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Sample records for plastic surgery residents

  1. The Future of Plastic Surgery Resident Education.

    PubMed

    Luce, Edward A

    2016-03-01

    The challenge of the current graduate medical education environment requires in plastic surgery acceptance of those contemporary pressures that cannot be substantially modified and address of those that can be successfully met. To do so implies an examination of conference didactics, intraoperative teaching, and a valid assessment of resident performance. PMID:26910690

  2. Maximizing Technological Resources in Plastic Surgery Resident Education.

    PubMed

    Khansa, Ibrahim; Janis, Jeffrey E

    2015-11-01

    Modern plastic surgery resident education demands the acquisition of an ever-increasing fund of knowledge and familiarity with more surgical techniques than ever before. This all must take place within the context and boundaries of Accreditation Council for Graduate Medical Education-mandated restrictions on work hours as well as balance of education and service. Technological resources have been developed and can be used to complement the skills that residents acquire while performing their day-to-day activities such as taking care of patients, reading textbooks and journal articles, and assisting or performing surgical procedures. Those complementary resources provide the benefits of portability and accessibility, and can thus be conveniently incorporated into the hectic daily life of a resident. This article presents a summary of the most commonly used currently available advanced technologies in plastic surgery resident education, and suggestions for integration of those technologies into a curriculum. PMID:26517465

  3. Hospital-based plastic surgery volunteerism: a resident's international experience.

    PubMed

    Huang, Andrew H; Rhodes, William R

    2012-04-01

    The purpose of this presentation is to describe an American plastic surgery resident's experience working for an academic year in a district-level general hospital in rural Kenya. The operative experience, educational value, and cultural adaptation over the custom-designed year are discussed. Furthermore, the logistics and ethics of picking a location, adjusting to the milieu, and treating patients are evaluated. The importance of a qualified, supportive, and perceptive mentor is emphasized. International volunteerism in plastic surgery beyond the more typical 1- or 2-week short-term trips can be extremely beneficial to a resident's experience, although long-term benefit to the served population should not be overestimated. A careful understanding of plastic surgery in relation to the global burden of disease highlights the fact that plastic surgery, although valuable, is limited in its role within international medical volunteerism. Not unexpectedly, obstetric, orthopedic, and general surgical skills are vital in the management of the most common surgical maladies. PMID:22421487

  4. Plastic Surgery

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? Plastic Surgery KidsHealth > For Teens > Plastic Surgery Print A A ... her forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word "plastic" ...

  5. Obtaining Accreditation Council for Graduate Medical Education Approval for International Rotations During Plastic Surgery Residency Training.

    PubMed

    Mackay, Donald R

    2015-06-01

    Global medicine and international rotations are becoming increasingly popular and relevant in training the next generation of Plastic Surgeons. The Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties have started to address the issues that will ensure our residents are protected as well as ensuring that they gain a valuable educational experience. The principles and the process for getting an International Rotation approved by the Plastic Surgery Residency Review Committee are outlined in this article. PMID:26080131

  6. Identification of Best Practices for Resident Aesthetic Clinics in Plastic Surgery Training: The ACAPS National Survey

    PubMed Central

    Wu, Cindy; Bentz, Michael L.; Redett, Richard J.; Shack, R. Bruce; David, Lisa R.; Taub, Peter J.; Janis, Jeffrey E.

    2015-01-01

    Introduction: Resident aesthetic clinics (RACs) have demonstrated good outcomes and acceptable patient satisfaction, but few studies have evaluated their educational, financial, or medicolegal components. We sought to determine RAC best practices. Methods: We surveyed American Council of Academic Plastic Surgeon members (n = 399), focusing on operational details, resident supervision, patient safety, medicolegal history, financial viability, and research opportunities. Of the 96 respondents, 63 reported having a RAC, and 56% of plastic surgery residency program directors responded. Results: RACs averaged 243 patient encounters and 53.9 procedures annually, having been in existence for 19.6 years (mean). Full-time faculty (73%) supervised chief residents (84%) in all aspects of care (65%). Of the 63 RACs, 45 were accredited, 40 had licensed procedural suites, 28 had inclusion/exclusion criteria, and 31 used anesthesiologists. Seventeen had overnight capability, and 17 had a Life Safety Plan. No cases of malignant hyperthermia occurred, but 1 facility death was reported. Sixteen RACs had been involved in a lawsuit, and 33 respondents reported financial viability of the RACs. Net revenue was transferred to both the residents’ educational fund (41%) and divisional/departmental overhead (37%). Quality measures included case logs (78%), morbidity/mortality conference (62%), resident surveys (52%), and patient satisfaction scores (46%). Of 63 respondents, 14 have presented or published RAC-specific research; 80 of 96 of those who were surveyed believed RACs enhanced education. Conclusions: RACs are an important component of plastic surgery education. Most clinics are financially viable but carry high malpractice risk and consume significant resources. Best practices, to maximize patient safety and optimize resident education, include use of accredited procedural rooms and direct faculty supervision of all components of care. PMID:26146599

  7. Do Plastic Surgery Programs with Integrated Residencies or Subspecialty Fellowships Have Increased Academic Productivity?

    PubMed Central

    Duquette, Stephen P.; Valsangkar, Nakul P.; Sood, Rajiv; Socas, Juan; Zimmers, Teresa A.

    2016-01-01

    Background: The aim of this study was to evaluate the effect of different surgical training pathways on the academic performance of plastic surgical divisions. Methods: Eighty-two academic parameters for 338 plastic surgeons (PS), 1737 general surgeons (GS), and 1689 specialist surgeons (SS) from the top 55 National Institutes of Health (NIH)-funded academic departments of surgery were examined using data gathered from websites, SCOPUS, and NIH Research Portfolio Online Reporting Tools. Results: The median size of a PS division was 7 faculty members. PS faculty had lower median publications (P)/citations (C) (ie, P/C) than GS and SS (PS: 25/328, GS: 35/607, and SS: 40/713, P < 0.05). Publication and citation differences were observed at all ranks: assistant professor (PS: 11/101, GS: 13/169, and SS: 19/249), associate professor (PS: 33/342, GS: 40/691, and SS: 44/780), and professor (PS: 57/968, GS: 97/2451, and SS: 101/2376). PS had a lower percentage of faculty with current/former NIH funding (PS: 13.5%, GS: 22.8%, and SS: 25.1%, P < 0.05). Academic productivity for PS faculty was improved in integrated programs. P/C for PS faculty from divisions with traditional 3-year fellowships was 19/153, integrated 6-year residency was 25/329, and both traditional and 6-year programs were 27/344, P < 0.05. Craniofacial and hand fellowships increased productivity within the integrated residency programs. P/C for programs with a craniofacial fellowship were 32/364 and for those that additionally had a hand fellowship were 45/536. PS faculty at divisions with integrated training programs also had a higher frequency of NIH funding. Conclusions: PS divisions vary in degree of academic productivity. Dramatically improved scholarly output is observed with integrated residency training programs and advanced specialty fellowships. PMID:27014543

  8. Cosmetic Plastic Surgery Statistics

    MedlinePlus

    2014 Cosmetic Plastic Surgery Statistics Cosmetic Procedure Trends 2014 Plastic Surgery Statistics Report Please credit the AMERICAN SOCIETY OF PLASTIC SURGEONS when citing statistical data or using ...

  9. Plastic Surgery for Teenagers

    MedlinePlus

    ... Surgery for Teenagers Plastic Surgery For Teenagers Briefing Paper Teenagers who want to have plastic surgery usually ... 669-678. Share Related Links Plastic Surgery Briefing Papers Find Your Surgeon Please enter a search Menu ...

  10. Ear Plastic Surgery

    MedlinePlus

    ... Find an ENT Doctor Near You Ear Plastic Surgery Ear Plastic Surgery Patient Health Information News media ... weight earrings. Does Insurance Pay for Cosmetic Ear Surgery? Insurance usually does not cover surgery solely for ...

  11. Plastic surgery's plastics.

    PubMed

    Ousterhout, D K; Stelnicki, E J

    1996-01-01

    Alloplastic materials have become an essential part of reconstructing the craniofacial skeleton. This article reviews several of the more commonly used implant materials and summarizes their mechanical properties and use in reconstructive surgery. PMID:8617027

  12. Plastic Surgery for Ethnic Patients

    MedlinePlus

    ... Home > News > Plastic Surgery for Ethnic Patients Briefing Paper: Plastic Surgery for Ethnic Patients More than 3. ... 2067-2071. Share Related Links Plastic Surgery Briefing Papers Menu Cosmetic Reconstructive Patient Safety Before & After Find ...

  13. Residency training in aesthetic surgery: maximizing the residents' experience.

    PubMed

    Stadelmann, W K; Rapaport, D P; Payne, W; Shons, A R; Krizek, T J

    1998-06-01

    Plastic surgery residency programs often rely on a residents' aesthetic clinic to help train residents in aesthetic surgery. The television media may be used to help boost interest in such clinics. We report our experience with a local television station in helping to produce a "health segment" broadcast that chronicled the experience of an aesthetic patient in the residents' aesthetic clinic. As a result of this broadcast, approximately 150 people responded by telephone and subsequently attended a series of seminars designed to screen patients and educate the audience about the aesthetic clinic. A total of 121 patients (112 women and 9 men) signed up for personal consultations. The age distribution and requested procedures are presented. From the data, we conclude that there is a healthy demand for reduced-fee plastic surgery procedures performed by residents in plastic surgery. The number and variety of cases generated are sufficiently diverse to provide a well-rounded operative experience. The pursuit of media coverage of a not-for-profit clinic has the potential for generating large patient volume. Such efforts, although very attractive, are not without their own risks, which must be taken into consideration before engaging the media in the public interest arena. PMID:9623845

  14. Facial plastic surgery database.

    PubMed

    Mendelsohn, M; Conrad, K

    1994-02-01

    Every facial plastic surgeon accumulates a vast library of professional slides and photographs that document his work. Manual cataloguing of the clinical and operative documentation is time consuming and provides limited analysis capabilities. The facial plastic surgery database is a state-of-the-art computer programme that allows the surgeon to sort and locate slides and photographs. Designed for the computer novice, it utilises a simple coding system to permit rapid data input. The codes can be tailored to allow for new procedures or alternative practice styles. There are sophisticated searching routines to quickly find slides and photographs based on any combination of patients and operative criteria. The database also includes an online colour atlas and workspace for recording of presentations. There are automated routines to analyse patients' clinical features, operative trends, and surgical results. Ultimately, examination of this data can be used to facilitate peer review, research, and self-education. PMID:8170012

  15. Evidence-Based Education in Plastic Surgery.

    PubMed

    Johnson, Shepard P; Chung, Kevin C; Waljee, Jennifer F

    2015-08-01

    Educational reforms in resident training have historically been driven by reports from medical societies and organizations. Although educational initiatives are well intended, they are rarely supported by robust evidence. The Accreditation Council for Graduate Medical Education recently introduced competency-based training, a form of outcomes-based education that has been used successfully in nonmedical professional vocations. This initiative has promise to advance the quality of resident education, but questions remain regarding implementation within plastic surgery. In particular, how will competency-based training impact patient outcomes, and will the methodologies used to assess competencies (i.e., milestones) be accurate and validated by literature? This report investigates resident educational reform and the need for more evidence-based educational initiatives in plastic surgery training. PMID:26218400

  16. The commercialization of plastic surgery.

    PubMed

    Swanson, Eric

    2013-09-01

    The last decade has brought a major challenge to the traditional practice of plastic surgery from corporations that treat plastic surgery as a commercial product and market directly to the public. This corporate medicine model may include promotion of a trademarked procedure or device, national advertising that promises stunning results, sales consultants, and claims of innovation, superiority, and improved safety. This article explores the ethics of this business practice and whether corporate medicine is a desirable model for patients and plastic surgeons. PMID:24081699

  17. Patient Safety: Guide to Safe Plastic Surgery

    MedlinePlus

    ... and Consumer Information > Patient Safety Guide to Safe Plastic Surgery Patient Safety More Resources Choose a surgeon you ... Important facts about the safety and risks of plastic surgery Questions to ask my plastic surgeon Choose a ...

  18. [Ethical aspects of plastic surgery].

    PubMed

    Colić, M

    1989-01-01

    In the past few years the abuse of ethical principles in plastic surgery has become increasingly noticeable. The reasons are various; it may be the desire to achieve personal recognition of plastic surgeons by means of different press articles or numerous yellow-press articles written by journalists whose only aim is to increase the circulation of their newspapers. In extreme cases the violation of medical secret or the surgeon's personality advertising is noticeable. Although this phenomenon is much more evident in the countries where plastic surgery is being performed at private clinics, it has in the past few years also become more obvious in our country. These ethical problems are present in plastic surgery because it is to often identified with aesthetic surgery. The fact that, with its more or less favorable results, it appears highly attractive to the public and thus get even the unwilling surgeon into the focus of various yellow-press articles and headlines. On the other hand, the very nature of the individual who specializes in this kind of surgery may be the principal basis for publicity. Such abuse of professional ethics is usually explained by claiming that the public should be properly informed, but in some cases it is but open advertising of the surgeon and his/her abilities. Establishing an ethical code which would entail all necessary moral sanctions in plastic surgery would act favorably to the protection of those plastic surgeons who perform their work according to the moral and ethical principles of their profession. PMID:2489525

  19. Successfully Integrating Research into Plastic Surgery Training Programs.

    PubMed

    Ballard, Tiffany N S; Sando, Ian C; Kasten, Steven J; Cederna, Paul S

    2015-11-01

    Successful integration of research into the educational mission of a plastic surgery residency program requires the support and dedication of the faculty members to create a culture that promotes innovation, discovery, and advancement of the field of plastic surgery. Dedicated research time during plastic surgery training is beneficial to both the resident and training program. Regardless of whether residents plan to pursue an academic career or enter private practice, participating in research provides an opportunity to develop skills to think critically and mature professionally. In this article, we review the benefits of resident research to both the trainee and training program and discuss strategies to overcome barriers to integrating research into the curriculum. PMID:26517468

  20. Anaesthetic complications in plastic surgery

    PubMed Central

    Nath, Soumya Sankar; Roy, Debashis; Ansari, Farrukh; Pawar, Sundeep T.

    2013-01-01

    Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist's concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients’ experience and surgical outcome. PMID:24501480

  1. Plastic Surgery Response in Natural Disasters.

    PubMed

    Chung, Susan; Zimmerman, Amanda; Gaviria, Andres; Dayicioglu, Deniz

    2015-06-01

    Disasters cause untold damage and are often unpredictable; however, with proper preparation, these events can be better managed. The initial response has the greatest impact on the overall success of the relief effort. A well-trained multidisciplinary network of providers is necessary to ensure coordinated care for the victims of these mass casualty disasters. As members of this network of providers, plastic surgeons have the ability to efficiently address injuries sustained in mass casualty disasters and are a valuable member of the relief effort. The skill set of plastic surgeons includes techniques that can address injuries sustained in large-scale emergencies, such as the management of soft-tissue injury, tissue viability, facial fractures, and extremity salvage. An approach to disaster relief, the types of disasters encountered, the management of injuries related to mass casualty disasters, the role of plastic surgeons in the relief effort, and resource management are discussed. In order to improve preparedness in future mass casualty disasters, plastic surgeons should receive training during residency regarding the utilization of plastic surgery knowledge in the disaster setting. PMID:26080117

  2. Selecting Residents in Podiatric Medicine and Surgery.

    PubMed

    Shofler, David

    2015-01-01

    Limited information exists to guide students of podiatric medicine and residency directors through the resident selection process. The present study aimed to evaluate the podiatric medicine and surgery resident selection process using an online survey. Residency directors of podiatric medicine and surgery programs across the United States and fourth-year students across all 9 colleges of podiatric medicine were contacted for participation. Two separate surveys were created, one for the directors and one for the students. The directors and students were asked the relative importance of 21 items considered in resident selection on a 7-point importance scale. Subsequent questions covered an array of related topics. The directors, compared with the students, identified the following items as more important (p < .05): previous disciplinary actions against the student, number of classes failed during school, undergraduate experiences and activities, number of Part I board attempts, class rank, involvement in research, and grade point average during podiatric medical school. The manual dexterity portion of the residency interview was considered significantly more important by the students than the directors. The directors more satisfied with their residents placed greater importance on the following items (p < .05): opinions of current residents, opinions of other attending physicians, and letters of recommendation. Additional trends and differences were also discovered. The results of the present study provide baseline data on the selection of podiatric medicine and surgery residents. PMID:25459090

  3. American Academy of Facial Plastic and Reconstructive Surgery

    MedlinePlus

    ... is the world's largest specialty association for facial plastic surgery. It represents more than 2,700 facial plastic ... the American Board of Otolaryngology , which includes facial plastic surgery. Others are certified in plastic surgery, ophthalmology, and ...

