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Andrew L. Blount

Bio: Andrew L. Blount is an academic researcher from Michigan State University. The author has contributed to research in topics: Retrospective cohort study & Capsular contracture. The author has an hindex of 6, co-authored 9 publications receiving 219 citations.

Papers
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Journal ArticleDOI
TL;DR: It is apparent that the early CC rate in primary augmentation can be less than 1%.

113 citations

Journal ArticleDOI
TL;DR: The use of recombinant factor VIIa (rFVIIa) (NovoSeven RT W ) to establish hemostasis during massive perioperative bleeding in cardiac surgery has been explored in several retrospective studies.
Abstract: Objective: The use of recombinant factor VIIa (rFVIIa) (NovoSeven RT W ) to establish hemostasis during massive perioperative bleeding in cardiac surgery has been explored in several retrospective studies While early results are promising, a paucity of data leaves many questions about its safety profile We sought to further define its use and associated outcomes in a large cohort study at a single institution Methods: A retrospective cohort study design was used, in which 236 patients received rFVIIa for bleeding after cardiac surgery These patients were matched with a cohort of 213 subjects, who had similar operations during the same period of time Primary end points included thrombo-embolic events, mortality, incidence of re-operation, use of blood products, and patient disposition at 30 days Statistical significance was assessed at p < 005 Results: There was no statistically significant difference in the incidence of stroke (34%, 19%; p = 032), renal failure (85%, 70%; p = 057), or 30-day mortality (77%, 43%; p = 014) between the rFVIIa and the control groups, respectively The rFVIIa group did experience a higher rate of re-operation for bleeding (110%, 19%; p = 00001) and had a two-fold increase in the use of each of the following: cryoprecipitate, fresh-frozen plasma, platelets, and packed red blood cells, relative to the control group ( p < 000001) Conclusions: rFVIIa is an effective hemostatic agent for intractable bleeding in high-risk cardiac surgery with an acceptable safety profile rFVIIa does not appear to be associated with increased postoperative complications, including thrombo-embolic events and death # 2011 European Association for Cardio-Thoracic Surgery Published by Elsevier BV All rights reserved

43 citations

Journal ArticleDOI
TL;DR: Early data show promise in terms of faster healing, improved scarring, and improved patient subjective outcome with the use of the bioelectric dressing on acute wounds.
Abstract: Despite advances in wound care treatments for the management of acute and chronic wounds, there remains an unmet need for interventions that accelerate epithelialization. Many authors in the past have advocated the use of electric currents to accelerate wound healing. Novel wound dressings with inherent electric activity are emerging, and studies of these specific modalities are lacking. The principal aim of this study is to evaluate the impact of a bioelectric dressing on acute wound healing. Thirteen patients who underwent skin grafting were enrolled. One half of all skin graft donor sites were treated with the bioelectric dressing and semi-occlusive dressing (SOD) and the other half using solely a SOD. Epithelialization was rated by a blinded burn surgeon attending. Participants also provided a self-assessment of their scar appearance. At week 1 postprocedure, average epithelialization of 71.8% was noted on the bioelectric dressing-treated side, compared with 46.9% on the SOD side, representing an average 34.62% faster wound healing (P = .015). At 1 month, patients rated the bioelectric dressing-treated half as superior in terms of scar color (P = .198), stiffness (P = .088), thickness (P = .038), and overall quality (P = .028). These early data show promise in terms of faster healing, improved scarring, and improved patient subjective outcome with the use of the bioelectric dressing on acute wounds. With fulfillment of an extended study population, the authors hope to provide a solid foundation for extrapolating their data beyond skin graft donor sites to all areas of wound care.

40 citations

Journal ArticleDOI
TL;DR: In contrast to previous studies, pain and satisfaction are worse in patients with intact Artelon spacers than those who had received LRTI, and its use for treatment of basilar thumb osteoarthritis is abandoned.
Abstract: Purpose To examine outcomes and complications of the porous polyurethaneurea (Artelon; Small Bone Innovations, Morrisville, PA) spacer compared to traditional surgical treatment of trapeziectomy with ligament reconstruction and tendon interposition (LRTI). Methods A retrospective chart review was undertaken of patients with carpometacarpal (CMC) arthritis who had either placement of an Artelon spacer or LRTI. Patients were brought back to clinic for interview and functional testing. Pain was graded using a visual analog scale. Grip and pinch strength, as well as range of motion at the first CMC joint, were measured. Nine-hole peg, Moberg pickup, and Jebson-Taylor tests were performed. Research and Development 36, Michigan Hand Outcomes, and Quick Disabilities of the Arm, Shoulder, and Hand questionnaires were administered. Results Thirty-eight patients received Artelon implants into the CMC joint, and 6 were lost to follow-up. Twelve of 32 patients (37%) required revision surgery with removal of implant and salvage arthroplasty. Twenty patients with nonrevised Artelon implants were compared with 10 patients who received 13 LRTI procedures. Patients with Artelon had significantly less pain improvement compared to those receiving the LRTI procedure. In addition, satisfaction was significantly decreased. There was no significant difference in any other functional or quality of life measures. Conclusions In our practice, use of the Artelon joint spacer resulted in an explantation rate of 37%. Due to these findings, we have abandoned its use for treatment of basilar thumb osteoarthritis. In contrast to previous studies, pain and satisfaction are worse in patients with intact Artelon spacers than those who had received LRTI. Type of study/level of evidence Therapeutic III.

