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Management of contaminated autologous grafts in plastic surgery.

Centeno RF, Desai AR, Watson ME - Eplasty (2008)

Bottom Line: Patients were not informed in 60% of graft contamination incidents.The survey results and review of the literature led to development of algorithms for the management of inadvertent graft contamination and patient disclosure.The algorithms presented are intended to serve as guides for prevention of contamination events or for their management should they occur.

View Article: PubMed Central - PubMed

Affiliation: Saint Croix Plastic Surgery & MediSpa, Christiansted, US Virgin Islands 00824. rfcenteno@gmail.com

ABSTRACT

Background: Contamination of autologous grafts unfortunately occurs in plastic surgery, but the literature provides no guidance for management of such incidents.

Methods: American Society of Aesthetic Plastic Surgery members were asked to complete an online survey that asked about the number and causes of graft contaminations experienced, how surgeons dealt with the problem, the clinical outcomes, and patient disclosure.

Results: Nineteen hundred surgeons were asked to participate in the survey, and 223 responded. Of these, 70% had experienced at least 1 graft contamination incident, with 26% experiencing 4 or more. The most frequently reported reason for graft contamination was a graft falling on the floor (reported by 75%). Nearly two thirds of the contaminated grafts related to craniofacial procedures. Ninety-four percent of grafts were managed with decontamination and completion of the operation. The most common method of decontamination was washing with povidone-iodine, but this practice is contrary to recommendations in the literature. Only 3 surgeons (1.9%) said a clinical infection developed following decontaminated graft use. Patients were not informed in 60% of graft contamination incidents. The survey results and review of the literature led to development of algorithms for the management of inadvertent graft contamination and patient disclosure.

Conclusions: Although autologous grafts do become contaminated in plastic surgery, the overwhelming majority can be safely decontaminated and produce minimal or no clinical sequelae. The algorithms presented are intended to serve as guides for prevention of contamination events or for their management should they occur.

No MeSH data available.


Related in: MedlinePlus

Survey sent to plastic surgeons on management of contaminated grafts.
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Figure 1: Survey sent to plastic surgeons on management of contaminated grafts.

Mentions: We developed a questionnaire for which a Web link was sent via e-mail by the Aesthetic Surgery Education and Research Foundation to members of the American Society of Aesthetic Plastic Surgery (ASAPS). Members were asked to participate in the survey and assured that their responses would be anonymous. The Web link connected surgeons to an 11-question online survey, shown in Figure 1, that was hosted by Survey Monkey (www.surveymonkey.com), a data collection and analysis company. The questionnaire was designed to obtain information on autograft contamination frequency, treatment preferences, clinical outcomes, and patient disclosure.


Management of contaminated autologous grafts in plastic surgery.

Centeno RF, Desai AR, Watson ME - Eplasty (2008)

Survey sent to plastic surgeons on management of contaminated grafts.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2344133&req=5

Figure 1: Survey sent to plastic surgeons on management of contaminated grafts.
Mentions: We developed a questionnaire for which a Web link was sent via e-mail by the Aesthetic Surgery Education and Research Foundation to members of the American Society of Aesthetic Plastic Surgery (ASAPS). Members were asked to participate in the survey and assured that their responses would be anonymous. The Web link connected surgeons to an 11-question online survey, shown in Figure 1, that was hosted by Survey Monkey (www.surveymonkey.com), a data collection and analysis company. The questionnaire was designed to obtain information on autograft contamination frequency, treatment preferences, clinical outcomes, and patient disclosure.

Bottom Line: Patients were not informed in 60% of graft contamination incidents.The survey results and review of the literature led to development of algorithms for the management of inadvertent graft contamination and patient disclosure.The algorithms presented are intended to serve as guides for prevention of contamination events or for their management should they occur.

View Article: PubMed Central - PubMed

Affiliation: Saint Croix Plastic Surgery & MediSpa, Christiansted, US Virgin Islands 00824. rfcenteno@gmail.com

ABSTRACT

Background: Contamination of autologous grafts unfortunately occurs in plastic surgery, but the literature provides no guidance for management of such incidents.

Methods: American Society of Aesthetic Plastic Surgery members were asked to complete an online survey that asked about the number and causes of graft contaminations experienced, how surgeons dealt with the problem, the clinical outcomes, and patient disclosure.

Results: Nineteen hundred surgeons were asked to participate in the survey, and 223 responded. Of these, 70% had experienced at least 1 graft contamination incident, with 26% experiencing 4 or more. The most frequently reported reason for graft contamination was a graft falling on the floor (reported by 75%). Nearly two thirds of the contaminated grafts related to craniofacial procedures. Ninety-four percent of grafts were managed with decontamination and completion of the operation. The most common method of decontamination was washing with povidone-iodine, but this practice is contrary to recommendations in the literature. Only 3 surgeons (1.9%) said a clinical infection developed following decontaminated graft use. Patients were not informed in 60% of graft contamination incidents. The survey results and review of the literature led to development of algorithms for the management of inadvertent graft contamination and patient disclosure.

Conclusions: Although autologous grafts do become contaminated in plastic surgery, the overwhelming majority can be safely decontaminated and produce minimal or no clinical sequelae. The algorithms presented are intended to serve as guides for prevention of contamination events or for their management should they occur.

No MeSH data available.


Related in: MedlinePlus