  4. Emotional intelligence in orthopedic surgery residents

    PubMed Central

    Chan, Kevin; Petrisor, Brad; Bhandari, Mohit

    2014-01-01

    Background Emotional intelligence (EI) is the ability to understand and manage emotions in oneself and others. It was originally popularized in the business literature as a key attribute for success that was distinct from cognitive intelligence. Increasing focus is being placed on EI in medicine to improve clinical and academic performance. Despite the proposed benefits, to our knowledge, there have been no previous studies on the role of EI in orthopedic surgery. We evaluated baseline data on EI in a cohort of orthopedic surgery residents. Methods We asked all orthopedic surgery residents at a single institution to complete an electronic version of the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT). We used completed questionnaires to calculate total EI scores and 4 branch scores. Data were analyzed according to a priori cutoff values to determine the proportion of residents who were considered competent on the test. Data were also analyzed for possible associations with age, sex, race and level of training. Results Thirty-nine residents (100%) completed the MSCEIT. The mean total EI score was 86 (maximum score 145). Only 4 (10%) respondents demonstrated competence in EI. Junior residents (p = 0.026), Caucasian residents (p = 0.009) and those younger than 30 years (p = 0.008) had significantly higher EI scores. Conclusion Our findings suggest that orthopedic residents score low on EI based on the MSCEIT. Optimizing resident competency in noncognitive skills may be enhanced by dedicated EI education, training and testing. PMID:24666445

  5. Sushruta: father of plastic surgery.

    PubMed

    Champaneria, Manish C; Workman, Adrienne D; Gupta, Subhas C

    2014-07-01

    Sushruta is considered the "Father of Plastic Surgery." He lived in India sometime between 1000 and 800 BC, and is responsible for the advancement of medicine in ancient India. His teaching of anatomy, pathophysiology, and therapeutic strategies were of unparalleled luminosity, especially considering his time in the historical record. He is notably famous for nasal reconstruction, which can be traced throughout the literature from his depiction within the Vedic period of Hindu medicine to the era of Tagliacozzi during Renaissance Italy to modern-day surgical practices. The primary focus of this historical review is centered on Sushruta's anatomical and surgical knowledge and his creation of the cheek flap for nasal reconstruction and its transition to the "Indian method." The influential nature of the Sushruta Samhita, the compendium documenting Sushruta's theories about medicine, is supported not only by anatomical knowledge and surgical procedural descriptions contained within its pages, but by the creative approaches that still hold true today. PMID:23788147

  6. Tissue transplantation in plastic surgery.

    PubMed

    Siemionow, Maria; Agaoglu, Galip

    2007-04-01

    The functional and aesthetic outcome following application of conventional reconstructive procedures or prosthetic materials is not satisfactory, especially in patients who have severe deformities and disabilities. Since the first successful hand transplantation in France in 1998, composite tissue allograft transplantation has gained a great deal of interest in the field of plastic surgery. It is obvious that composite tissue allograft transplantation will improve patients' life quality, but this might be at the expense of decreasing life expectancy. Currently, the main obstacle for composite tissue allograft transplantation is the use of life-long immunosuppression therapy because of their well-known side effects. In addition, the ethical, social, and psychologic issues are raised when discussing face transplantation. The long-term results of the recently performed partial face transplantations will be critical to judge the future applications of partial or total face transplantation. PMID:17418675

  7. Views of College Students on Plastic Surgery

    PubMed Central

    Ahmad, Muhammad; Mohmand, Humayun; Ahmad, Nabila

    2013-01-01

    BACKGROUND Various studies have been conducted in many countries to determine the perception/awareness about plastic surgery. The present study assessed the views of college students about plastic surgery. METHODS A questionnaire consisted of nine questions regarding the basic knowledge about plastic surgery was randomly distributed among college students. The students were given 20 minutes to fill out the forms. RESULTS A total of 250 male and 250 female college students were randomly included in the study. The mean age of the male students was 21.1 years as compared to 20.7 years of female students. The top five conditions named were related to hair (89.8%) followed by face scars (88%). The most common procedure named by the students was liposuction (88.2%) followed by hair transplantation. 80.2% of the students opted not to be a plastic surgeon if given an opportunity to select the profession. 33.8% of the students had seen some kinds of plastic surgery operation. Only 5.6% of the students (3.4% male and 2.2% female) had seen some kinds of plastic surgery procedure. 68% of male students and 48% of female students wished to have a plastic surgery procedure sometime in their lives. Majority of the students (88%) got the information from the internet. The second most common source was magazines (85.2%). Majority of the students (53.4%) had an idea of an invisible scar as a result of having a plastic surgery procedure. Only 22% thought to have no scar. Late Michael Jackson was at the top of the list of celebrities having a plastic surgery procedure (97.8%) followed by Nawaz Shariff (92.4%). CONCLUSION Despite the rapid growth of plastic surgery in the last two decades, a large portion of population remains unaware of the spatiality. It is essential to institute programs to educate healthcare consumers and providers about the plastic surgery. PMID:25489513

  8. Medical leech therapy in plastic reconstructive surgery.

    PubMed

    Houschyar, Khosrow S; Momeni, Arash; Maan, Zeshaan N; Pyles, Malcolm N; Jew, Olivia S; Strathe, Marion; Michalsen, Andreas

    2015-10-01

    The use of Hirudo medicinalis in clinical practice has increased in recent years. The primary indication in plastic surgery has traditionally been venous congestion. However, other reported clinical applications were in varicose veins, thrombophlebitis, and osteoarthritis. In this review, we summarize recent data elucidating the role that medicinal leeches play in the field of plastic surgery. PMID:26297126

  9. The plastic surgery match: predicting success and improving the process.

    PubMed

    Claiborne, Jeffrey R; Crantford, J Clayton; Swett, Katrina R; David, Lisa R

    2013-06-01

    Plastic surgery continues to be a very competitive program to match into out of medical school. To analyze the match process, all applicants to our plastic surgery residency program in 2012 were surveyed. Our results showed that with matching into plastic surgery as the primary outcome measure, those who matched applied to more plastic surgery programs, received and accepted more interview invitations, were younger, were less likely to be foreign medical graduates, reported higher costs, had higher Step 1 and Step 2 scores, were more likely to be an Alpha Omega Alpha member, and conducted more research. In addition to looking at variables that affected the success of the match, other questions regarding the match process were posed. Most interestingly, 10% of applicants still reported violations of the match communication guidelines. Furthermore, the mean cost of interviewing for the plastic surgery match was $6073.In summary, applicants with diversified strengths had the best chance of matching. On the basis of the results of this study, applicants should attend a large number of interviews to optimize their match success. With medical student debt a growing problem, programs need to find ways to control interview costs. Residency program compliance with match communication guidelines has improved, but compliance should be universal. With these data, applicants can be better prepared for the match to optimize their success and programs can work to improve the match process. PMID:23673567

  10. Critical care education in general surgery residencies.

    PubMed

    Meyer, A A; Fakhry, S M; Sheldon, G F

    1989-08-01

    Surgical critical care (SCC) was recently identified as an essential component of general surgery by the American Board of Surgery (ABS). Previous studies have found limited attention to critical care education in general surgery programs. This survey was developed to determine the changes in critical care education, following the emphasis by the ABS. The survey determined the format for SCC education, the time and resources committed, and the views of the program directors toward SCC. Program directors of all 296 approved general surgery residencies were surveyed, with a 79% response. Most program directors (91%) agree that SCC is an essential component of general surgery, and 72% believe a separate intensive care unit (ICU) rotation should be used in SCC education. Education in SCC was provided by a separate ICU service in 110 (47%) of the programs. The remaining 53% used care of patients in the ICU during traditional services as their educational experience. The average ICU rotation for surgery residents was 9 weeks and usually occurred in the second year of training. In 97% of the 110 programs with an ICU service, lectures and conferences were conducted regularly. Seventeen programs sponsored critical care fellowships, and 25 additional programs were considering them. Ninety percent of surgical ICU services had faculty that consisted exclusively of surgeons or surgeons and other specialists. Only 53% of surgeons attending on an ICU service had a reduction in their other responsibilities. Despite overwhelming agreement that critical care is an essential component of general surgery, less than half of the training programs have an ICU service to coordinate resident education in SCC. If surgeons are to continue to provide total care to their patients, there needs to be increased commitment to SCC education. PMID:2763037

  11. Ethical issues in plastic and reconstructive surgery.

    PubMed

    Sterodimas, Aris; Radwanski, Henrique N; Pitanguy, Ivo

    2011-04-01

    Plastic, reconstructive, and cosmetic surgery refers to a variety of operations performed in order to repair or restore body parts to look normal or to enhance a certain structure or anatomy that is already normal. Several ethical considerations such as a patient's right for autonomy, informed consent, beneficence, and nonmalfeasance need to be given careful consideration. The principal objective of the medical profession is to render services to humanity with full respect for human dignity. Plastic surgeons should merit the confidence of patients entrusted to their care, rendering to each a full measure of service and devotion. They require an extensive amount of education and training. The increases in demand for aesthetic plastic surgery and the advocacy of practice in the media have raised concerns about the circumstances under which cosmetic surgery is ethical and permissible. Innovative research, and new technologies derived from such research, almost always raises ethical and policy concerns. Medical ethics regulate what is, and what is not, correct in promoting plastic surgery to the public. It is essential to create an educated and informed public about the ethical issues in the plastic and reconstructive surgery field. Plastic surgeons need to carefully evaluate the degree of deformity, physical and emotional maturity, and desired outcome of patients who request plastic surgery procedures. Science is a powerful force for change in modern society and plastic surgeons have a responsibility to shepherd that change with thoughtful advocacy and careful ethical scrutiny of their own behavior. PMID:21336881

  12. Fifty Years of Innovation in Plastic Surgery

    PubMed Central

    Hughes-Hallett, Archie; Marcus, Hani J; Yang, Guang-Zhong; Darzi, Ara; Hettiaratchy, Shehan

    2016-01-01

    Background Innovation has molded the current landscape of plastic surgery. However, documentation of this process only exists scattered throughout the literature as individual articles. The few attempts made to profile innovation in plastic surgery have been narrative, and therefore qualitative and inherently biased. Through the implementation of a novel innovation metric, this work aims to identify and characterise the most prevalent innovations in plastic surgery over the last 50 years. Methods Patents and publications related to plastic surgery (1960 to 2010) were retrieved from patent and MEDLINE databases, respectively. The most active patent codes were identified and grouped into technology areas, which were subsequently plotted graphically against publication data. Expert-derived technologies outside of the top performing patents areas were additionally explored. Results Between 1960 and 2010, 4,651 patents and 43,118 publications related to plastic surgery were identified. The most active patent codes were grouped under reconstructive prostheses, implants, instruments, non-invasive techniques, and tissue engineering. Of these areas and other expert-derived technologies, those currently undergoing growth include surgical instruments, implants, non-invasive practices, transplantation and breast surgery. Innovations related to microvascular surgery, liposuction, tissue engineering, lasers and prostheses have all plateaued. Conclusions The application of a novel metric for evaluating innovation quantitatively outlines the natural history of technologies fundamental to the evolution of plastic surgery. Analysis of current innovation trends provides some insight into which technology domains are the most active. PMID:27019807

  13. Ophthalmic plastic and orbital surgery in Taiwan.

    PubMed

    Hsu, Chi-Hsin; Lin, I-Chan; Shen, Yun-Dun; Hsu, Wen-Ming

    2014-06-01

    We describe in this paper the current status of ophthalmic plastic and orbital surgery in Taiwan. Data were collected from the Bureau of National Health Insurance of Taiwan, the Bulletin of the Taiwan Ophthalmic Plastic and Reconstructive Society, and the Statistics Yearbook of Practicing Physicians and Health Care Organizations in Taiwan by the Taiwan Medical Association. We ascertained that 94 ophthalmologists were oculoplastic surgeons and accounted for 5.8% of 1621 ophthalmologists in Taiwan. They had their fellowship training abroad (most ophthalmologists trained in the United States of America) or in Taiwan. All ophthalmologists were well trained and capable of performing major oculoplastic surgeries. The payment rates by our National Health Insurance for oculoplastic and orbital surgeries are relatively low, compared to Medicare payments in the United States. Ophthalmologists should promote the concept that oculoplastic surgeons specialize in periorbital plastic and aesthetic surgeries. However, general ophthalmologists should receive more educational courses on oculoplastic and cosmetic surgery. PMID:24898627

  14. 21 CFR 878.3925 - Plastic surgery kit and accessories.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Plastic surgery kit and accessories. 878.3925... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3925 Plastic surgery kit and accessories. (a) Identification. A plastic surgery kit and accessories is a device intended...

  15. 21 CFR 878.3925 - Plastic surgery kit and accessories.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Plastic surgery kit and accessories. 878.3925... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3925 Plastic surgery kit and accessories. (a) Identification. A plastic surgery kit and accessories is a device intended...

  16. 21 CFR 878.3925 - Plastic surgery kit and accessories.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Plastic surgery kit and accessories. 878.3925... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3925 Plastic surgery kit and accessories. (a) Identification. A plastic surgery kit and accessories is a device intended...

  17. 21 CFR 878.3925 - Plastic surgery kit and accessories.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Plastic surgery kit and accessories. 878.3925... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3925 Plastic surgery kit and accessories. (a) Identification. A plastic surgery kit and accessories is a device intended...

  18. 21 CFR 878.3925 - Plastic surgery kit and accessories.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Plastic surgery kit and accessories. 878.3925... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3925 Plastic surgery kit and accessories. (a) Identification. A plastic surgery kit and accessories is a device intended...

  19. Survey of Attitudes on Professionalism in Plastic and Reconstructive Surgery

    PubMed Central

    Kim, Jin Yong; Kang, Seok Joo; Kim, Jin Woo; Kim, Young Hwan

    2013-01-01

    Background The purpose of this study is to analyze the current attitudes toward professionalism, the core values, and the type of professionalism among plastic surgeons in Korea to establish a code of ethics regarding the role of professionalism for plastic and reconstructive surgeons. Methods From March 9, to July 1, 2012, face-to-face and mail surveys were conducted targeting the 325 participants (256 specialists and 69 residents) who are registered members of the Korean Society of Plastic and Reconstructive Surgeons. The proportion of each response given to an item was obtained through statistical processing through frequency analysis. The Mann-Whitney U test was used to compare the differences in the responses between the resident group and the specialist group. Results The survey results on the perception of professionalism in plastic surgery showed that a high proportion (90.5%) of the respondents viewed the future of plastic surgeons as bright. Through evaluation of the importance of the value items,"professional dominance" (4.58 pts), "autonomy" (4.45 pts), "lifestyle" (4.34 pts), and "commercialism" (4.31 pts) were assessed as critical values. "Altruism" (3.84 pts), "interpersonal competence" (3.79 pts), and "social justice" (3.61 pts) were viewed as lesser values. This difference showed the characteristics of an entrepreneurial outlook. Conclusions Plastic surgeons should pursue excellence, humanism, accountability, and altruism in order to overcome the crisis of professionalism in plastic surgery. In order to develop the necessary competencies of professionals, vocational education should be arranged by the Korean Society of Plastic Surgeons, and an appropriate code of ethics should be established. PMID:23533062

  20. Emerging techniques in aesthetic plastic surgery.

    PubMed

    Toledo, Luiz S

    2009-04-01

    This article outlines the experience of authorities on emerging techniques in plastic surgery that are discussed within this issue, such as mesotherapy and lipodissolve, Russian threads, radiofrequency, and "laser lipo." Readers are invited to analyze the findings and determine whether there is something that could apply to their practices. PMID:19309640

  1. [Lasers in plastic surgery--vascular lasers].

    PubMed

    Siewiera, Ireneusz P; Wysocki, Mariusz S; Latkowski, Ireneusz T

    2007-01-01

    Laser treatment of the cutaneous vascular lesions gained approbation and well-established position among plastic surgery techniques. Rapidly evolving laser market delivers us modem and safer devices. In the paper we discuss the most common vascular lesions and available lasers used to treat them. Described indications and safety rules might be useful for many specialists for their patient therapy choice. PMID:17726873

  2. Exposure to plastic surgery during undergraduate medical training: A single-institution review

    PubMed Central

    Austin, Ryan E; Wanzel, Kyle R

    2015-01-01

    BACKGROUND: Applications to surgical residency programs have declined over the past decade. Even highly competitive programs, such as plastic surgery, have begun to witness these effects. Studies have shown that early surgical exposure has a positive influence on career selection. OBJECTIVE: To review plastic surgery application trends across Canada, and to further investigate medical student exposure to plastic surgery. METHODS: To examine plastic surgery application trends, national data from the Canadian Resident Matching Service database were analyzed, comparing 2002 to 2007 with 2008 to 2013. To evaluate plastic surgery exposure, a survey of all undergraduate medical students at the University of Toronto (Toronto, Ontario) during the 2012/2013 academic year was conducted. RESULTS: Comparing 2002 to 2007 and 2008 to 2013, the average number of national plastic surgery training positions nearly doubled, while first-choice applicants decreased by 15.3%. The majority of Canadian academic institutions experienced a decrease in first-choice applicants; 84.7% of survey respondents indicated they had no exposure to plastic surgery during their medical education. Furthermore, 89.7% believed their education had not provided a basic understanding of issues commonly managed by plastic surgeons. The majority of students indicated they receive significantly less plastic surgery teaching than all other surgical subspecialties. More than 44% of students not considering plastic surgery as a career indicated they may be more likely to with increased exposure. CONCLUSION: If there is a desire to grow the specialty through future generations, recruiting tactics to foster greater interest in plastic surgery must be altered. The present study suggests increased and earlier exposure for medical students is a potential solution. PMID:25821773

  3. Mentorship: Concepts and Application to Plastic Surgery Training Programs

    PubMed Central

    Franzblau, Lauren E.; Kotsis, Sandra V.; Chung, Kevin C.

    2016-01-01

    Background Countless papers have demonstrated and emphasized the importance of mentoring in academic medicine. However, the upcoming role of mentors in the evolving medical field is poorly defined. As translational medicine, collaboration, and healthcare priorities change, so too must the goals and usage of mentoring. The aims of this paper are to demonstrate key aspects of effective mentoring in academic plastic surgery, show institutions how to cultivate mentoring relationships among their faculty and trainees, and provide direction for how to optimize the future use of mentoring to best prepare the next generation of plastic surgeons. Methods We reviewed the current literature regarding mentorship and the evolution of academic medicine. Results Mentors not only facilitate their protégés’ entrance into the field and future success, but can also attract medical students and residents to careers in research and abet the racial and gender discrepancies in plastic surgery and academia. Ideally faculty should undergo some form of training before they enter mentoring relationships. This will ensure that they are aware of their specific duties as mentors, are able to communicate with mentees, and can avoid potential pitfalls. Conclusions Mentorship is a tool. If used correctly, it can help recruit and retain talented physician-scientists to plastic surgery to satisfy the growing demand. This will require institutions to actively support mentorship, provide opportunities and resources for training mentors, and enable faculty to allocate time to this vital pursuit. PMID:23629123

  4. PLink, plastic surgery and the Internet.

    PubMed

    van Heijningen, R I; Mannaerts, G H; Blondeel, P N; Spauwen, P H

    1998-03-01

    The Internet is a fast growing, global computer network that is easy to access at a low cost. This form of communication allows rapid electronic exchange of information such as text, pictures, animations, video and sound. This offers physicians an opportunity to enhance the quality of patient care, research and communication with colleagues. Patients who previously had limited access to information concerning diseases and treatment options are now able to find medical information on the Internet. The quality of information found on the Internet varies widely, from the most up-to-date protocols, produced by leading physicians and surgeons, to out of date or inaccurate recommendations. Faced with an enormous quantity of information of variable quality, guidelines certified by recognised medical organisations are essential to provide websites with valuable information. This so-called "safe house principle" creates reliable places on the Internet ("safe houses") that are generally accepted and trusted for containing valid information. We have created such a "safe house" on plastic surgical topics for the Netherlands Society for Plastic Surgery called "PLink" (the Plastic Surgery link). Its goals are: 1. to provide a well-organised list of existing plastic surgery Internet resources; 2. to improve communication; and 3. to provide original information on plastic surgical subjects for patients and physicians. Professionals always review the content. Since July 1996 our files have been accessed over 1.3 million times in 17 months, with the visit rate increasing from 1470 in July 1996 to 4200 in March 1997 and remaining stable since then. This indicates that there is a growing need for high quality information on plastic surgery on the Internet. PMID:9659108

  5. American Society of Ophthalmic Plastic and Reconstructive Surgery

    MedlinePlus

    ... of clinical practice in the fields of aesthetic, plastic and reconstructive surgery specializing in the face, orbits, eyelids, and lacrimal ... of clinical practice in the fields of aesthetic, plastic and reconstructive surgery specializing in the face, orbits, eyelids, and lacrimal ...

