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Related Concept Videos

Flail Chest-II01:26

Flail Chest-II

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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
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Pneumothorax-I01:26

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A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
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Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
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Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
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Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
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Updated: May 16, 2025

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Hyperbaric Oxygen Therapy in Immediate Tissue Expander-Based Breast Reconstruction.

Katherine J Zhu1, Matthew J Heron, Rafael Felix P Tiongco

  • 1From the Department of Plastic & Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.

Annals of Plastic Surgery
|April 1, 2025
PubMed
Summary
This summary is machine-generated.

Hyperbaric oxygen therapy (HBOT) can salvage mastectomy skin flaps in prepectoral tissue expander (TE) breast reconstruction. While HBOT use correlated with higher complication rates, it successfully salvaged nearly twice as many mastectomy pockets compared to no treatment.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Hyperbaric Medicine

Background:

  • Prepectoral tissue expander (TE) placement is a common breast reconstruction method.
  • This technique may increase the risk of mastectomy skin flap ischemia compared to subpectoral placement.
  • Hyperbaric oxygen therapy (HBOT) can salvage compromised flaps, but evidence on patient selection and benefits is limited.

Purpose of the Study:

  • To evaluate the outcomes of hyperbaric oxygen therapy (HBOT) in patients undergoing immediate tissue expander (TE) breast reconstruction.
  • To identify patient groups who may benefit most from HBOT for managing mastectomy skin flap ischemia.

Main Methods:

  • Retrospective review of patients undergoing immediate TE breast reconstruction over a 6-year period.
  • Collection of patient demographics, intraoperative data, HBOT treatment details, complications, and reconstruction outcomes.
  • Comparative analysis of outcomes between patients receiving HBOT and those who did not.

Main Results:

  • Prepectoral TE placement was more common (86%) than subpectoral (14%).
  • Only prepectoral TE patients received HBOT (19 patients/33 breasts).
  • HBOT recipients had higher rates of skin necrosis, reoperation for necrosis, and TE explantation, but HBOT salvaged significantly more mastectomy pockets (76% vs. 41%).

Conclusions:

  • Patients with prepectoral TE placement were more likely to receive HBOT.
  • HBOT demonstrated a significant ability to salvage mastectomy pockets in cases of skin necrosis.
  • Findings offer valuable insights for managing mastectomy skin flap ischemia with HBOT.