MARC details
| 000 -LEADER |
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| fixed length control field |
03960nam a22005657a 4500 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION |
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| fixed length control field |
171205s20182018 xxu||||| |||| 00| 0 eng d |
| 022 ## - INTERNATIONAL STANDARD SERIAL NUMBER |
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| International Standard Serial Number |
0363-5023 |
| 040 ## - CATALOGING SOURCE |
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| Original cataloging agency |
Ovid MEDLINE(R) |
| 099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC) |
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| PMID |
29103849 |
| 245 ## - TITLE STATEMENT |
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| Title |
The Effect of Skin Pigmentation on Determination of Limb Ischemia. |
| 251 ## - Source |
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| Source |
Journal of Hand Surgery - American Volume. 43(1):24-32.e1, 2018 01. |
| 252 ## - Abbreviated Source |
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| Abbreviated source |
J Hand Surg [Am]. 43(1):24-32.e1, 2018 01. |
| 252 ## - Abbreviated Source |
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| Former abbreviated source |
J Hand Surg [Am]. , 2017 Nov 02 |
| 253 ## - Journal Name |
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| Journal name |
The Journal of hand surgery |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Year |
2018 |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Manufacturer |
FY2018 |
| 266 ## - Date added to catalog |
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| Date added to catalog |
2017-12-05 |
| 268 ## - Previous citation |
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| -- |
Journal of Hand Surgery - American Volume. , 2017 Nov 02 |
| 501 ## - WITH NOTE |
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| Local holdings |
Available in print through MWHC library: 1999 - 2002, Available online from MWHC library: 1995 - present |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
CONCLUSIONS: Skin pigmentation significantly affects the identification of an ischemic limb/skin flaps on physical examination. Whereas the standard treatment for monitoring of free tissue transfer is clinical examination, that may not be sufficient for patients with increased skin pigmentation. Surgeons should exercise particular vigilance during physical examination of a potentially ischemic limb/skin flaps with greater skin pigmentation. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
METHODS: We conducted a study of healthy controls exposed to limb ischemia. The subjects were classified based on skin pigmentation using a defined skin type assessment tool, a visual color scale, and self-description of race. Participants were randomized by limb and tourniquet status; surgeons were blinded to both. Ischemia was induced by tourniquet insufflations, and board-certified orthopedic and plastic surgeons who had completed an accredited hand surgery fellowship conducted physical examinations. The surgeons monitored the forearms at 2, 6, and 10 minutes based on appearance of ischemia, capillary refill, and color in 3 locations on the limbs (posterior interosseous artery flap skin territory, radial forearm flap skin territory, and the digits). |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
PURPOSE: Timely identification of tissue ischemia is critical, both in the traumatized limb and following free tissue transfer. The purpose of this study was to determine if skin pigmentation affects the ability to detect limb ischemia. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
RESULTS: We found a significant decrease in the ability to detect ischemia in participants with increased skin pigmentation, as documented by all metrics, when evaluating the posterior interosseous artery and radial forearm flap skin territories at all time points. For example, when monitoring the posterior interosseous artery flap with the tourniquet insufflated at time 10 minutes, 92.9% of Caucasians were correctly identified as being ischemic whereas only 23.3% of African Americans were correctly identified. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic II. Copyright (c) 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved. |
| 546 ## - LANGUAGE NOTE |
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| Language note |
English |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Forearm/bs [Blood Supply] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Ischemia/di [Diagnosis] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Physical Examination |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Skin Pigmentation/ph [Physiology] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Adult |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Continental Population Groups |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Free Tissue Flaps |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Healthy Volunteers |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Humans |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Middle Aged |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Tourniquets |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Young Adult |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
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| Institution |
Curtis National Hand Center |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
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| Institution |
MedStar Health Research Institute |
| 657 ## - INDEX TERM--FUNCTION |
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| Medline publication type |
Journal Article |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Higgins, James P |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Katz, Ryan D |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Means, Kenneth R Jr |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Polfer, Elizabeth M |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Tefera, Eshetu |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Zimmerman, Ryan M |
| 790 ## - Authors |
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| All authors |
Higgins JP, Katz RD, Means KR Jr, Polfer EM, Tefera E, Zimmerman RM |
| 856 ## - ELECTRONIC LOCATION AND ACCESS |
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| DOI |
<a href="https://dx.doi.org/10.1016/j.jhsa.2017.09.002">https://dx.doi.org/10.1016/j.jhsa.2017.09.002</a> |
| Public note |
https://dx.doi.org/10.1016/j.jhsa.2017.09.002 |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) |
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| Koha item type |
Journal Article |
| Item type description |
Article |