  6. The General Surgery Chief Resident Operative Experience

    PubMed Central

    Drake, Frederick Thurston; Horvath, Karen D.; Goldin, Adam B.; Gow, Kenneth W.

    2014-01-01

    IMPORTANCE The chief resident (CR) year is a pivotal experience in surgical training. Changes in case volume and diversity may impact the educational quality of this important year. OBJECTIVE To evaluate changes in operative experience for general surgery CRs. DESIGN, SETTING, AND PARTICIPANTS Review of Accreditation Council for Graduate Medical Education case logs from 1989–1990 through 2011–2012 divided into 5 periods. Graduates in period 3 were the last to train with unrestricted work hours; those in period 4 were part of a transition period and trained under both systems; and those in period 5 trained fully under the 80-hour work week. Diversity of cases was assessed based on Accreditation Council for Graduate Medical Education defined categories. MAIN OUTCOMES AND MEASURES Total cases and defined categories were evaluated for changes over time. RESULTS The average total CR case numbers have fallen (271 in period 1 vs 242 in period 5, P < .001). Total CR cases dropped to their lowest following implementation of the 80-hour work week (236 cases), but rebounded in period 5. The percentage of residents’ 5-year operative experience performed as CRs has decreased (30% in period 1 vs 25.6% in period 5, P < .001). Regarding case mix: thoracic, trauma, and vascular cases declined steadily, while alimentary and intra-abdominal operations increased. Recent graduates averaged 80 alimentary and 78 intra-abdominal procedures during their CR years. Compared with period 1, in which these 2 categories represented 47.1% of CR experience, in period 5, they represented 65.2% (P < .001). Endocrine experience has been relatively unchanged. CONCLUSIONS AND RELEVANCE Total CR cases declined especially acutely following implementation of the 80-hour work week but have since rebounded. Chief resident cases contribute less to overall experience, although this proportion stabilized before the 80-hour work week. Case mix has narrowed, with significant increases in alimentary and intra-abdominal cases. Broad-based general surgery training may be jeopardized by reduced case diversity. Chief resident cases are crucial in surgical training and educators should consider these findings as surgical training evolves. PMID:23864049

  7. Glove perforation during plastic surgery.

    PubMed

    Cole, R P; Gault, D T

    1989-07-01

    Intraoperative perforation of surgical gloves is common. Nine hundred and forty surgical gloves were tested after 100 consecutive plastic surgical operations, each involving a surgeon, a variable number of assistants and a scrub nurse. In the first 52 operations, single gloves were used and 21.5% of the staff were found to have a perforated glove. In the second 48 operations, double gloves were used by all members of the surgical team and the number with perforations (of both inner and outer gloves) was reduced to 9%. Most perforations occurred on the dorsum of the hand and fingers and on the thumb tip, especially in the non-dominant hand. The risk of acquiring AIDS due to glove perforation is low but the consequences of such an event could be lethal. PMID:2765743

  8. Three Decades of History and Perspectives of Khon Kaen University's Plastic Surgery.

    PubMed

    Chowchuen, Bowornsilp

    2015-08-01

    Plastic surgery consists of two major fields: reconstructive surgery and cosmetic surgery with its roots lie in the reconstruction aspect. In Thailand, the plastic surgery procedures, performed during the initial period, included cleft lip and cleft palate repairs and skin graftings: In 1987, the Plastic Surgery Unit was established in the Department of Surgery, Srinagarind Hospital in Khon Kaen, which is the city in the Center of the northeast Thailand. In 1991, the partnership training of resident in plastic surgery with Siriraj Hospital was established and continued until the present time. All fields of plastic surgery were managed and educated in the Plastic Surgery Unit. Since the first batch of plastic surgery training program in 2009, the unit has many advanced in interdisciplinary management, the management of cleft center burn center postgraduate training program, research, community services, and national, regional and international coloration. The future perspectives involve educationfor 21st century skills, integration of teaching, research and community services, and a focus on evidence-based medicine and benchmarked outcomes are the future perspectives. PMID:26742363

  9. National efforts to reform residency education in surgery.

    PubMed

    Sachdeva, Ajit K; Bell, Richard H; Britt, L D; Tarpley, John L; Blair, Patrice Gabler; Tarpley, Margaret J

    2007-12-01

    Major changes in surgical practice and myriad external mandates have affected residency education in surgery. The traditional surgery residency education and training model has come under scrutiny, and calls for major reform of this model have been made by a variety of stakeholders. The American Surgical Association appointed a Blue Ribbon Committee in 2002 to consider the recent changes in surgical practice and surgical education and propose solutions that would ensure a well-educated and well-trained surgical workforce for the future. This committee included representatives from the American Surgical Association, the American College of Surgeons, the American Board of Surgery, and the Residency Review Committee for Surgery. The committee made several far-reaching recommendations relating to residency education in surgery. After the Blue Ribbon Committee completed its task in 2004, representatives from the aforementioned four organizations, the Association of Program Directors in Surgery, and the Association for Surgical Education created a national consortium called the Surgical Council on Resident Education (SCORE). This consortium is pursuing efforts to reform residency education in surgery and implement several key recommendations of the Blue Ribbon Committee. The principal area of focus of SCORE is the development of a national curriculum for surgery residency education and training. Other activities of SCORE include the development of a Web site to support surgery residency education and pursuit of international collaboration. SCORE's efforts will be key to offering surgery residents the best educational experiences, preparing residents for future practice, and supporting delivery of surgical care of the highest quality. The authors examine the current state of residency education in surgery and explore efforts underway to reform this educational model. PMID:18046129

  10. Telemedicine and Plastic Surgery: A Pilot Study

    PubMed Central

    Valente, Denis Souto; Silveira Eifler, Luciano; Carvalho, Lauro Aita; Filho, Gustavo Azambuja Pereira; Ribeiro, Vinicius Weissheimer; Padoin, Alexandre Vontobel

    2015-01-01

    Background. Telemedicine can be defined as the use of electronic media for transmission of information and medical data from one site to another. The objective of this study is to demonstrate an experience of telemedicine in plastic surgery. Methods. 32 plastic surgeons received a link with password for real-time streaming of a surgery. At the end of the procedure, the surgeons attending the procedure by the Internet answered five questions. The results were analyzed with descriptive statistics. Results. 27 plastic surgeons attended the online procedure in real-time. 96.3% considered the access to the website as good or excellent and 3.7% considered it bad. 14.8% reported that the transmission was bad and 85.2% considered the quality of transmission as good or excellent. 96.3% classified the live broadcasting as a good or excellent learning experience and 3.7% considered it a bad experience. 92.6% reported feeling able to perform this surgery after watching the demo and 7.4% did not feel able. 100% of participants said they would like to participate in other surgical demonstrations over the Internet. Conclusion. We conclude that the use of telemedicine can provide more access to education and medical research, for plastic surgeons looking for medical education from distant regions. PMID:26609429

  11. Telemedicine and Plastic Surgery: A Pilot Study.

    PubMed

    Valente, Denis Souto; Silveira Eifler, Luciano; Carvalho, Lauro Aita; Filho, Gustavo Azambuja Pereira; Ribeiro, Vinicius Weissheimer; Padoin, Alexandre Vontobel

    2015-01-01

    Background. Telemedicine can be defined as the use of electronic media for transmission of information and medical data from one site to another. The objective of this study is to demonstrate an experience of telemedicine in plastic surgery. Methods. 32 plastic surgeons received a link with password for real-time streaming of a surgery. At the end of the procedure, the surgeons attending the procedure by the Internet answered five questions. The results were analyzed with descriptive statistics. Results. 27 plastic surgeons attended the online procedure in real-time. 96.3% considered the access to the website as good or excellent and 3.7% considered it bad. 14.8% reported that the transmission was bad and 85.2% considered the quality of transmission as good or excellent. 96.3% classified the live broadcasting as a good or excellent learning experience and 3.7% considered it a bad experience. 92.6% reported feeling able to perform this surgery after watching the demo and 7.4% did not feel able. 100% of participants said they would like to participate in other surgical demonstrations over the Internet. Conclusion. We conclude that the use of telemedicine can provide more access to education and medical research, for plastic surgeons looking for medical education from distant regions. PMID:26609429

  12. The Residency Training Experience in Podiatric Medicine and Surgery.

    PubMed

    Shofler, David; Chuang, Taijung; Argade, Nina

    2015-01-01

    The podiatric medicine and surgery residency is currently characterized by 3 years of comprehensive training. Contemporary issues have recently influenced the direction of training in the profession of podiatric medicine. Formal investigation into the residency training experience has, nonetheless, been limited. The purpose of the present study was to conduct a learning needs assessment of podiatric residency training. An electronic survey was developed, with comparable versions for program directors and residents. The specific topics investigated included the use of minimum activity volume numbers, learning resources, duty hours, strengths and weaknesses of residents, motivation of hosting student externship positions, noncognitive residency traits, meetings between residents and directors, resident satisfaction, and director satisfaction. A total of 197 program directors nationwide were sent the survey electronically, and 109 (53%) responded. Of 230 residents receiving the survey, 159 (78%) responded. Several statistically significant differences, and notable similarities, were observed between the 2 groups encompassing many aspects of the survey. A majority opinion, among both directors and residents, was found that the use of procedural assessment tools might improve resident evaluation. The responding directors and residents agreed that the following 3 topics were weaknesses in podiatric training: practice management, biomechanics, and performing podiatric research. Direct feedback immediately after surgery was the most valuable learning resource reported by the residents. The results of our study reflect the current status of the podiatric medicine and surgery residency and could facilitate improvement in the residency training experience. PMID:25979295

  13. “Oriental anthropometry” in plastic surgery

    PubMed Central

    Senna-Fernandes, Vasco

    2008-01-01

    Background: According to Chinese medicine, the acupuncture-points' (acupoints) locations are proportionally and symmetrically distributed in well-defined compartment zones on the human body surface Oriental Anthropometry” (OA). Acupoints, if considered as aesthetic-loci, might be useful as reference guides in plastic surgery (PS). Aim: This study aimed to use aesthetic-loci as anatomical reference in surgical marking of Aesthetic Plastic Surgery. Method: This was an observational study based on aesthetic surgeries performed in private clinic. This study was based on 106 cases, comprising of 102 women and 4 men, with ages varying from 07 to 73 years, and with heights of between 1.34 m and 1.80 m. Patients were submitted to aesthetic surgical planning by relating aesthetic-loci to conventional surgical marking, including breast surgeries, abdominoplasty, rhytidoplasty, blepharoplasty, and hair implant. The aesthetic-surgical-outcome (ASO) of the patients was assessed by a team of plastic surgeons (who were not involved in the surgical procedures) over a follow-up period of one year by using a numeric-rating-scale in percentage (%) terms. A four-point-verbal-rating-scale was used to record the patients' opinion of therapeutic-satisfaction (TS). Results: ASO was 75.3 ± 9.4% and TS indicated that most patients (58.5%) obtained “good” results. Of the remainder, 38.7% found the results “excellent”, and 2.8% found them “fair”. Discussion and Conclusion: The data suggested that the use of aesthetic-loci may be a useful tool for PS as an anatomical reference for surgical marking. However, further investigation is required to assess the efficacy of the OA by providing the patients more reliable balance and harmony in facial and body contours surgeries. PMID:19753249

  14. Psychiatric issues in cosmetic plastic surgery.

    PubMed

    Ericksen, William Leif; Billick, Stephen Bates

    2012-09-01

    The objective of cosmetic surgery is increased patient self-esteem and confidence. Most patients undergoing a procedure report these results post-operatively. The success of any procedure is measured in patient satisfaction. In order to optimize patient satisfaction, literature suggests careful pre-operative patient preparation including a discussion of the risks, benefits, limitations and expected results for each procedure undertaken. As a general rule, the patients that are motivated to surgery by a desire to align their outward appearance to their body-image tend to be the most satisfied. There are some psychiatric conditions that can prevent a patient from being satisfied without regard aesthetic success. The most common examples are minimal defect/Body Dysmorphic Disorder, the patient in crisis, the multiple revision patient, and loss of identity. This paper will familiarize the audience with these conditions, symptoms and related illnesses. Case examples are described and then explored in terms of the conditions presented. A discussion of the patient's motivation for surgery, goals pertaining to specific attributes, as well as an evaluation of the patient's understanding of the risks, benefits, and limitations of the procedure can help the physician determine if a patient is capable of being satisfied with a cosmetic plastic surgery procedure. Plastic surgeons can screen patients suffering from these conditions relatively easily, as psychiatry is an integral part of medical school education. If a psychiatric referral is required, then the psychiatrist needs to be aware of the nuances of each of these conditions. PMID:22252848

  15. Substance use by surgical residents and students entering surgery.

    PubMed

    Bunch, W H; Storr, C L; Hughes, P H; Baldwin, D C

    1996-02-15

    We studied the use of alcohol, tobacco, and nine unprescribed or illegal substances by surgical residents and medical students accepted into surgical programs. With the exception of alcohol, surgical residents had less lifetime experience and used less than other residents or nonmedical college graduates. Students entering surgery had used these substances more frequently and were more likely to be using them regularly than were residents. Residency directors need to be aware of the change in attitude and use patterns of present residents as compared with those of the past. PMID:8769951

  16. Plastic Surgery for the Oncological Patient

    PubMed Central

    Daigeler, Adrien; Harati, Kamran; Kapalschinski, Nicolai; Goertz, Ole; Hirsch, Tobias; Lehnhardt, Marcus; Kolbenschlag, Jonas

    2014-01-01

    The therapy of oncological patients has seen tremendous progress in the last decades. For most entities, it has been possible to improve the survival as well as the quality of life of the affected patients. To supply optimal cancer care, a multidisciplinary approach is vital. Together with oncologists, radiotherapists and other physicians, plastic surgeons can contribute to providing such care in all stages of treatment. From biopsies to the resection of advanced tumors, the coverage of the resulting defects and even palliative care, plastic surgery techniques can help to improve survival and quality of life as well as mitigate negative effects of radiation or the problems arising from exulcerating tumors in a palliative setting. This article aims to present the mentioned possibilities by illustrating selected cases and reviewing the literature. Especially in oncological patients, restoring their quality of life with the highest patient safety possible is of utmost importance. PMID:25593966

  17. Deep vein thrombosis chemoprophylaxis in plastic surgery.

    PubMed

    Gold, Alan

    2013-07-01

    The practice of plastic surgery is a unique mixture of art and science, and both must be carefully balanced to provide the best possible care for patients. To do that, clinicians should be practicing evidence-based medicine. This article discusses the prevalence and risks associated with deep vein thrombosis and the reasons and options for its possible chemoprophylaxis. Until evidence-based medicine best-practice recommendations can be developed, it would be prudent for clinicians to empirically select and consistently apply a risk stratification system and prophylaxis regimen of their choice for the benefit of their patients. PMID:23830748

  18. [Pathomimia and plastic surgery, a case report].

    PubMed

    Rizzi, P; Guillier, D; See, L A; Roche, M; Zwetyenga, N

    2015-12-01

    Pathomimia is defined as a dummy pathology self-induced deliberately and is neither associated with mental confusion nor disturbance of consciousness. This article reports a case of pathomimia in plastic surgery. One of our patients had intentionally injected physiological saline solution into her breast implants in order to increase their volume. Implants removal was necessary because of severe local inflammatory signs. Psychiatric assessment revealed body dysmorphic disorder (BDD) developed on an hysterical personality, which explained the self-induced injuries. This nosologic entity must be promptly identified because it's diagnosis remains problematic and a multidisciplinary medical management is essential. PMID:26362995

  19. Surgery Resident Selection and Evaluation: A Critical Incident Study.

    ERIC Educational Resources Information Center

    Edwards, Janine C.; And Others

    1993-01-01

    Selecting and evaluating general surgery residents were studied using the Critical Incident Technique for 235 critical incidents identified by 10 faculty members and 4 senior residents. Derived categories of behavior to define surgical competence were used to develop an interview evaluation form and a handbook for interviewing applicants. (SLD)

  20. Rater Effects in Clinical Performance Ratings of Surgery Residents

    ERIC Educational Resources Information Center

    Iramaneerat, Cherdsak; Myford, Carol M.

    2006-01-01

    A multi-faceted Rasch measurement (MFRM) approach was used to analyze clinical performance ratings of 24 first-year residents in one surgery residency program in Thailand to investigate three types of rater effects: leniency, rater inconsistency, and restriction of range. Faculty from 14 surgical services rated the clinical performance of…

  1. Applying the Concepts of Innovation Strategies to Plastic Surgery

    PubMed Central

    Wang, Yirong; Kotsis, Sandra V.; Chung, Kevin C.

    2014-01-01

    Background: Plastic surgery has a well-known history of innovative procedures and products. However, with the rise in competition, such as aesthetic procedures being performed by other medical specialties, there is a need for continued innovation in plastic surgery to create novel treatments to advance this specialty. Although many articles introduce innovative technologies and procedures, there is a paucity of publications to highlight the application of principles of innovation in plastic surgery. Methods: We review the literature regarding business strategies for innovation. Results: We evaluate concepts of innovation, process of innovation (idea generation, idea evaluation, idea conversion, idea diffusion and adoption), ethical issues, and the application to plastic surgery. Conclusions: Adopting a business model of innovation is helpful to promote a new paradigm of progress to propel plastic surgery to new avenues of creativity. PMID:23897344

  2. Novel oral anticoagulants in plastic surgery.

    PubMed

    Munson, C F; Reid, A J

    2016-05-01

    Novel oral anticoagulants (NOACs) have emerged as a good alternative to warfarin in the prevention of stroke for patients with atrial fibrillation. NOAC use is increasing rapidly; therefore, greater understanding of their use in the perioperative period is important for optimal care. Studies and reviews that reported on the use of NOACs were identified, with particular focus on the perioperative period. PubMed was searched for relevant articles published between January 2000 and August 2015. The inevitable rise in the use of NOACs such as rivaroxaban (Xarelto™), apixaban (Eliquis™), edoxaban (Lixiana™) and dabigatran (Pradaxa™) may present a simplified approach to perioperative anticoagulant management due to fewer drug interactions, rapidity of onset of action and relatively short half-lives. Coagulation status, however, cannot reliably be monitored and no antidotes are currently available. When planning for discontinuation of NOACs, special consideration of renal function is required. Advice regarding the management of bleeding complications is provided for consideration in emergency surgery. In extreme circumstances, haemodialysis may be considered for bleeding with the use of dabigatran. NOACs will increasingly affect operative planning in plastic surgery. In order to reduce the incidence of complications associated with anticoagulation, the management of NOACs in the perioperative period requires knowledge of the time of last dose, renal function and the bleeding risk of the planned procedure. Consideration of these factors will allow appropriate interpretation of the current guidelines. PMID:27013144

  3. Colorectal Surgeons Teaching General Surgery Residents: Current Challenges and Opportunities

    PubMed Central

    Schmitz, Connie C.; Chow, Christopher J.; Rothenberger, David A.

    2012-01-01

    Effective teaching for general surgery residents requires that faculty members with colorectal expertise actively engage in the education process and fully understand the current context for residency training. In this article, we review important national developments with respect to graduate medical education that impact resident supervision, curriculum implementation, resident assessment, and program evaluation. We argue that establishing a culture of respect and professionalism in today's teaching environment is one of the most important legacies that surgical educators can leave for the coming generation. Faculty role modeling and the process of socializing residents is highlighted. We review the American College of Surgeons' Code of Professional Conduct, summarize some of the current strategies for teaching and assessing professionalism, and reflect on principles of motivation that apply to resident training both for the trainee and the trainer. PMID:23997668

  4. Commentary: the case for expanding general surgery residencies.

    PubMed

    Russell, John C; Nelson, M Timothy; Fry, Donald E

    2010-05-01

    Despite the significant growth in population in the United States since 1980 and societal and demographic factors such as an aging population, there has been no increase in the number of graduating general surgery residents each year, which has created a worsening shortage of general surgeons. Other factors, such as stricter duty hours requirements and an increase in the number and variety of procedures general surgeons must perform, have also contributed to this shortage. Yet, applicant demand for general surgery positions is currently strong and will increase as new medical schools are created and current medical schools expand class size. The authors of this commentary propose an expansion of the Accreditation Council for Graduate Medical Education-approved general surgery categorical resident positions as the necessary first step in addressing the current and projected shortage of general surgeons. Before this expansion of general surgery residencies can occur, impediments such as the availability of residency spots for both U.S. and international medical graduates, the availability of educational opportunities for residents in teaching hospitals, and inadequate financial resources, such as a lack of funding from the Centers for Medicare and Medicaid, must be overcome. PMID:20520020

  5. Laser therapy in plastic surgery: decolorization in port wine stains

    NASA Astrophysics Data System (ADS)

    Peszynski-Drews, Cezary; Wolf, Leszek

    1996-03-01

    For the first time laserotherapy is described as a method of port wine stain decolorization in plastic surgery. The authors present their 20-year experience in the treatment of port wine stains with the argon laser and dye laser.

  6. General Surgery Resident Vascular Operative Experience in the Era of Endovascular Surgery and Vascular Fellowships.

    PubMed

    Yan, Huan; Maximus, Steven; Kim, Jerry J; Smith, Brian; Kim, Dennis; Koopmann, Matthew; DeVirgilio, Christian

    2015-10-01

    Advances in endovascular surgery have resulted in a decline in major open arterial reconstructions nationwide. Our objective is to investigate the effect of endovascular surgery on general surgery resident experience with open vascular surgery. Between 2004 and 2014, 112 residents graduated from two academic institutions in Southern California. Residents were separated into those who graduated in 2004 to 2008 (period 1) and in 2009 to 2014 (period 2). Case volumes of vascular procedures were compared using two-sample t test. A total of 43 residents were in period 1 and 59 residents were in period 2. In aggregate, there was no significant difference in open cases recorded between the two periods (84 vs 87, P = 0.194). Subgroup analysis showed period 2 recorded significantly fewer cases of open aneurysm repair (5 vs 3, P < 0.001), cerebrovascular (14 vs 10, P = 0.007), and peripheral obstructive procedures (16 vs 13, P = 0.017). Dialysis access procedures constituted the largest group of procedures and remained similar between the two periods (35 vs 42, P = 0.582). General surgery residents experienced a significant decline in several index open major arterial reconstruction cases. This decline was offset by maintenance of dialysis access procedures. If the trend continues, future general surgeons will not be proficient in open vascular procedures. PMID:26595111

  7. Army orthopaedic surgery residency program directors' selection criteria.

    PubMed

    Orr, Justin D; Hoffmann, Jeffrey D; Arrington, Edward D; Gerlinger, Tad L; Devine, John G; Belmont, Philip J

    2015-01-01

    Factors associated with successful selection in U.S. Army orthopaedic surgical programs are unreported. The current analysis includes survey data from all Army orthopaedic surgery residency program directors (PDs) to determine these factors. PDs at all Army orthopaedic surgery residency programs were provided 17 factors historically considered critical to successful selection and asked to rank order the factors as well as assign a level of importance to each. Results were collated and overall mean rankings are provided. PDs unanimously expressed that performance during the on-site orthopaedic surgery rotation at the individual program director's institution was most important. Respondents overwhelmingly reported that Steps 1 and 2 licensing exam scores were next most important, respectively. Survey data demonstrated that little importance was placed on letters of recommendation and personal statements. PDs made no discriminations based on allopathic or osteopathic degrees. The most important factors for Army orthopaedic surgery residency selection were clerkship performance at the individual PD's institution and licensing examination score performance. Army PDs consider both USMLE and COMLEX results, because Army programs have a higher percentage of successful osteopathic applicants. PMID:25988694

  8. Accreditation Council for Graduate Medical Education Case Log: General Surgery Resident Thoracic Surgery Experience

    PubMed Central

    Kansier, Nicole; Varghese, Thomas K.; Verrier, Edward D.; Drake, F. Thurston; Gow, Kenneth W.

    2014-01-01

    Background General surgery resident training has changed dramatically over the past 2 decades, with likely impact on specialty exposure. We sought to assess trends in general surgery resident exposure to thoracic surgery using the Accreditation Council for Graduate Medical Education (ACGME) case logs over time. Methods The ACGME case logs for graduating general surgery residents were reviewed from academic year (AY) 1989–1990 to 2011–2012 for defined thoracic surgery cases. Data were divided into 5 eras of training for comparison: I, AY89 to 93; II, AY93 to 98; III, AY98 to 03; IV, AY03 to 08; V, AY08 to 12. We analyzed quantity and types of cases per time period. Student t tests compared averages among the time periods with significance at a p values less than 0.05. Results A total of 21,803,843 general surgery cases were reviewed over the 23-year period. Residents averaged 33.6 thoracic cases each in period I and 39.7 in period V. Thoracic cases accounted for nearly 4% of total cases performed annually (period I 3.7% [134,550 of 3,598,574]; period V 4.1% [167,957 of 4,077,939]). For the 3 most frequently performed procedures there was a statistically significant increase in thoracoscopic approach from period II to period V. Conclusions General surgery trainees today have the same volume of thoracic surgery exposure as their counterparts over the last 2 decades. This maintenance in caseload has occurred in spite of work-hour restrictions. However, general surgery graduates have a different thoracic surgery skill set at the end of their training, due to the predominance of minimally invasive techniques. Thoracic surgery educators should take into account these differences when training future cardiothoracic surgeons. PMID:24968766

  9. Cosmetic surgery in times of recession: macroeconomics for plastic surgeons.

    PubMed

    Krieger, Lloyd M

    2002-10-01

    Periods of economic downturn place special demands on the plastic surgeon whose practice involves a large amount of cosmetic surgery. When determining strategy during difficult economic times, it is useful to understand the macroeconomic background of these downturns and to draw lessons from businesses in other service industries. Business cycles and monetary policy determine the overall environment in which plastic surgery is practiced. Plastic surgeons can take both defensive and proactive steps to maintain their profits during recessions and to prepare for the inevitable upturn. Care should also be taken when selecting pricing strategy during economic slowdowns. PMID:12360083

  10. Surgery resident selection and evaluation. A critical incident study.

    PubMed

    Edwards, J C; Currie, M L; Wade, T P; Kaminski, D L

    1993-03-01

    This article reports a study of the process of selecting and evaluating general surgery residents. In personnel psychology terms, a job analysis of general surgery was conducted using the Critical Incident Technique (CIT). The researchers collected 235 critical incidents through structured interviews with 10 general surgery faculty members and four senior residents. The researchers then directed the surgeons in a two-step process of sorting the incidents into categories and naming the categories. The final essential categories of behavior to define surgical competence were derived through discussion among the surgeons until a consensus was formed. Those categories are knowledge/self-education, clinical performance, diagnostic skills, surgical skills, communication skills, reliability, integrity, compassion, organization skills, motivation, emotional control, and personal appearance. These categories were then used to develop an interview evaluation form for selection purposes and a performance evaluation form to be used throughout residency training. Thus a continuum of evaluation was established. The categories and critical incidents were also used to structure the interview process, which has demonstrated increased interview validity and reliability in many other studies. A handbook for structuring the interviews faculty members conduct with applicants was written, and an interview training session was held with the faculty. The process of implementation of the structured selection interviews is being documented currently through qualitative research. PMID:10124420

  11. Quality Metrics in Surgery Resident Performance of Screening Colonoscopy.

    PubMed

    Ortolani, John B; Zhong, Xin; Tershak, Daniel R; Ferrara, John J; Paget, Charles J

    2015-07-01

    In an attempt to further standardize surgical training, the American Board of Surgery now requires that residents provide evidence that they are certified in flexible endoscopy. This prospective study was designed to determine whether, through a structured curriculum, junior level residents could learn to conduct competent and safe screening colonoscopy (SC). An Institutional Review Board-approved prospective analysis of SC performed by five postgraduate year-2 residents during the 2012-2013 academic year was completed. All SC were performed under direct supervision of one of the two surgical endoscopists after each resident passed a structured endoscopy simulation curriculum. The following metrics of the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology were recorded: bowel prep quality; cecal intubation; withdrawal time; number of visualized polyps; procedural duration; final pathology; adenoma detection rate (ADR); and, complications. Power analysis revealed that 108 procedures were required for an 80 per cent probability of data analysis accuracy. (American Society for Gastrointestinal Endoscopy ASGE/American College of Gastroenterology benchmark values in parentheses): 166 colonoscopies were performed, of which 149 met inclusion criteria. Bowel prep was considered "excellent" or "good" in 90 per cent of cases. The cecum was reached in 96 per cent of cases. Mean withdrawal time was 12 minutes (≥6 minute). Average procedure time was 30 minutes (≤ 30 minute). Polyp(s) were visualized and removed in 30 per cent of patients. The overall adenoma detection rate was 22.8 per cent (>20%). The ADR for males was 29.5 per cent (>25%). The ADR for females was 18.2 per cent (>15%). Average polyp size was 7.7 mm (range: 2-25 mm). No patients were readmitted for bleeding or perforation. Within a structured learning environment, trained surgical endoscopists can teach junior level surgery residents to perform safe and competent screening colonoscopy. PMID:26140892

  12. Canadian vascular surgery residents' perceptions regarding future job opportunities.

    PubMed

    Cooper, Joel A; Dubois, Luc; Power, Adam H; DeRose, Guy; MacKenzie, Kent S; Forbes, Thomas L

    2015-06-01

    The objective was to determine the employment environment for graduates of Canadian vascular surgery training programs. A cross-sectional survey of residents and graduates (2011-2012) was used. Thirty-seven residents were invited with a response rate of 57%, and 14 graduates with a response rate of 71%; 70% of graduates felt the job market played an important role in their decision to pursue vascular surgery as a career compared to 43% of trainees. The top three concerns were the lack of surgeons retiring, the overproduction of trainees, and saturation of the job market. The majority (62%) of trainees see themselves extending their training due to lack of employment. All of the graduates obtained employment, with 50% during their second year (of two years) of training and 30% after training was completed. Graduates spent an average of 12 ± 10.6 months seeking a position and applied to 3.3 ± 1.5 positions, with a mean of 1.9 ± 1.3 interviews and 2 ± 1.2 offers. There was a discrepancy between the favorable employment climate experienced by graduates and the pessimistic outlook of trainees. We must be progressive in balancing the employment opportunities with the number of graduates. Number and timing of job offers is a possible future metric of the optimal number of residents. PMID:24966271

  13. A finite-element facial model for simulating plastic surgery.

    PubMed

    Pieper, S D; Laub, D R; Rosen, J M

    1995-10-01

    CAPS (Computer-Aided Plastic Surgery) is a prototype computer program that uses a three-dimensional graphic model of a human face and incorporates a finite-element mathematical model of the physical properties of the soft tissue. This program can estimate the biomechanic consequences of ablation and rearrangement of tissue. The results of two hypothetical surgeries on the face are presented: A surgeon could use this program as a sketch pad to predict and compare the outcome of facial plastic procedures on a patient-specific model. The relation of this program to previous work is discussed, and directions for research and possible applications are addressed. PMID:7568485

  14. Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models

    PubMed Central

    Maluf, Miguel Angel; Gomes, Walter José; Bras, Ademir Massarico; de Araújo, Thiago Cavalcante Vila Nova; Mota, André Lupp; Cardoso, Caio Cesar; Coutinho, Rafael Viana dos S.

    2015-01-01

    OBJECTIVE Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. METHODS First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. RESULTS The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. CONCLUSION 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art. PMID:26735604

  15. American plastic surgery and global health: a brief history.

    PubMed

    Hughes, Christopher D; Alkire, Blake; Martin, Christine; Semer, Nadine; Meara, John G

    2012-02-01

    Access to essential surgical care in resource-poor settings is gaining recognition as a major component of international public health efforts. As evidence is mounting about the burden of surgically treatable disease in low- and middle-income countries, so too is the evidence for the significant need for plastic surgery treatment of disease rising in these areas. American plastic surgery has a long history with international surgical efforts in resource-poor regions around the world. Early experiences were not formalized until after World War II, when a foundation partnership provided a venue for interested plastic surgeons to volunteer. These efforts progressed and advanced throughout the 1960s-1970s, but were ultimately devastated by the Vietnam War. Subsequent international plastic surgical experiences by American surgeons over the last 40 years have been largely through several nongovernmental organizations. American plastic surgical involvement in global surgery has changed significantly over the last 70 years. Although quality care is being delivered to resource-poor regions around the world, many of the challenges of regionally appropriate, sustainable care persist today. PMID:21301287

  16. Systematic survey of opinion regarding the thoracic surgery residency.

    PubMed

    Wilcox, B R; Stritter, F T; Anderson, R P; Gay, W A; Kaiser, G C; Orringer, M B; Rainer, W G; Replogle, R L

    1993-05-01

    To summarize this rather wide-ranging study, let us review the high points. The future practice of thoracic surgery will be increasingly affected by governmental factors and will have even greater technological dimensions. To do this work, we must continue to attract high-caliber individuals, and this is best accomplished by the early and continuing involvement in the educational process of strong role models from our field. These future surgeons must be motivated to do good work and should have high ethical standards as well as maturity and high intelligence. Experienced, involved faculty leading the residents through a broad program that offers graduated assumption of clinical and leadership responsibilities will facilitate the development of mature clinical judgment. Residents must be taught the clinical skills necessary to do all thoracic operations, leaving subspecialization to postresidency fellowships. The educational program should be humane in its demands and collegial in its application. It should incorporate experiences beyond the operating room, including the opportunity to read, think, and interact with local mentors and colleagues from around the country. The requirements of certification should not be so rigid as to preclude the development of different pathways to the same end. Likewise, although the accreditation process must protect the resident from exploitation, it must not be so restrictive that it does not allow for educational innovation and justifiable differences among programs. These are the thoughtful opinions of our colleagues. They deserve serious consideration. PMID:8494460

  17. Orthopedic Prosthetic Infections: Plastic Surgery Management.

    PubMed

    Meaike, Jesse D; Kaufman, Matthew G; Izaddoost, Shayan A

    2016-05-01

    Orthopedic prosthetic infections are potentially devastating complications. Plastic surgeons are frequently consulted to aid in the management of the soft tissue defects that are created by these infections. A review of the existing literature was performed to identify established treatment methods for soft tissue coverage of orthopedic hardware infections for a variety of anatomic locations. The following treatment guidelines and soft tissue reconstructive options were identified as viable options for the management of exposed or infected orthopedic hardware. This review provides descriptions of the various soft tissue reconstructive options available as well as adjunctive treatment methods. PMID:27152099

  18. New Guidelines Issued on Breast, Genital Plastic Surgery for Teen Girls

    MedlinePlus

    ... 158457.html New Guidelines Issued on Breast, Genital Plastic Surgery for Teen Girls Leading ob/gyn group says ... News) -- A growing interest among teenaged girls in plastic surgery on their breasts or genitals has prompted a ...

  19. [Third dimension and craniofacial plastic surgery].

    PubMed

    Devauchelle, B

    1995-12-01

    Via an inverse approach to that of the Renaissance painter's treatment of perspective, the third dimension must be obtained from flat radiological information in order to reconstitute (virtually and materially) the volumes which it analyses. These images are analysed mathematically by computer. The applications are and will be numerous, especially in cranio-maxillo-facial surgery. Surgical simulation, without claiming to assess their soft tissue repercussions, section and virtually reposition bone segments: symmetrization and correction of hypotrophy are easy to visualize; computer-assisted surgical teaching applications (endoscopic surgery) are discussed. Multimodal images superimpose information from various sources: operative views and pre-recorded images are available to the surgeon and guide him in his "surgical navigation". Prototyping of skeletal anatomical specimens (prior to tumour or soft tissue specimens) provides the therapist with a precise preoperative spatial configuration of the abnormalities to be corrected, and the reconstructions to be performed. These developments, and others to come, are the sole objective of 3D imaging, beautiful in itself, but ineffective alone. PMID:8787340

  20. Pricing strategy for aesthetic surgery: economic analysis of a resident clinic's change in fees.

    PubMed

    Krieger, L M; Shaw, W W

    1999-02-01

    The laws of microeconomics explain how prices affect consumer purchasing decisions and thus overall revenues and profits. These principles can easily be applied to the behavior aesthetic plastic surgery patients. The UCLA Division of Plastic Surgery resident aesthetics clinic recently offered a radical price change for its services. The effects of this change on demand for services and revenue were tracked. Economic analysis was applied to see if this price change resulted in the maximization of total revenues, or if additional price changes could further optimize them. Economic analysis of pricing involves several steps. The first step is to assess demand. The number of procedures performed by a given practice at different price levels can be plotted to create a demand curve. From this curve, price sensitivities of consumers can be calculated (price elasticity of demand). This information can then be used to determine the pricing level that creates demand for the exact number of procedures that yield optimal revenues. In economic parlance, revenues are maximized by pricing services such that elasticity is equal to 1 (the point of unit elasticity). At the UCLA resident clinic, average total fees per procedure were reduced by 40 percent. This resulted in a 250-percent increase in procedures performed for representative 4-month periods before and after the price change. Net revenues increased by 52 percent. Economic analysis showed that the price elasticity of demand before the price change was 6.2. After the price change it was 1. We conclude that the magnitude of the price change resulted in a fee schedule that yielded the highest possible revenues from the resident clinic. These results show that changes in price do affect total revenue and that the nature of these effects can be understood, predicted, and maximized using the tools of microeconomics. PMID:9950562

  1. Goals and Methodology for a Surgery Residency Program: A Committee Approach.

    ERIC Educational Resources Information Center

    Knecht, Charles D.; And Others

    1979-01-01

    Written goals of a small animal residency program established by Purdue University are identified and an elaborate list of methodology for goals is provided. Tables include: summary of required activities of residents, checklist of residency progress, and comparable effort for surgery residency and masters program. (Author/MLW)

  2. Resident Exposure to Peripheral Nerve Surgical Procedures During Residency Training.

    PubMed

    Gil, Joseph A; Daniels, Alan H; Akelman, Edward

    2016-05-01

    Background Variability in case exposures has been identified for orthopaedic surgery residents. It is not known if this variability exists for peripheral nerve procedures. Objective The objective of this study was to assess ACGME case log data for graduating orthopaedic surgery, plastic surgery, general surgery, and neurological surgery residents for peripheral nerve surgical procedures and to evaluate intraspecialty and interspecialty variability in case volume. Methods Surgical case logs from 2009 to 2014 for the 4 specialties were compared for peripheral nerve surgery experience. Peripheral nerve case volume between specialties was performed utilizing a paired t test, 95% confidence intervals were calculated, and linear regression was calculated to assess the trends. Results The average number of peripheral nerve procedures performed per graduating resident was 54.2 for orthopaedic surgery residents, 62.8 for independent plastic surgery residents, 84.6 for integrated plastic surgery residents, 22.4 for neurological surgery residents, and 0.4 for surgery residents. Intraspecialty comparison of the 10th and 90th percentile peripheral nerve case volume in 2012 revealed remarkable variability in training. There was a 3.9-fold difference within orthopaedic surgery, a 5.0-fold difference within independent plastic surgery residents, an 8.8-fold difference for residents from integrated plastic surgery programs, and a 7.0-fold difference within the neurological surgery group. Conclusions There is interspecialty and intraspecialty variability in peripheral nerve surgery volume for orthopaedic, plastic, neurological, and general surgery residents. Caseload is not the sole determinant of training quality as mentorship, didactics, case breadth, and complexity play an important role in training. PMID:27168883

  3. Nanotechnology and regenerative therapeutics in plastic surgery: The next frontier.

    PubMed

    Tan, Aaron; Chawla, Reema; G, Natasha; Mahdibeiraghdar, Sara; Jeyaraj, Rebecca; Rajadas, Jayakumar; Hamblin, Michael R; Seifalian, Alexander M

    2016-01-01

    The rapid ascent of nanotechnology and regenerative therapeutics as applied to medicine and surgery has seen an exponential rise in the scale of research generated in this field. This is evidenced not only by the sheer volume of papers dedicated to nanotechnology but also in a large number of new journals dedicated to nanotechnology and regenerative therapeutics specifically to medicine and surgery. Aspects of nanotechnology that have already brought benefits to these areas include advanced drug delivery platforms, molecular imaging and materials engineering for surgical implants. Particular areas of interest include nerve regeneration, burns and wound care, artificial skin with nanoelectronic sensors and head and neck surgery. This study presents a review of nanotechnology and regenerative therapeutics, with focus on its applications and implications in plastic surgery. PMID:26422652

  4. [Johann Friedrich Dieffenbach (1792-1847) as the founder of plastic surgery. His contribution to maxillofacial surgery].

    PubMed

    Schultheiss, D; Knöner, W; Kramer, F J; Jonas, U

    1998-11-01

    Johann Friedrich Dieffenbach (1792-1847) is generally known as the founder of modern plastic surgery. One focus of his work, apart from the physiology of transplantation and operative techniques, was reconstructive oral and maxillofacial surgery. This special aspect of plastic surgery as well as Dieffenbach's biography is presented in this historic article. PMID:9881000

  5. [Biomaterials in plastic and maxillofacial surgery].

    PubMed

    Lodd, J P

    1995-12-01

    The major progress in biomaterials over recent years have concerned osteosynthesis, reconstruction and creation of the shapes of bones and soft tissues and gluing. In the authors' field of osteosynthesis, "pure" medical titanium, particularly T40, is perfectly adapted to situations (face, hand) in which the bone constraints are much lower than those encountered in hip and long bone surgery. Two improvements can be recommended: reheated titanium T40 due to its improved ductility; cermets (ceramo-metallic biomaterials) which have an excellent biocompatibility and which allow bone-implant liaisons, particularly for the bony fixation of epithesis supports. Ceramics and coral can be safely used to fill bone defects, in situations with low constraints. Numerous products are available and improve each year. For an equal quality, it is preferable to use the least expensive. Numerous products are available for reconstruction or creation of soft tissues, but present various disadvantages such as collagen, which is not resorbed, collagen-bioceramic, bone-collagen, hydroxyapatite-gelatin composites have a promising future, but the follow-up is too short at the present time. Fluorinated polymers, of which Gore-Tex is the leader, have been used for about thirty years in multiple applications, and certainly have a great future. The technology of biological glues is difficult, but this line of research is very interesting and promising for glues derived from non-living substances. PMID:8787341

  6. Bioplastique as a complement in conventional plastic surgery.

    PubMed

    Nácul, A M; Nácul, A P; Greca de Born, A

    1998-01-01

    This research presents reports of cases where a biocompatible and alloplastic biomaterial-Bioplastique-was used, associated with conventional plastic surgery or as a complement to it, with the aim of achieving a better final aesthetic result. Four cases are presented where Bioplastique was used in association with rhytidoplasty, rhinoplasty, and other surgical techniques. This material has shown itself to be appropriate to complement surgery; achieving a final result which would not be possible without any resort to a complement or any other hard procedure by the surgeon and is not more traumatic for the patient. PMID:9852179

  7. A brief history of plastic surgery in Iran.

    PubMed

    Kalantar-Hormozi, Abdoljalil

    2013-03-01

     Although the exact time of performing plastic surgery is not addressed in the medical and historical literature, it can be supposed that these surgical procedures have a long and fascinating history.  Recent excavations provided many documents regarding the application of medical instruments, surgical and even reconstructive procedures during the pre-historic and ancient periods. Actually, there is no historical definite time-zone separating general and cosmetic operations in the pre-modern time; however, historically there have been many surgeons who tried to perform reconstructive procedures during their usual medical practice. This article presents a brief look at the history of plastic surgery form the ancient to the contemporary era, with a special focus on Iran. PMID:23432179

  8. Career evaluation and the decision process for plastic surgery graduates.

    PubMed

    Davison, Steven P; Clemens, Mark W

    2011-08-01

    National experience shows that 50 percent of physicians change positions within the first 2 years of practice. Because of market pressures, medicine in general and plastic surgery in particular are shifting away from solo practice. The authors examine the primary reasons for turnover and discuss job search priorities for recent plastic surgery graduates and established surgeons in job transition, with a current analysis of the different job opportunities available, ranging from government to private practice. The advantages and disadvantages of different positions are compared and income data are presented. Academic income is close to that of private practice at a mean of $366,141 annually but requires more work as measured by an overall higher relative value unit of productivity. The concept of creating a personal inventory before seeking the best job match is introduced. PMID:21788848

  9. On One Application of Fourier Analysis in Plastic Surgery

    NASA Astrophysics Data System (ADS)

    Rakhimov, Abdumalik; Zainuddin, Hishamuddin

    In present paper, we discuss the spectral methods of measurement of the degree of speech and/or quality of sound by comparing the coefficient of performance indicators depending on energy distributions, ratio of energy of the fundamental tone and energy of overtones. Such a method is very efficient for string oscillation with different initial conditions and it is useful for justification of applications of Fourier analysis in plastic surgery in treatment of some medical diseases.

  10. Management of Contaminated Autologous Grafts in Plastic Surgery

    PubMed Central

    Centeno, Robert F; Desai, Ankit R; Watson, Marla E

    2008-01-01

    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. PMID:18496583

  11. The role of the physiotherapy in the plastic surgery patients after oncological breast surgery

    PubMed Central

    Sandrin, Fabio

    2014-01-01

    Introduction Breast cancer is the disease which causes the greatest concern among women worldwide, with an estimated 1,152,161 new cases each year. The improvement of surgical techniques, neoadjuvant and adjuvant treatment enhance the survival time and recovery of these patients. As surgery is the first choice for the treatment of breast neoplasms reconstructive surgery has become an important procedure helping to reconstruct the mutilation after radical or conservative breast surgery. The objective of this article is to review the scientific literature and examine the available data regarding the role of physiotherapy in patients who undergo plastic reconstruction after oncological breast surgery, including suggestions on how physiotherapy could be applied in that population. Materials and methods Our review was obtained by searching the PubMed (National Library of Medicine, USA) and LILACS (Latin American and Caribbean Health Sciences) databases. Terms applied concerned physiotherapy and breast reconstructive surgery. The time of limit for our search was from 1995 until the present date. Results Fourteen articles were included in our review that matched our search criteria. Conclusions Physiotherapy is a field that still needs evidence based on daily routine and studies in the oncological physiotherapy field. Evaluation should be standardized and rehabilitation techniques used are empirical and should be researched in patients who undergo plastic reconstruction after breast surgery. The lack of post-surgery exercise protocols makes it difficult to analyse the patient’s evolution and makes it a challenge to investigate the true role of physiotherapy in this population. PMID:25083493

  12. The ACGME case log: General surgery resident experience in pediatric surgery

    PubMed Central

    Gow, Kenneth W.; Drake, F. Thurston; Aarabi, Shahram; Waldhausen, John H.

    2014-01-01

    Background General surgery (GS) residents in ACGME programs log cases performed during their residency. We reviewed designated pediatric surgery (PS) cases to assess for changes in performed cases over time. Methods The ACGME case logs for graduating GS residents were reviewed from academic year (AY) 1989–1990 to 2010–2011 for designated pediatric cases. Overall and designated PS cases were analyzed. Data were combined into five blocks: Period I (AY1989–90 to AY1993–94), Period II (AY1994–95 to AY1998–99), Period III (AY1999–00 to AY2002–03), Period IV (AY2003–04 to AY2006–07), and Period V (AY2007–08 to AY2010–11). Periods IV and V were delineated by implementation of duty hour restrictions. Student t-tests compared averages among the time periods with significance at P < .05. Results Overall GS case load remained relatively stable. Of total cases, PS cases accounted for 5.4% in Period I and 3.7% in Period V. Designated pediatric cases declined for each period from an average of 47.7 in Period I to 33.8 in Period V. These changes are due to a decline in hernia repairs, which account for half of cases. All other cases contributed only minimally to the pediatric cases. The only laparoscopic cases in the database were anti-reflux procedures, which increased over time. Conclusions GS residents perform a diminishing number of designated PS cases. This decline occurred before the onset of work-hour restrictions. These changes have implications on the capabilities of the current graduating workforce. However, the case log does not reflect all cases trainees may be exposed to, so revision of this list is recommended. PMID:23932601

  13. Emerging Applications of Bedside 3D Printing in Plastic Surgery

    PubMed Central

    Chae, Michael P.; Rozen, Warren M.; McMenamin, Paul G.; Findlay, Michael W.; Spychal, Robert T.; Hunter-Smith, David J.

    2015-01-01

    Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D) reconstructions, are limited by their representation on 2D workstations. 3D printing, also known as rapid prototyping or additive manufacturing, was once the province of industry to fabricate models from a computer-aided design (CAD) in a layer-by-layer manner. The early adopters in clinical practice have embraced the medical imaging-guided 3D-printed biomodels for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. With increasing accessibility, investigators are able to convert standard imaging data into a CAD file using various 3D reconstruction softwares and ultimately fabricate 3D models using 3D printing techniques, such as stereolithography, multijet modeling, selective laser sintering, binder jet technique, and fused deposition modeling. However, many clinicians have questioned whether the cost-to-benefit ratio justifies its ongoing use. The cost and size of 3D printers have rapidly decreased over the past decade in parallel with the expiration of key 3D printing patents. Significant improvements in clinical imaging and user-friendly 3D software have permitted computer-aided 3D modeling of anatomical structures and implants without outsourcing in many cases. These developments offer immense potential for the application of 3D printing at the bedside for a variety of clinical applications. In this review, existing uses of 3D printing in plastic surgery practice spanning the spectrum from templates for facial transplantation surgery through to the formation of bespoke craniofacial implants to optimize post-operative esthetics are described. Furthermore, we discuss the potential of 3D printing to become an essential office-based tool in plastic surgery to assist in preoperative planning, developing intraoperative guidance tools, teaching patients and surgical trainees, and producing patient-specific prosthetics in everyday surgical practice. PMID:26137465

  14. Emerging Applications of Bedside 3D Printing in Plastic Surgery.

    PubMed

    Chae, Michael P; Rozen, Warren M; McMenamin, Paul G; Findlay, Michael W; Spychal, Robert T; Hunter-Smith, David J

    2015-01-01

    Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D) reconstructions, are limited by their representation on 2D workstations. 3D printing, also known as rapid prototyping or additive manufacturing, was once the province of industry to fabricate models from a computer-aided design (CAD) in a layer-by-layer manner. The early adopters in clinical practice have embraced the medical imaging-guided 3D-printed biomodels for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. With increasing accessibility, investigators are able to convert standard imaging data into a CAD file using various 3D reconstruction softwares and ultimately fabricate 3D models using 3D printing techniques, such as stereolithography, multijet modeling, selective laser sintering, binder jet technique, and fused deposition modeling. However, many clinicians have questioned whether the cost-to-benefit ratio justifies its ongoing use. The cost and size of 3D printers have rapidly decreased over the past decade in parallel with the expiration of key 3D printing patents. Significant improvements in clinical imaging and user-friendly 3D software have permitted computer-aided 3D modeling of anatomical structures and implants without outsourcing in many cases. These developments offer immense potential for the application of 3D printing at the bedside for a variety of clinical applications. In this review, existing uses of 3D printing in plastic surgery practice spanning the spectrum from templates for facial transplantation surgery through to the formation of bespoke craniofacial implants to optimize post-operative esthetics are described. Furthermore, we discuss the potential of 3D printing to become an essential office-based tool in plastic surgery to assist in preoperative planning, developing intraoperative guidance tools, teaching patients and surgical trainees, and producing patient-specific prosthetics in everyday surgical practice. PMID:26137465

  15. Plastic surgery and the biometric e-passport: implications for facial recognition.

    PubMed

    Ologunde, Rele

    2015-04-01

    This correspondence comments on the challenges of plastic reconstructive and aesthetic surgery on the facial recognition algorithms employed by biometric passports. The limitations of facial recognition technology in patients who have undergone facial plastic surgery are also discussed. Finally, the advice of the UK HM passport office to people who undergo facial surgery is reported. PMID:25162924

  16. Plastic Surgeons' Opinions of Facial Surgery for Individuals with Down Syndrome.

    ERIC Educational Resources Information Center

    May, Deborah C.; Turnbull, Nancy

    1992-01-01

    One hundred plastic surgeons responded to a survey on opinions toward facial plastic surgery for individuals with Down's syndrome. Twenty-four of the surgeons had performed the surgery. Surgeons indicated appropriate circumstances for the surgery, consent requirements, degree of understanding expected of the patient, and degree of discomfort

  17. 75 FR 68972 - Medical Devices; General and Plastic Surgery Devices; Classification of Tissue Adhesive With...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-10

    ... HUMAN SERVICES Food and Drug Administration 21 CFR Part 878 Medical Devices; General and Plastic Surgery..., 21 CFR part 878 is amended as follows: PART 878--GENERAL AND PLASTIC SURGERY DEVICES 0 1. The... wounds from surgical incisions, including punctures from minimally invasive surgery, and...

  18. Plastic Surgeons' Opinions of Facial Surgery for Individuals with Down Syndrome.

    ERIC Educational Resources Information Center

    May, Deborah C.; Turnbull, Nancy

    1992-01-01

    One hundred plastic surgeons responded to a survey on opinions toward facial plastic surgery for individuals with Down's syndrome. Twenty-four of the surgeons had performed the surgery. Surgeons indicated appropriate circumstances for the surgery, consent requirements, degree of understanding expected of the patient, and degree of discomfort…

  19. The Utility of Outcome Studies in Plastic Surgery

    PubMed Central

    Sinno, Hani; Dionisopoulos, Tassos; Slavin, Sumner A.; Ibrahim, Ahmed M. S.; Chung, Kevin C.

    2014-01-01

    Summary: Outcome studies help provide the evidence-based science rationalizing treatment end results that factor the experience of patients and the impact on society. They improve the recognition of the shortcoming in clinical practice and provide the foundation for the development of gold standard care. With such evidence, health care practitioners can develop evidence-based justification for treatments and offer patients with superior informed consent for their treatment options. Furthermore, health care and insurance agencies can recognize improved cost-benefit options in the purpose of disease prevention and alleviation of its impact on the patient and society. Health care outcomes are ultimately measured by the treatment of disease, the reduction of symptoms, the normalization of laboratory results and physical measures, saving a life, and patient satisfaction. In this review, we outline the tools available to measure outcomes in plastic surgery and subsequently allow the objective measurements of plastic surgical conditions. Six major outcome categories are discussed: (1) functional measures; (2) preference-based measures and utility outcome scores; (3) patient satisfaction; (4) health outcomes and time; (5) other tools: patient-reported outcome measurement information system, BREAST-Q, and Tracking Operations and Outcomes for Plastic Surgeons; and (6) cost-effectiveness analysis. We use breast hypertrophy requiring breast reduction as an example throughout this review as a representative plastic surgical condition with multiple treatments available. PMID:25426372

  20. Sir William Arbuthnot Lane and His Contributions to Plastic Surgery.

    PubMed

    Breakey, Richard William F; Mulliken, John B

    2015-07-01

    Surgical subspecialties were just emerging at the turn of the 20th Century, before this time, general surgeons had to adjust their operative skills to address disorders throughout the body. Sir William Arbuthnot Lane was a British surgeon, whose restless mind led him to wander throughout the field of general surgery and beyond. Although controversial, he advanced in the repair of cleft lip and palate, introduced the "no touch" operative technique, internal fixation of fractures, and is credited as the first surgeon to perform open massage of the heart. During The Great War, he established the British Plastic Surgery unit at Sidcup and delegated the care of facial and jaw injuries to young Major Harold Gillies. Lane later founded The New Health Society, an organization that stimulated the natural food movement. Sadly, in his latter years Lane's thinking drifted further away from with the times and his professional credibility waned. Nevertheless, Lane's variegated life is of sufficient interest to deserve reassessment. PMID:26114517

  1. Measuring outcomes in craniofacial and pediatric plastic surgery.

    PubMed

    Wong, Karen W Y; Forrest, Christopher R; Goodacre, Tim E E; Klassen, Anne F

    2013-04-01

    This article discusses the measurement of outcomes in craniofacial and pediatric plastic surgery, using examples of craniosynostosis and cleft lip and/or palate (CLP). The challenges in measuring the standard outcomes of function, aesthetics, and health-related quality of life are discussed, along with the importance of developing evidence and studying quality improvement in this specialty. The need to define specific and comprehensive goals is discussed with a focus on patient-reported outcomes (PROs). Examples from the development of the CLEFT-Q, a PRO instrument for patients with CLP, are provided to support the need to seek the patient perspective. PMID:23506771

  2. Standardized photography in facial plastic surgery: pearls and pitfalls.

    PubMed

    Becker, D G; Tardy, M E

    1999-01-01

    Photographic images in facial plastic surgery play a critical role in photodocumentation, patient education, preoperative planning, and self-education. Consistent, uniform, high-quality photography allows the best opportunity for critical self-assessment and self-education. The purpose of this article is to review important elements in the production of standardized, uniform photographs with a 35-mm camera or with a digital camera. Equipment, lighting and background, film selection, and a standardized photographic technique are detailed. Principles of intraoperative photography are also reviewed. PMID:11816129

  3. A tribute to the founding figures of the American Board of Plastic Surgery.

    PubMed

    Singh, Mansher; Noone, R Barrett; Afolabi, Halimat; Caterson, Edward J

    2015-06-01

    The American Board of Plastic Surgery recently celebrated its 75th anniversary as an established specialty board. This historical article provides an outline of the events that led to the formation of the American Board of Plastic Surgery and gives insight into the personalities and achievements of the key individuals whose unique talents coalesced into a common vision of making plastic surgery the diverse and well-respected specialty that it is today. This is a historical literature review outlining the circumstances leading to the formation of American Board of Plastic Surgery. The emphasis on the role of its founding fathers is reviewed and detailed in the article. The founding figures continue to inspire us through their unrelenting dedication to the field of plastic surgery. Over the past 75 years, the field of plastic surgery has been very well served by their successors, and these founding figures have fostered a surgical specialty of great repute. PMID:25724058

  4. Reduction Mammoplasty: A Comparison Between Operations Performed by Plastic Surgery and General Surgery

    PubMed Central

    Kordahi, Anthony M.; Lee, Edward S.

    2015-01-01

    Background: Reduction mammoplasty is an often-performed procedure by plastic surgeons and increasingly by general surgeons. The question has been posed in both general surgical literature and plastic surgical literature as to whether this procedure should remain the domain of surgical specialists. Some general surgeons are trained in breast reductions, whereas all plastic surgeons receive training in this procedure. The National Surgical Quality Improvement Project provides a unique opportunity to compare the 2 surgical specialties in an unbiased manner in terms of preoperative comorbidities and 30-day postoperative complications. Methods: The National Surgical Quality Improvement Project database was queried for the years 2005–2012. Patients were identified as having undergone a reduction mammoplasty by Current Procedural Terminology codes. Results were refined to include only females with an International Classification of Diseases, Ninth Revision, code of 611.1 (hypertrophy of breasts). Information was collected regarding age, surgical specialty performing procedure, body mass index, and other preoperative variables. The outcomes utilized were presence of superficial surgical site infection, presence of deep surgical site infection, presence of wound dehiscence, postoperative respiratory compromise, pulmonary embolism, deep vein thrombosis, perioperative transfusion, operative time, reintubation, reoperation, and length of hospital stay. Results: During this time period, there were 6239 reduction mammaplasties performed within the National Surgical Quality Improvement Project database: 339 by general surgery and 5900 by plastic surgery. No statistical differences were detected between the 2 groups with regard to superficial wound infections, deep wound infections, organ space infections, or wound dehiscence. There were no significant differences noted between within groups with regard to systemic postoperative complications. Patients undergoing a procedure by general surgery were more likely to experience a failure of skin flaps, necessitating a return to the operative room (P < .05). Operative time was longer in procedures performed by general surgery (P < .05). Conclusion: Several important differences appear to exist between reduction mammaplasties performed by general surgery and plastic surgery. A focused training in reduction mammoplasty appears to be beneficial to the patient. The limitations of this study include a lack of long-term follow-up with regard to aesthetic outcome, nipple malposition, nipple sensation, and late wound sequelae. PMID:26435766

  5. Value-based purchasing paradigms for facial plastic surgery.

    PubMed

    Berman, Bettina; Friedman, Craig D

    2010-08-01

    The United States spends more per capita for health care than any other nation in the world. Unfortunately, this expenditure has not necessarily translated into improved patient outcomes. Technological advances coupled with an aging population have contributed to a steady increase in health care spending, projected to have reached $2.5 trillion in 2009. Until recently, facial plastic surgeons have not given attention to value-based purchasing and pay-for-performance paradigms, perceiving these quality agendas as primarily applicable to primary care physicians and chronic disease management. As the use of quality measure factors in physician reimbursement schemes for primary medical care becomes more prevalent, it is imperative that surgical specialists have better insight and knowledge of these trends and their impact. This review will define quality and outcomes parameters in conjunction with an analysis of how outcomes may, in the future, be attached to reimbursement for facial plastic surgeons. Illustration of common facial plastic surgery procedures and potential quality/outcome/performance schema will highlight key elements to assist these surgeons in preparing for the transformation of the health care system to quality and outcomes metrics. PMID:20665405

  6. Multiple timescales of body schema reorganization due to plastic surgery.

    PubMed

    Iodice, Pierpaolo; Scuderi, Nicolò; Saggini, Raoul; Pezzulo, Giovanni

    2015-08-01

    Plastic surgery modifies the distribution of mass centers of a person's body segments, changing his or her posture. The functional reorganization processes that lead subjects to re-integrate these body changes into a new stable body (posture) schema is poorly understood but current theories suggest the possible contribution of two components: a feedback mechanism that strongly depends on sensory input and an internal model that is relatively less dependent on sensory input and improves posture control, for example by compensating for delayed feedback. To assess the relative contributions of these two mechanisms during the functional reorganization of a posture scheme, we have conducted a longitudinal postural study in a population of healthy adults who were subject to breast plastic surgery to reduce or augment body weight. We measured participants' orthostatic posture and ground reaction force immediately after, after 4 months, and 1 year after the surgery. To investigate the role of visual sensory information in the reorganization process we tested the participants with eyes open and closed. Our results indicate that participants find a new dynamical equilibrium within a few days. However, posture maintenance remains sub-optimal long after the center of masses and the resultant of ground reaction force stop changing; in some cases, for more than 4 months. Furthermore, the re-adaptation process is faster and more efficient in the eyes-open than in the eyes-closed condition. These results suggest that the reorganization involves different subsystems (responsible for the biomechanical changes, the re-calibration of feedback mechanisms, and the re-adaptation of internal models), which act at different timescales. PMID:25964999

  7. Reaching Our Successors: Millennial Generation Medical Students and Plastic Surgery as a Career Choice

    PubMed Central

    Ibrahim, Abdulrasheed; Asuku, Malachy E

    2016-01-01

    Background: Research shows that career choices are made as a result of preconceived ideas and exposure to a specialty. If plastic surgery is to continue to attract the best, factors that may dissuade the millennial generation medical students from pursuing plastic surgery as a career must be identified and addressed. We explored the determinants of interest in plastic surgery as a career choice amongst millennial generation medical students. Materials and Methods: A survey regarding factors considered important in choosing plastic surgery was conducted amongst final year medical students in September 2011. Participants were asked to rate their agreement or disagreement with 18 statements on a four-point Likert scale (1 = very unimportant; 4 = very important). Statistical analyses were performed using Chi-square test to compare categorical variables between male and female medical students. Values of P < 0.05 were considered significant. Results: The most important factors influencing the decision of medical students to choose plastic surgery as a career include; plastic surgeons appear happy in their work 93 (85%), Plastic surgeons have rewarding careers 78 (71%), and plastic surgeons provide good role models for medical students 96 (87%). An overall score of > 3.0 was seen in all the subscales except in gender equity and life style concerns. There were statistically significant differences between male and female students in opinions of a spouse, a significant other, or family members in choosing plastic surgery P < 0.5 and my choice of plastic surgery will be influenced by my decision to have a family P < 0.5. Conclusion: Factors influencing the decision of medical students to choose plastic surgery were related to the perceived quality of life as a plastic surgeon and the ability of plastic surgeons to provide good role models for medical students. Female medical students were more concerned with gender equity and work-life balance in selecting plastic surgery compared to male medical students. PMID:27013852

  8. Aesthetic surgery economics: lessons from corporate boardrooms to plastic surgery practices.

    PubMed

    Krieger, L M; Shaw, W W

    2000-03-01

    Healthcare traditionally has been described as not conforming to the laws of economics. Consumers pay for aesthetic surgery directly, thus freeing it from the usual confounding factors and making it more likely to comply with the market forces explained by economics. Recent studies have demonstrated the ability of classic economics to analyze, predict, and optimize the financial environment of aesthetic surgery. This article describes economic principles and how they can be applied to aesthetic surgery. Some of the basic instruments of economics include the study of supply and demand, prices, and price elasticity; capital investments; communication and cooperation; and consumer cognitive limitations. Each of these tools offers plastic surgeons the opportunity to gain improved control of their financial environment. PMID:10724282

  9. The transforming training pathway of plastic and craniofacial surgery in China.

    PubMed

    Pan, Sida; Yin, Kanhua; Zhang, Yang; Xu, Haisong; Wei, Min

    2015-03-01

    The history of plastic surgery in China dates back to about 17 centuries ago when Chinese ancestors documented a case of cleft lip repair, whereas the concepts of modern plastic surgery were imported from the West. In the last 50 years, the Chinese plastic surgeons have thrived and, through their hard work and even harder-gained experiences, witnessed the emergence of microsurgery in the 1960s, the development of craniofacial surgery during the 1970s, and cosmetic surgery becoming a trend since 1980s.With the fast renovation of treatment methods and the broadened spectrum of indications, more specialists with solid basic science knowledge and adequate clinical experience are needed for providing plastic, reconstructive, and aesthetic treatment. Attempts and efforts have been made to establish a suitable training system in China for plastic surgeons and plastic subspecialists recently, which led to the transformation of pathway for one to become a plastic surgeon and provoked thoughts upon the upcoming challenges. PMID:25699531

  10. Learning styles of medical students, general surgery residents, and general surgeons: implications for surgical education

    PubMed Central

    2010-01-01

    Background Surgical education is evolving under the dual pressures of an enlarging body of knowledge required during residency and mounting work-hour restrictions. Changes in surgical residency training need to be based on available educational models and research to ensure successful training of surgeons. Experiential learning theory, developed by David Kolb, demonstrates the importance of individual learning styles in improving learning. This study helps elucidate the way in which medical students, surgical residents, and surgical faculty learn. Methods The Kolb Learning Style Inventory, which divides individual learning styles into Accommodating, Diverging, Converging, and Assimilating categories, was administered to the second year undergraduate medical students, general surgery resident body, and general surgery faculty at the University of Alberta. Results A total of 241 faculty, residents, and students were surveyed with an overall response rate of 73%. The predominant learning style of the medical students was assimilating and this was statistically significant (p < 0.03) from the converging learning style found in the residents and faculty. The predominant learning styles of the residents and faculty were convergent and accommodative, with no statistically significant differences between the residents and the faculty. Conclusions We conclude that medical students have a significantly different learning style from general surgical trainees and general surgeons. This has important implications in the education of general surgery residents. PMID:20591159

  11. Incorporating skin care into a facial plastic surgery practice.

    PubMed

    TerKonda, Raj P

    2004-02-01

    Starting a skin care practice takes patience and dedication, but it provides your patients with a necessary service for a comprehensive facial plastic and reconstructive surgery practice. This article discusses the differences between physician-directed skin care and spa-directed skin care and emphasizes procedures that may be performed by an aesthetician in a physician's office. Skin care practice can be classified into skin care regimens: chemical peels, microdermabrasion, and makeup. Optimal skin care regimens incorporate pharmaceutical-grade ingredients, including tretinoin, topical vitamin C, and hydroquinone. Microdermabrasion and superficial chemical peels, such as glycolic, salicylic, and trichloroacetic acid peels, are discussed. Noninvasive procedures by the physician, such as Botox and laser treatments, complement the procedures performed by the aesthetician. However, the physician is ultimately responsible for the philosophy of the skin care practice. Patient education, customer service, and skin health are key ingredients for success. PMID:15034808

  12. [Plastic surgery of extended defects after exenteration of the pelvis].

    PubMed

    Abdou, A; Bruns, H; Troja, A; Antolovic, D; Li, L; Raab, H-R

    2015-04-01

    Extended resections of pelvic malignancies, especially in cases of recurrent malignancies, result in the formation of large tissue defects in the region of the pelvic floor and perineum, which are difficult to deal with. Both after extra levator rectal excision and pelvic exenteration, wound healing deficiencies and local infections of the perineal wound are frequent. Primary closure is often impossible due to a lack of tissue substance after resection and an additional previous radiotherapy in most cases. This can result in poor or non-healing wounds, a consecutive need of complex care and an increased risk of secondary problems including tumour recurrences. A permanent wound closure of good quality can therefore only be achieved by plastic surgery. This can be done by local or distant muscle flaps with or without skin, for example, the gluteus maximus flap, the vertical rectus abdominis muscle flap (VRAM) or free flaps such as the latissimus dorsi flap. PMID:25874472

  13. Incorporating resident/fellow training into a robotic surgery program.

    PubMed

    Vetter, Monica Hagan; Green, Isabel; Martino, Martin; Fowler, Jeffrey; Salani, Ritu

    2015-12-01

    With the rapid uptake of the robotic approach in gynecologic surgery, a thorough understanding of the technology, including its uses and limitations, is critical to maximize patient outcomes and safety. This review discusses the role of training modalities and development of curricula for robotic surgery. Furthermore, methods for incorporating the entire surgical team and the process of credentialing/maintaining privileges are described. PMID:26289120

  14. 76 FR 20840 - Medical Devices; General and Plastic Surgery Devices; Classification of the Low Level Laser...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 878 Medical Devices; General and Plastic Surgery... PLASTIC SURGERY DEVICES 0 1. The authority citation for 21 CFR part 878 continues to read as...

  15. 75 FR 70112 - Medical Devices; General and Plastic Surgery Devices; Classification of Non-Powered Suction...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-17

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 878 Medical Devices; General and Plastic Surgery...--GENERAL AND PLASTIC SURGERY DEVICES 0 1. The authority citation for 21 CFR part 878 continues to read...

  16. 76 FR 43119 - Medical Devices; General and Plastic Surgery Devices; Classification of the Focused Ultrasound...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 878 Medical Devices; General and Plastic Surgery... PLASTIC SURGERY DEVICES 0 1. The authority citation for 21 CFR part 878 continues to read as...

  17. Plastic Surgery Intervention with Down Syndrome Persons: Summary of a Conference.

    ERIC Educational Resources Information Center

    Exceptional Parent, 1983

    1983-01-01

    The article discusses the role of plastic surgery for persons with Down Syndrome, as considered in a recent conference. The functions of team plastic surgery, importance of intensive speech therapy, and the question of ultimate therapeutic value are among questions considered. (CL)

  18. Leg ulcer plastic surgery descent by laser therapy

    NASA Astrophysics Data System (ADS)

    Telfer, Jacqui; Filonenko, Natalia; Salansky, Norman M.

    1994-02-01

    Low energy laser therapy (LELT) was used to treat chronic leg ulcers. Seven patients, aged 59 to 96 years, with 11 leg ulcers were referred for laser therapy by plastic surgeons. They had a history of ulceration of 3 - 50 years and five of the patients had breakdown of previous skin grafts. Laser treatments were administered with a microprocessor-controlled device. A 22 red ((lambda) equals 660 nm) laser head was utilized to provide a dose of (4 - 6) J/cm2 and 7 infrared ((lambda) equals 880 nm) head to provide a dose of (4 - 8) J/cm2. The patients were treated three to five times per week, 25 - 30 treatments per course. Three patients underwent two courses of laser therapy with three weeks interval between them. All patients, after 5 - 10 laser treatments, have gotten relief of pain and decreased the amount of analgesics used. All ulcers in six patients were completely healed and two ulcers in the seventh patient decreased in size by 75%. One may conclude the developed laser methodology might be used as a preventative measure to avoid plastic surgery or improve its success.

  19. Cloud-Based Applications for Organizing and Reviewing Plastic Surgery Content

    PubMed Central

    Luan, Anna; Momeni, Arash; Lee, Gordon K.

    2015-01-01

    Cloud-based applications including Box, Dropbox, Google Drive, Evernote, Notability, and Zotero are available for smartphones, tablets, and laptops and have revolutionized the manner in which medical students and surgeons read and utilize plastic surgery literature. Here we provide an overview of the use of Cloud computing in practice and propose an algorithm for organizing the vast amount of plastic surgery literature. Given the incredible amount of data being produced in plastic surgery and other surgical subspecialties, it is prudent for plastic surgeons to lead the process of providing solutions for the efficient organization and effective integration of the ever-increasing data into clinical practice. PMID:26576208

  20. Cloud-Based Applications for Organizing and Reviewing Plastic Surgery Content.

    PubMed

    Luan, Anna; Momeni, Arash; Lee, Gordon K; Galvez, Michael G

    2015-01-01

    Cloud-based applications including Box, Dropbox, Google Drive, Evernote, Notability, and Zotero are available for smartphones, tablets, and laptops and have revolutionized the manner in which medical students and surgeons read and utilize plastic surgery literature. Here we provide an overview of the use of Cloud computing in practice and propose an algorithm for organizing the vast amount of plastic surgery literature. Given the incredible amount of data being produced in plastic surgery and other surgical subspecialties, it is prudent for plastic surgeons to lead the process of providing solutions for the efficient organization and effective integration of the ever-increasing data into clinical practice. PMID:26576208

  1. CURRENT STATUS OF RESIDENCY TRAINING IN LAPAROSCOPIC SURGERY IN BRAZIL: A CRITICAL REVIEW

    PubMed Central

    NÁCUL, Miguel Prestes; CAVAZZOLA, Leandro Totti; de MELO, Marco Cezário

    2015-01-01

    Introduction The surgeon's formation process has changed in recent decades. The increase in medical schools, new specialties and modern technologies induce an overhaul of medical education. Medical residency in surgery has established itself as a key step in the formation of the surgeon, and represents the ideal and natural way for teaching laparoscopy. However, the introduction of laparoscopic surgery in the medical residency programs in surgical specialties is insufficient, creating the need for additional training after its termination. Objective To review the surgical teaching ways used in services that published their results. Methods Survey of relevant publications in books, internet and databases in PubMed, Lilacs and Scielo through july 2014 using the headings: laparoscopy; simulation; education, medical; learning; internship and residency. Results The training method for medical residency in surgery focused on surgical procedures in patients under supervision, has proven successful in the era of open surgery. However, conceptually turns as a process of experimentation in humans. Psychomotor learning must not be developed directly to the patient. Training in laparoscopic surgery requires the acquisition of psychomotor skills through training conducted initially with surgical simulation. Platforms based teaching problem solving as the Fundamentals of Laparoscopic Surgery, developed by the American Society of Gastrointestinal Endoscopic Surgery and the Laparoscopic Surgical Skills proposed by the European Society of Endoscopic Surgery has been widely used both for education and for the accreditation of surgeons worldwide. Conclusion The establishment of a more appropriate pedagogical process for teaching laparoscopic surgery in the medical residency programs is mandatory in order to give a solid surgical education and to determine a structured and safe professional activity. PMID:25861077

  2. Are plastic surgery advertisements conforming to the ethical codes of the american society of plastic surgeons?

    PubMed

    Spilson, Sandra V; Chung, Kevin C; Greenfield, Mary Lou V H; Walters, Madonna

    2002-03-01

    Cosmetic surgeons have increasingly come under fire for using advertisements that may be deceptive or intended for the solicitation of vulnerable consumers. However, aesthetic surgery is a growing business that relies heavily on advertising to survive. To prevent the use of deceptive advertisements, the American Society of Plastic Surgeons has developed a code of ethics for its physician members. We conducted a study to determine the prevalence of cosmetic surgery advertisements considered objectionable by the lay public. These advertisements were published in the Yellow Pages of the 10 largest U.S. cities. Because all of the advertisements in this study contained the American Society of Plastic Surgeons logo, we also determined whether its members are upholding the ethical code of advertising. We asked a convenience sample of 50 participants to rate 104 advertisements using four yes/no questions derived from the code of ethics and one overall yes/no question regarding whether the advertisement was objectionable. We obtained the mean percentage of "yes" responses for each advertisement, from the total sample, for each question. We found that the study participants felt that 25 percent of the advertisements used images of persons or facsimiles that falsely and deceptively created unjustified expectations of favorable results. The participants responded that 22 percent of the advertisements appealed primarily to the layperson's fears, anxieties, or emotional vulnerabilities. In addition, 18 percent of the advertisements were considered to be objectionable. Discretion is currently left up to physicians as to the ethical nature of their advertisements. Although the majority of American Society of Plastic Surgeons members uphold the ethical code of advertising, there are still a substantial number of published advertisements that the average consumer considers to be in violation of this code. PMID:11884856

  3. Impact of Subspecialty Fellowship Training on Research Productivity Among Academic Plastic Surgery Faculty in the United States

    PubMed Central

    Therattil, Paul J.; Chung, Stella; Lee, Edward S.

    2015-01-01

    Purpose: The impact of subspecialty fellowship training on research productivity among academic plastic surgeons is unknown. The authors’ aim of this study was to (1) describe the current fellowship representation in academic plastic surgery and (2) evaluate the relationship between h-index and subspecialty fellowship training by experience and type. Methods: Academic plastic surgery faculty (N = 590) were identified through an Internet-based search of all ACGME-accredited integrated and combined residency programs. Research output was measured by h-index from the Scopus database as well as a number of peer-reviewed publications. The Kruskal-Wallis test, with a subsequent Mann-Whitney U test, was used for statistical analysis to determine correlations. Results: In the United States, 72% (n = 426) of academic plastic surgeons had trained in 1 or more subspecialty fellowship program. Within this cohort, the largest group had completed multiple fellowships (28%), followed by hand (23%), craniofacial (22%), microsurgery (15%), research (8%), cosmetic (3%), burn (2%), and wound healing (0.5%). Higher h-indices correlated with a research fellowship (12.5; P < .01) and multiple fellowships (10.4; P < .01). Craniofacial-trained plastic surgeons demonstrated the next highest h-index (9.8), followed by no fellowship (8.4), microsurgery (8.3), hand (7.7), cosmetic (5.2), and burn (5.1). Conclusion: Plastic surgeons with a research fellowship or at least 2 subspecialty fellowships had increased academic productivity compared with their colleagues. Craniofacial-trained physicians also demonstrated a higher marker for academic productivity than multiple other specialties. In this study, we show that the type and number of fellowships influence the h-index and further identification of such variables may help improve academic mentorship and productivity within academic plastic surgery. PMID:26664673

  4. Long-term Outcomes of Performing a Postdoctoral Research Fellowship During General Surgery Residency

    PubMed Central

    Robertson, Charles M.; Klingensmith, Mary E.; Coopersmith, Craig M.

    2007-01-01

    Objective: To determine whether dedicated research time during surgical residency leads to funding following postgraduate training. Summary Background Data: Unlike other medical specialties, a significant number of general surgery residents spend 1 to 3 years in dedicated laboratory research during their training. The impact this has on obtaining peer reviewed research funding after residency is unknown. Methods: Survey of all graduates of an academic general surgery resident program from 1990 to 2005 (n = 105). Results: Seventy-five (71%) of survey recipients responded, of which 66 performed protected research during residency. Fifty-one currently perform research (mean effort, 26%; range, 2%–75%). Twenty-three respondents who performed research during residency (35%) subsequently received independent faculty funding. Thirteen respondents (20%) obtained NIH grants following residency training. The number of papers authored during resident research was associated with obtaining subsequent faculty grant support (9.3 vs. 5.2, P = 0.02). Faculty funding was associated with obtaining independent research support during residency (42% vs. 17%, P = 0.04). NIH-funded respondents spent more combined years in research before and during residency (3.7 vs. 2.8, P = 0.02). Academic surgeons rated research fellowships more relevant to their current job than private practitioners (4.3 vs. 3.4 by Likert scale, P < 0.05). Both groups considered research a worthwhile use of their time during residency (4.5 vs. 4.1, P = not significant). Conclusions: A large number of surgical trainees who perform a research fellowship in the middle of residency subsequently become funded investigators in this single-center survey. The likelihood of obtaining funding after residency is related to productivity and obtaining grant support during residency as well as cumulative years of research prior to obtaining a faculty position. PMID:17414597

  5. Integrated surgical residency initiative: implications for cardiothoracic surgery.

    PubMed

    Ikonomidis, John S; Crawford, Fred A; Fann, James I

    2014-01-01

    The history, conceptualization, and implementation of the integrated six year cardiothoracic residency paradigm is discussed. Emphasis is placed of critcal logistical points, as well as the challenges associated with obtaining operative case requirements. Strategies for providing and monitoring didactic and technical skills education are presented. PMID:24952753

  6. Program Director Opinions of Core Competencies in Hand Surgery Training: Analysis of Differences Between Plastic and Orthopedic Surgery Accredited Programs

    PubMed Central

    Sears, Erika Davis; Larson, Bradley P.; Chung, Kevin C.

    2016-01-01

    Background The aim of this study was to conduct a national survey of hand surgery fellowship program directors to determine differences of opinions of essential components of hand surgery training among program directors from plastic and orthopedic surgery programs. Methods We performed a web-based survey of 74 program directors from all ACGME accredited hand surgery fellowship programs to determine components that are essential for hand surgery training. The survey included assessment of 9 general areas of practice, 97 knowledge topics, and 172 procedures. 27 scales of related survey items were created to determine differences between specialty groups based on clinical themes. Results We had an 84% response rate, including 49 orthopedic and 12 plastic surgery program directors. There were significant differences in mean responses between the specialty groups in 11 of 27 scales. Only one scale, forearm fractures, contained items with a significantly stronger preference for essential rating among orthopedic surgeons. The other 10 scales contained items with a significantly higher preference for essential rating among plastic surgeons, most of which related to soft tissue injury and reconstruction. The burn scale had the greatest discrepancy in opinion of essential ratings between the groups, followed by pedicled and free tissue transfer, and amputation and fingertip injuries. Conclusions Despite being united under the subspecialty of hand surgery, program directors tend to emphasize clinical areas that are stressed in their respective primary disciplines. These differences promote the advantage of programs providing exposure to both plastic and orthopedic surgery trained hand surgeons. PMID:23446569

  7. Plastic Surgery on Children with Down Syndrome: Parents' Perceptions of Physical, Personal, and Social Functioning.

    ERIC Educational Resources Information Center

    Kravetz, Shlomo; And Others

    1992-01-01

    This study compared perceptions of parents of 19 children with Down's syndrome (DS) who had undergone plastic facial surgery with perceptions of parents of DS children who had not received surgery. The comparison found little evidence of positive impact of the surgery on parents' perceptions of their children's physical, personal, and social

  8. Plastic Surgery on Children with Down Syndrome: Parents' Perceptions of Physical, Personal, and Social Functioning.

    ERIC Educational Resources Information Center

    Kravetz, Shlomo; And Others

    1992-01-01

    This study compared perceptions of parents of 19 children with Down's syndrome (DS) who had undergone plastic facial surgery with perceptions of parents of DS children who had not received surgery. The comparison found little evidence of positive impact of the surgery on parents' perceptions of their children's physical, personal, and social…

  9. The effects of the addition of a pediatric surgery fellow on the operative experience of the general surgery resident.

    PubMed

    Raines, Alexander; Garwe, Tabitha; Adeseye, Ademola; Ruiz-Elizalde, Alejandro; Churchill, Warren; Tuggle, David; Mantor, Cameron; Lees, Jason

    2015-06-01

    Adding fellows to surgical departments with residency programs can affect resident education. Our specific aim was to evaluate the effect of adding a pediatric surgery (PS) fellow on the number of index PS cases logged by the general surgery (GS) residents. At a single institution with both PS and GS programs, we examined the number of logged cases for the fellows and residents over 10 years [5 years before (Time 1) and 5 years after (Time 2) the addition of a PS fellow]. Additionally, the procedure related relative value units (RVUs) recorded by the faculty were evaluated. The fellows averaged 752 and 703 cases during Times 1 and 2, respectively, decreasing by 49 (P = 0.2303). The residents averaged 172 and 161 cases annually during Time 1 and Time 2, respectively, decreasing by 11 (P = 0.7340). The total number of procedure related RVUs was 4627 and 6000 during Times 1 and 2, respectively. The number of cases logged by the PS fellows and GS residents decreased after the addition of a PS fellow; however, the decrease was not significant. Programs can reasonably add an additional PS fellow, but care should be taken especially in programs that are otherwise static in size. PMID:26031275

  10. 21 CFR 878.4810 - Laser surgical instrument for use in general and plastic surgery and in dermatology.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... plastic surgery and in dermatology. 878.4810 Section 878.4810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4810 Laser surgical instrument for use in general and plastic surgery and...

  11. 21 CFR 878.4810 - Laser surgical instrument for use in general and plastic surgery and in dermatology.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... plastic surgery and in dermatology. 878.4810 Section 878.4810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4810 Laser surgical instrument for use in general and plastic surgery and...

  12. 21 CFR 878.4810 - Laser surgical instrument for use in general and plastic surgery and in dermatology.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... plastic surgery and in dermatology. 878.4810 Section 878.4810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4810 Laser surgical instrument for use in general and plastic surgery and...

  13. 21 CFR 878.4810 - Laser surgical instrument for use in general and plastic surgery and in dermatology.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... plastic surgery and in dermatology. 878.4810 Section 878.4810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4810 Laser surgical instrument for use in general and plastic surgery and...

  14. 21 CFR 878.4810 - Laser surgical instrument for use in general and plastic surgery and in dermatology.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... plastic surgery and in dermatology. 878.4810 Section 878.4810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4810 Laser surgical instrument for use in general and plastic surgery and...

  15. Integrating educational objectives and the evaluation process in a general surgery residency program.

    PubMed

    Leibrandt, T J; Kukora, J S; Dent, T L

    2001-07-01

    Although the Accreditation Council for Graduate Medical Education (ACGME) requires that all of its approved residency programs have written goals and objectives and an evaluation process, many programs have difficulty achieving these goals. For eight years, the general surgery residency program at Abington Memorial Hospital has used a system that integrates each rotation's cognitive, clinical, and procedural objectives into the faculty's evaluation of residents and residents' evaluation of the rotation. The integration of goals and objectives with the post-rotation evaluations provides the program with an ongoing and continual assessment of each resident's progress, the effectiveness of the faculty as teachers, and the educational value of each rotation. In this essay, the authors describe this integrated system and provide examples of one rotation's goals and objectives and the evaluation forms used by faculty and residents. PMID:11448835

  16. Providing mentorship support to general surgery residents: a model for structured group facilitation

    PubMed Central

    Champion, Caitlin; Bennett, Sean; Carver, David; El Tawil, Karim; Fabbro, Sarah; Howatt, Neil; Noei, Farahnaz; Rae, Rachel; Haggar, Fatima; Arnaout, Angel

    2015-01-01

    Summary Mentorship is foundational to surgical training, with recognized benefits for both mentees and mentors. The University of Ottawa General Surgery Mentorship Program was developed as a module-based group facilitation program to support inclusive personal and professional development of junior general surgery residents. The group format provided an opportunity for both vertical and horizontal mentorship relationships between staff mentors and resident mentees. Perceived benefits of program participants were evaluated at the conclusion of the first year of the program. The program was well-received by staff and resident participants and may provide a time-efficient and inclusive mentorship structure with the additional benefit of peer support. We review the development and implementation of the program to date and share our mentorship experience to encourage the growth of formal mentorship opportunities within general surgery training programs. PMID:26424687

  17. Coprocessing of waste plastics with coal and petroleum resid using different catalysts

    SciTech Connect

    Hyun Ku Joo; Curtis, C.W.

    1996-12-31

    Waste plastics are a source of hydrocarbons that are currently not being used effectively. Only {approximately}2% of the plastics are being recycled, and the remainder is being disposed of in landfills. Waste plastics are produced from petroleum and are composed primarily of hydrocarbons but also contain some antioxidants and colorants. A number of problems are associated with the recycling effort, including convincing consumer households of the necessity to recycle, separating the waste plastics effectively for primary recycling of the plastic back to the monomer, and having sufficient waste plastic for processing, particularly in areas a far distance from the population centers. Tertiary recycling that results in the production of fuels and chemical feedstocks from waste plastics will provide an additional source of hydrocarbon fuels and chemical feedstocks. The addition of other hydrocarbon sources such as our most abundant U.S. hydrocarbon resource, coal, will provide a constancy of supply as well as an additional source of hydrocarbon fuels and feedstocks. Results are presented on the investigations of catalytic coprocessing of petroleum resid, a polyethylene, and coal.

  18. Legal issues of computer imaging in plastic surgery: a primer.

    PubMed

    Chávez, A E; Dagum, P; Koch, R J; Newman, J P

    1997-11-01

    Although plastic surgeons are increasingly incorporating computer imaging techniques into their practices, many fear the possibility of legally binding themselves to achieve surgical results identical to those reflected in computer images. Computer imaging allows surgeons to manipulate digital photographs of patients to project possible surgical outcomes. Some of the many benefits imaging techniques pose include improving doctor-patient communication, facilitating the education and training of residents, and reducing administrative and storage costs. Despite the many advantages computer imaging systems offer, however, surgeons understandably worry that imaging systems expose them to immense legal liability. The possible exploitation of computer imaging by novice surgeons as a marketing tool, coupled with the lack of consensus regarding the treatment of computer images, adds to the concern of surgeons. A careful analysis of the law, however, reveals that surgeons who use computer imaging carefully and conservatively, and adopt a few simple precautions, substantially reduce their vulnerability to legal claims. In particular, surgeons face possible claims of implied contract, failure to instruct, and malpractice from their use or failure to use computer imaging. Nevertheless, legal and practical obstacles frustrate each of those causes of actions. Moreover, surgeons who incorporate a few simple safeguards into their practice may further reduce their legal susceptibility. PMID:9385982

  19. Are general surgery residents adequately prepared for hepatopancreatobiliary fellowships? A questionnaire-based study

    PubMed Central

    Osman, Houssam; Parikh, Janak; Patel, Shirali; Jeyarajah, D Rohan

    2015-01-01

    Background The present study was conducted to assess the preparedness of hepatopancreatobiliary (HPB) fellows upon entering fellowship, identify challenges encountered by HPB fellows during the initial part of their HPB training, and identify potential solutions to these challenges that can be applied during residency training. Methods A questionnaire was distributed to all HPB fellows in accredited HPB fellowship programmes in two consecutive academic years (n = 42). Reponses were then analysed. Results A total of 19 (45%) fellows responded. Prior to their fellowship, 10 (53%) were in surgical residency and the rest were in other surgical fellowships or surgical practice. Thirteen (68%) were graduates of university-based residency programmes. All fellows felt comfortable in performing basic laparoscopic procedures independently at the completion of residency and less comfortable in performing advanced laparoscopy. Eight (42%) fellows cited a combination of inadequate case volume and lack of autonomy during residency as the reasons for this lack of comfort. Thirteen (68%) identified inadequate preoperative workup and management as their biggest fear upon entering practice after general surgery training. A total of 17 (89%) fellows felt they were adequately prepared to enter HPB fellowship. Extra rotations in transplant, vascular or minimally invasive surgery were believed to be most helpful in preparing general surgery residents pursing HPB fellowships. Conclusions Overall, HPB fellows felt themselves to be adequately prepared for fellowship. Advanced laparoscopic procedures and the perioperative management of complex patients are two of the challenges facing HPB fellows. General surgery residents who plan to pursue an HPB fellowship may benefit from spending extra rotations on certain subspecialties. Focus on perioperative workup and management should be an integral part of residency and fellowship training. PMID:25387852

  20. The bioethics of separating conjoined twins in plastic surgery.

    PubMed

    Lee, Michelle; Gosain, Arun K; Becker, Devra

    2011-10-01

    The incidence of craniopagus twins approximates four to six per 10 million births. Although rare, surgical separation of conjoined twins poses significant technical and ethical challenges. The present report uses the case of craniopagus twins AD and TD to examine the bioethical issues faced by a multidisciplinary medical team in planning the separation of craniopagus twins. AD and TD are craniopagus twins conjoined at the head. TD's head is conjoined to the back of AD's head. Neurologically, AD has the dominant cerebral circulation. TD has two normal kidneys, whereas AD has none. AD depends on TD's renal function and, on separation, will require either a kidney transplant or lifelong dialysis. This case report reviews one approach to analyzing and solving complex ethical dilemmas in pediatric plastic surgery. The principles reviewed are (1) autonomy and informed consent, focusing especially on the role of children in the informed consent process; (2) beneficence and nonmaleficence, two intricately intertwined principles because separation could potentially cause irreversible harm to one twin while improving the quality of life for the other (as separation is not a life-saving procedure, is it ethical to perform a procedure with unknown surgical risk to improve children's quality of life?); and (3) justice (is it fair to allocate excessive medical resources for the twins' separation?). The present report explores the ethics behind such decisions with respect to the separation of conjoined twins. PMID:21921746

  1. Laparoscopy training in Belgium: results from a nationwide survey, in urology, gynecology, and general surgery residents

    PubMed Central

    De Win, Gunter; Everaerts, Wouter; De Ridder, Dirk; Peeraer, Griet

    2015-01-01

    Background The purpose of this study was to investigate the exposure of Belgian residents in urology, general surgery, and gynecology to laparoscopic surgery and to training of laparoscopic skills in dedicated training facilities. Methods Three similar specialty-specific questionnaires were used to interrogate trainees in urology, general surgery, and gynecology about their exposure to laparoscopic procedures, their acquired laparoscopic experience, training patterns, training facilities, and motivation. Residents were contacted via their Belgian specialist training organization, using Survey Monkey as an online survey tool. Data were analyzed with descriptive statistics. Results The global response rate was 58%. Only 28.8% of gynecology respondents, 26.9% of urology respondents, and 52.2% of general surgery respondents felt they would be able to perform laparoscopy once they had finished their training. A total 47% of urology respondents, 66.7% of general surgery respondents, and 69.2% of gynecology respondents had a surgical skills lab that included laparoscopy within their training hospital or university. Most training programs did not follow the current evidence about proficiency-based structured simulation training with deliberate practice. Conclusion Belgian resident training facilities for laparoscopic surgery should be optimized. PMID:25674032

  2. Flash scanning the CO2 laser: a revival of the CO2 laser in plastic surgery

    NASA Astrophysics Data System (ADS)

    Lach, Elliot

    1994-09-01

    The CO2 laser has broad clinical application yet also presents a number of practical disadvantages. These drawbacks have limited the success and utilization of this laser in plastic surgery. Flashscanner technology has recently been used for char-free CO2 laser surgery of the oropharynx, the external female genital tract, and perirectal mucosa. A commercially available optomechanical flashscanner unit `Swiftlase,' was adapted to a CO2 laser and used for treatment in numerous plastic surgical applications. Conditions and situations that were treated in this study included generalized neurofibromatosis, tuberous sclerosis, rhinophyma, viral warts, breast reconstruction, and deepithelialization prior to microsurgery or local flap transfer and/or skin graft placement. There were no significant wound healing complications. Some patients previously sustained undue scarring from conventional CO2 laser surgery. Conservative, primarily ablative CO2 laser surgery with the Swiftlase has usefulness for treatment of patients in plastic surgery including those that were previously unsuccessfully treated.