29 citations

Journal Article
TL;DR: Laroscopic ventral hernia Repair is becoming an accepted technique for hernia repair in the United States, with a well-documented low recurrence rate, and this series demonstrates that this approach is equally safe and effective for a significantly older population.
Abstract: BACKGROUND AND OBJECTIVES The recurrence rate after laparoscopic ventral hernia repair is lower than the rate of recurrence via the open approach in many series. Studies have demonstrated the safety and efficacy of this procedure but have had relatively young patient populations. We present our experience in a significantly older population. METHODS A retrospective chart review of all patients 80 to 89 years of age undergoing a laparoscopic ventral hernia repair at our institution from May 2000 to June 2007 was performed. Data collected included demographics, number and type of previous abdominal operations, number of previous hernia repairs, defect and mesh size, postoperative complications, and follow-up. RESULTS Twenty octogenarian patients underwent laparoscopic ventral hernia repair. Nine were men and 11 were women. The mean age was 82 years. Thirteen patients (65%) had one or more associated comorbidities at the time of surgery. Eighteen patients (90%) had undergone a mean of 1.7 prior abdominal operations. Six (30%) patients had undergone a mean of 1.1 previous open hernia repairs; 5 (83%) with mesh. Eight patients (40%) had an additional operative procedure at the time of laparoscopic hernia repair. Ten minor complications occurred in 10 patients (50%). Four major complications occurred in 4 patients (20%). One patient required reoperation for evacuation of hematoma at a trocar site. No patients complained of pain at a transabdominal suture site or persistent seromas by 6 weeks of follow-up. At mean follow-up of 3.1 months, no recurrences occurred and no patients required mesh removal in this series. No deaths occurred. CONCLUSION Laparoscopic ventral hernia repair is becoming an accepted technique for hernia repair in the United States, with a well-documented low recurrence rate. Our series demonstrates that this approach is equally safe and effective for a significantly older segment of the population.

16 citations


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Journal ArticleDOI
TL;DR: In this article, the current state of wound healing and wound management products, with emphasis on the demand for more advanced forms of wound therapy and some of the current challenges and driving forces behind this demand, are reviewed.

580 citations

Journal ArticleDOI
TL;DR: The 10-year data from the Natrelle Core Study can guide surgeons and patients in decision-making, demonstrate safety and high levels of patient satisfaction, and significant improvement over baseline was seen in overall breast satisfaction and satisfaction with breast size, shape, feel, and how well they matched.
Abstract: Background:Allergan’s Natrelle round silicone-filled breast implants were approved by the U.S. Food and Drug Administration in 2006 based on interim results from the Core Study; final 10-year study results are now available.Methods:Seven hundred fifteen subjects were implanted with smooth and Biocel

252 citations

Journal ArticleDOI
TL;DR: The incidence of contracture developing is lower with the use of textured implants, submuscular placement and theUse of polyurethane coated implants, while recent research has focussed on preventing capsular contracture from occurring, or treating it with autologous fat transfer.
Abstract: Capsular contracture is the most common complication following implant based breast surgery and is one of the most common reasons for reoperation. Therefore, it is important to try and understand why this happens, and what can be done to reduce its incidence. A literature search using the MEDLINE database was conducted including search terms 'capsular contracture breast augmentation', 'capsular contracture pathogenesis', 'capsular contracture incidence', and 'capsular contracture management', which yielded 82 results which met inclusion criteria. Capsular contracture is caused by an excessive fibrotic reaction to a foreign body (the implant) and has an overall incidence of 10.6%. Risk factors that were identified included the use of smooth (vs. textured) implants, a subglandular (vs. submuscular) placement, use of a silicone (vs. saline) filled implant and previous radiotherapy to the breast. The standard management of capsular contracture is surgical via a capsulectomy or capsulotomy. Medical treatment using the off-label leukotriene receptor antagonist Zafirlukast has been reported to reduce severity and help prevent capsular contracture from forming, as has the use of acellular dermal matrices, botox and neopocket formation. However, nearly all therapeutic approaches are associated with a significant rate of recurrence. Capsular contracture is a multifactorial fibrotic process the precise cause of which is still unknown. The incidence of contracture developing is lower with the use of textured implants, submuscular placement and the use of polyurethane coated implants. Symptomatic capsular contracture is usually managed surgically, however recent research has focussed on preventing capsular contracture from occurring, or treating it with autologous fat transfer.

224 citations

Journal ArticleDOI
TL;DR: This 10-year prospective trial demonstrated the long-term safety and effectiveness of Natrelle 410 anatomical form-stable implants, as the complication rates were low and the satisfaction rates were high.

163 citations

Journal ArticleDOI
TL;DR: Using the principles of the 14-point plan to minimize bacterial load at the time of surgery, the development and subsequent sequelae of capsular contracture and breast implant–associated ALCL may be reduced, especially with higher-risk macrotextured implants.
Abstract: Background:Bacteria/biofilm on breast implant surfaces has been implicated in capsular contracture and breast implant–associated anaplastic large-cell lymphoma (ALCL). Macrotextured breast implants have been shown to harbor more bacteria than smooth or microtextured implants. Recent reports also sug

158 citations