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Dr. Allen and Dr. Joshua L. Levine, who operate together in Manhattan, often recommend a prospective patient talk at length with patients of theirs who have had a successful flap procedure, like Ms. Hodges, the magazine publisher and karate student, as well as with those whose first flap reconstructions failed and required a second procedure.
This reconstruction (Paley's level of difficulty 9) required a second procedure (internal fixation and bone graft) to promote union after the initial conversion procedure (original frame time 242 days).
The primary outcome measure was the number of patients who required a second procedure of fracture reduction after initial treatment.
Median operative time was 22 minutes (16 35 min), hospital stay for most patients was 24 72 hours (36 median), and 50% required a second procedure (1 required 3 procedures).
Of the 9 patients who were considered to have obtained clinical cure by the investigator but required a second procedure, the surgical review panel changed 2 patients' outcomes (1 per treatment arm) from cure to failure because of evidence of ongoing infection at the time of the second intervention.
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In the Seprafilm group, 18 patients required a planned second laparotomy and 4 of the 18 required a third procedure.
The condition often requires a second procedure for debridement and removal of exposed internal fixation.
Induction of fetal demise via transabdominal injection has been used to facilitate second-trimester abortion but requires a second procedure and has associated risks.
It seems promising for the treatment of patients with severe elbow instability but requires a second procedure for removal.
The impact of sentinel node biopsy in women who have symptomatic large tumours is unproven, and around half of these women will require a second procedure to clear their axilla or radiotherapy as treatment.
Of these patients 18 (11%) required a second drainage procedure after their OU treatment; 11 (6%) of the patients had an initial incision and drainage procedure performed after their OU stay.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com