  3. The Effect of Financial Conflicts of Interest in Plastic Surgery Literature.

    PubMed

    Leavitt, Adam; Pace, Elizabeth; Reintgen, Christian; Mast, Bruce A

    2016-06-01

    Medical research has a long history of joint venture between commercial entities and nonindustry researchers. Significant concern exists among accrediting bodies for medical education and federal granting agencies that conflicts of interest (COIs) exist that affect the validity of the research. This study evaluates the legitimacy of this concern.All clinical breast and cosmetic articles in Plastic and Reconstructive Surgery and Annals of Plastic Surgery were reviewed for calendar year 2013. If a financial disclosure was present, the article was then reviewed to determine if the subject/findings were in favor of the commercial conflict and, if so, whether the study was valid. To assess plastic surgery versus other specialties, articles from Dermatology and Journal of Bone and Joint Surgery were similarly reviewed from January to April of 2013.Two hundred seventy-two clinical articles were reviewed. Only 15 (5.5%) had a true COI: the article's findings favored the commercial interest of at least 1 author: for each journal, Plastic and Reconstructive Surgery, 7.7%; Annals of Plastic Surgery, 3.3%; Dermatology, 2.2%; Journal of Bone and Joint Surgery, 7.5%. Conflicts of interest were not statistically significant between pooled articles of plastic surgery versus dermatology/orthopedics. However, COI was statistically greater (P = 0.05) in Plastic and Reconstructive Surgery compared with Annals and Dermatology.Despite public and regulatory concerns, this assessment demonstrates that the peer-review process of leading journals polices true COIs. Published articles provide sound research despite presumed COIs. As such, the integrity and validity of published research remain high. PMID:26678100

  4. Computer-Simulated Arthroscopic Knee Surgery: Effects of Distraction on Resident Performance.

    PubMed

    Cowan, James B; Seeley, Mark A; Irwin, Todd A; Caird, Michelle S

    2016-03-01

    Orthopedic surgeons cite "full focus" and "distraction control" as important factors for achieving excellent outcomes. Surgical simulation is a safe and cost-effective way for residents to practice surgical skills, and it is a suitable tool to study the effects of distraction on resident surgical performance. This study investigated the effects of distraction on arthroscopic knee simulator performance among residents at various levels of experience. The authors hypothesized that environmental distractions would negatively affect performance. Twenty-five orthopedic surgery residents performed a diagnostic knee arthroscopy computer simulation according to a checklist of structures to identify and tasks to complete. Participants were evaluated on arthroscopy time, number of chondral injuries, instances of looking down at their hands, and completion of checklist items. Residents repeated this task at least 2 weeks later while simultaneously answering distracting questions. During distracted simulation, the residents had significantly fewer completed checklist items (P<.02) compared with the initial simulation. Senior residents completed the initial simulation in less time (P<.001), with fewer chondral injuries (P<.005) and fewer instances of looking down at their hands (P<.012), compared with junior residents. Senior residents also completed 97% of the diagnostic checklist, whereas junior residents completed 89% (P<.019). During distracted simulation, senior residents continued to complete tasks more quickly (P<.006) and with fewer instances of looking down at their hands (P<.042). Residents at all levels appear to be susceptible to the detrimental effects of distraction when performing arthroscopic simulation. Addressing even straightforward questions intraoperatively may affect surgeon performance. [Orthopedics. 2016; 39(2):e240-e245.]. PMID:26811955

  5. Efficacy of communication amongst staff members at plastic and reconstructive surgery section using smartphone and mobile WhatsApp

    PubMed Central

    Wani, Shabeer Ahmad; Rabah, Sari M.; AlFadil, Sara; Dewanjee, Nancy; Najmi, Yahya

    2013-01-01

    Objective: The objective of this study is to assess the efficacy of smartphone and its WhatsApp application as a communication method amongst the staff of plastic and reconstructive surgery section at tertiary care health facility. Materials and Methods: From January 2012 onwards, the authors used smartphones and its WhatsApp application as a communication method amongst their team for various aspects of patient management and as a tool for academic endorsements. Results: During the period of this study, there were 116 episodes regarding patient management, which were handled, in a timely fashion by using this application. In addition opinion of rotating residents in the section was sought regarding the efficacy of this method of communication. Overall majority of residents were satisfied with this mode of communication. Conclusions: This new method of communication is an effective method for clinical and academic endorsements. The method is cheap and quick and easy to operate. PMID:24459338

  6. Visual Acuity Outcomes of Toric Lens Implantation in Patients Undergoing Cataract Surgery at a Residency Training Program.

    PubMed

    Sundy, Meryl; McKnight, Dustin; Eck, Craig; Rieger, Frank

    2016-01-01

    Ophthalmology residents must become competent in the use of a variety of intraocular lenses (IOLs) and refractive technologies designed to reduce spectacle use after cataract surgery. Our study of visual acuity outcomes with toric IOLs at the Harry S. Truman Memorial Veterans' Hospital revealed that residents achieved an uncorrected visual acuity of 20/40 or better in 88% of the surgeries they performed, a rate comparable to that reported by other residency programs and by cataract surgeons. PMID:27039489

  7. Evidence-Based Strategies to Reduce Postoperative Complications in Plastic Surgery.

    PubMed

    Harrison, Bridget; Khansa, Ibrahim; Janis, Jeffrey E

    2016-01-01

    Reconstructive plastic surgery is vital in assisting patients with reintegration into society after events such as tumor extirpation, trauma, or infection have left them with a deficit of normal tissue. Apart from performing a technically sound operation, the plastic surgeon must stack the odds in the favor of the patient by optimizing them before and after surgery. The surgeon must look beyond the wound, at the entire patient, and apply fundamental principles of patient optimization. This article reviews the evidence behind the principles of patient optimization that are commonly used in reconstructive surgery patients. PMID:26371388

  8. Duty Hours, Quality of Care, and Patient Safety: General Surgery Resident Perceptions

    PubMed Central

    Borman, Karen R; Jones, Andrew T; Shea, Judy A

    2012-01-01

    Background The balance between patient treatment risks and training residents to proficiency is confounded by duty hours limits. Stricter limits have been recommended to enhance quality and safety, although supporting data are scarce. Study Design A previously piloted survey was delivered with the 2010 American Board of Surgery In-Training Exam (ABSITE). First postgraduate year (PGY1) and PGY2 trainees took the Junior exam (IJE); PGY3 and above took the Senior exam (ISE). Residency type, size and location were linked to examinees using program codes. Five survey items queried all residents about care quality impact of further hours limits; online test residents answered 7 more items probing medical error sources. Data were analyzed using factorial ANOVA for association with gender, PGY level, and program demographics. Results 6161 Categorical Surgery residents (CS) took the ABSITE: 60% men, 60% ISE, 2/3 in University programs. Paper (n=5079) and online (n=1082) examinees were similar. Item response rates ranged from 91-98%. Few (<25%) perceived that stricter hours limits would improve care quality to a large or maximal extent. IJE plus West and Northeast residents significantly more often favored fewer hours. Factors perceived as contributing to medical errors usually or always by ≥ 15% of residents were incomplete handoffs, inexperience or lack of knowledge, insufficient ancillary personnel, and excessive workload. Conclusions Most CS do not perceive that reduced duty hours will noticeably improve quality of care. Resident perceptions of causes of medical errors suggest that system changes are more likely to enhance patient safety than further hours limits. PMID:22632914

  9. Quality Improvement-Focused Departmental Grand Rounds Reports: A Strategy to Engage General Surgery Residents.

    PubMed

    Abelson, Jonathan S; Mitchell, Katrina B; Afaneh, Cheguevera; Rich, Barrie S; Frey, Theresa J; Gellman, Carol; Pomp, Alfons; Michelassi, Fabrizio

    2016-05-01

    Background Many institutions are seeking ways to enhance their surgical trainees' quality improvement (QI) skills. Objective To educate trainees about the importance of lifelong performance improvement, chief residents at New York Presbyterian Hospital-Weill Cornell Medicine are members of a multidisciplinary QI team tasked with improving surgical outcomes. We describe the process and the results of this effort. Methods Our analysis used 2 data sources to assess complication rates: the National Surgical Quality Improvement Program (NSQIP) and ECOMP, our own internal complication database. Chief residents met with a multidisciplinary QI team to review complication rates from both data sources. Chief residents performed a case-by-case analysis of complications and a literature search in areas requiring improvement. Based on this information, chief residents met with the multidisciplinary team to select interventions for implementation, and delivered QI-focused grand rounds summarizing the QI process and new interventions. Results Since 2009, chief residents have presented 16 QI-focused grand rounds. Urinary tract infections (UTIs) and surgical site infections (SSIs) were the most frequently discussed. Interventions to improve UTIs and SSIs were introduced to the department of surgery through these reports in 2011 and 2012. During this time we saw improvement in outcomes as measured by NSQIP odds ratio. Conclusions Departmental grand rounds are a suitable forum to review NSQIP data and our internal, resident-collected data as a means to engage chief residents in QI improvement, and can serve as a model for other institutions to engage surgery residents in QI projects. PMID:27168893

  10. Training surgical residents for a career in academic global surgery: a novel training model.

    PubMed

    Swain, JaBaris D; Matousek, Alexi C; Scott, John W; Cooper, Zara; Smink, Douglas S; Bolman, Ralph Morton; Finlayson, Samuel R G; Zinner, Michael J; Riviello, Robert

    2015-01-01

    Academic global surgery is a nascent field focused on improving surgical care in resource-poor settings through a broad-based scholarship agenda. Although there is increasing momentum to expand training opportunities in low-resource settings among academic surgical programs, most focus solely on establishing short-term elective rotations rather than fostering research or career development. Given the complex nature of surgical care delivery and programmatic capacity building in the resource-poor settings, many challenges remain before global surgery is accepted as an academic discipline and an established career path. Brigham and Women's Hospital has established a specialized global surgery track within the general surgery residency program to develop academic leaders in this growing area of need and opportunity. Here we describe our experience with the design and development of the program followed by practical applications and lessons learned from our early experiences. PMID:25911458

  11. Facial plastic surgery area acquisition method based on point cloud mathematical model solution.

    PubMed

    Li, Xuwu; Liu, Fei

    2013-09-01

    It is one of the hot research problems nowadays to find a quick and accurate method of acquiring the facial plastic surgery area to provide sufficient but irredundant autologous or in vitro skin source for covering extensive wound, trauma, and burnt area. At present, the acquisition of facial plastic surgery area mainly includes model laser scanning, point cloud data acquisition, pretreatment of point cloud data, three-dimensional model reconstruction, and computation of area. By using this method, the area can be computed accurately, but it is hard to control the random error, and it requires a comparatively longer computation period. In this article, a facial plastic surgery area acquisition method based on point cloud mathematical model solution is proposed. This method applies symmetric treatment to the point cloud based on the pretreatment of point cloud data, through which the comparison diagram color difference map of point cloud error before and after symmetry is obtained. The slicing mathematical model of facial plastic area is got through color difference map diagram. By solving the point cloud data in this area directly, the facial plastic area is acquired. The point cloud data are directly operated in this method, which can accurately and efficiently complete the surgery area computation. The result of the comparative analysis shows the method is effective in facial plastic surgery area. PMID:24036743

  12. Joseph Constantine Carpue and the Bicentennial of the Birth of Modern Plastic Surgery

    PubMed Central

    Freshwater, M. Felix

    2015-01-01

    September 2014 marked the bicentennial of the birth of modern plastic surgery. It was then that Carpue began a prospective observational study of nasal reconstruction that culminated in his 1816 monograph, which caused an explosion of interest in reconstructive surgery throughout Europe. In conducting his study, Carpue demonstrated ethical standards and the power of planning a procedure. His methods to document his results accurately would remain unsurpassed until photography was adopted at the end of the 19th century. Carpue took an apocryphal story of surgery performed in India more than twenty years earlier and transformed it into the beginning of modern plastic surgery. He succeeded in a number of unrecognized tasks that are themselves landmarks not only in plastic surgical history, but surgical history: devising the first prospective observational study, using exclusion criteria, maintaining appropriate patient confidentiality, setting a standard for preoperative disclosure and ethical approval over a century before these measures were codified, having independent documentation of his preoperative and postoperative findings, devising a method to objectively monitor and document the forehead flap, and describing the potential value of tissue expansion. He shared his experience by publishing his results and by lecturing in Europe. His contemporaries recognized him for his contributions and he was honored by election to the Royal Society. Carpue launched the modern era of plastic surgery in an ethical, logical, and objective manner. While plastic surgery has changed in the last two centuries, the principles that Carpue followed remain valid. PMID:25795909

  13. Joseph Constantine Carpue and the Bicentennial of the Birth of Modern Plastic Surgery.

    PubMed

    Freshwater, M Felix

    2015-08-01

    September 2014 marked the bicentennial of the birth of modern plastic surgery. It was then that Carpue began a prospective observational study of nasal reconstruction that culminated in his 1816 monograph, which caused an explosion of interest in reconstructive surgery throughout Europe. In conducting his study, Carpue demonstrated ethical standards and the power of planning a procedure. His methods to document his results accurately would remain unsurpassed until photography was adopted at the end of the 19th century. Carpue took an apocryphal story of surgery performed in India more than twenty years earlier and transformed it into the beginning of modern plastic surgery. He succeeded in a number of unrecognized tasks that are themselves landmarks not only in plastic surgical history, but surgical history: devising the first prospective observational study, using exclusion criteria, maintaining appropriate patient confidentiality, setting a standard for preoperative disclosure and ethical approval over a century before these measures were codified, having independent documentation of his preoperative and postoperative findings, devising a method to objectively monitor and document the forehead flap, and describing the potential value of tissue expansion. He shared his experience by publishing his results and by lecturing in Europe. His contemporaries recognized him for his contributions and he was honored by election to the Royal Society. Carpue launched the modern era of plastic surgery in an ethical, logical, and objective manner. While plastic surgery has changed in the last two centuries, the principles that Carpue followed remain valid. PMID:25795909

  14. Face recognition via edge-based Gabor feature representation for plastic surgery-altered images

    NASA Astrophysics Data System (ADS)

    Chude-Olisah, Chollette C.; Sulong, Ghazali; Chude-Okonkwo, Uche A. K.; Hashim, Siti Z. M.

    2014-12-01

    Plastic surgery procedures on the face introduce skin texture variations between images of the same person (intra-subject), thereby making the task of face recognition more difficult than in normal scenario. Usually, in contemporary face recognition systems, the original gray-level face image is used as input to the Gabor descriptor, which translates to encoding some texture properties of the face image. The texture-encoding process significantly degrades the performance of such systems in the case of plastic surgery due to the presence of surgically induced intra-subject variations. Based on the proposition that the shape of significant facial components such as eyes, nose, eyebrow, and mouth remains unchanged after plastic surgery, this paper employs an edge-based Gabor feature representation approach for the recognition of surgically altered face images. We use the edge information, which is dependent on the shapes of the significant facial components, to address the plastic surgery-induced texture variation problems. To ensure that the significant facial components represent useful edge information with little or no false edges, a simple illumination normalization technique is proposed for preprocessing. Gabor wavelet is applied to the edge image to accentuate on the uniqueness of the significant facial components for discriminating among different subjects. The performance of the proposed method is evaluated on the Georgia Tech (GT) and the Labeled Faces in the Wild (LFW) databases with illumination and expression problems, and the plastic surgery database with texture changes. Results show that the proposed edge-based Gabor feature representation approach is robust against plastic surgery-induced face variations amidst expression and illumination problems and outperforms the existing plastic surgery face recognition methods reported in the literature.

  15. Plastic Surgery and the Breast: A Citation Analysis of the Literature

    PubMed Central

    Joyce, Kenneth M.; Sugrue, Conor M.; Kelly, John C.; Carroll, Sean M.; Kerin, Michael J.; Kelly, Jack L.

    2014-01-01

    Background: A large proportion of the plastic surgery literature is dedicated to the breast. It is one of the most common topics in our specialty, yet it is unclear which articles have been the most influential. The purpose of this study was to identify the top 100 most-cited articles on breast in the plastic surgery literature and examine the characteristics of each individual article. Methods: Using an electronic database through the Web of Science, we were able to determine the 6 journals that contributed to the 100 most-cited articles on breast in the plastic surgery literature. Results: Each article was examined individually looking at characteristics such as subject matter, article type, country of origin, institution, authorship, and year of publication. Plastic and Reconstructive Surgery contributed the most articles to the top 100 with 81 articles including the most-cited article which has been referenced 673 times to date. The United States produced 73% of the top 100 articles, and the most prolific institution was the University of Texas M. D. Anderson Cancer Center with 15 articles. