was made of the patient demographic data, the clinical decisions (and their reasons), and the patient choices (and their reasons). A transverse rectus abdominis myocutaneous flap was the commonest method of reconstruction. One hundred thirty-five (76%) were judged to be suitable for locoregional surgery. Of these M+R was offered to 83 patients, whereas 53 were not considered because of combinations of cosmetic considerations (31), risk factors (25), old age (13), and oncological factors (nine). Fifty-one of the 83 (61%) offered M+R declined it because they preferred a simpler procedure (34), regarded breast appearance as unimportant (15), preferred breast conservation (five), did not have a partner (three), felt that they were too old (two), or had religious reasons (two). Ultimately 69 (51%) underwent M, 34 (25%) WLE, and 32 (24%) M+R. There was no correlation between acceptance or not of M+R and age, race, employment, education level, or marital status. We conclude that many patients were suitable for M+R, but fewer than half accepted it; this decision was unrelated to age, race, employment, or marital status.

Age Factors↗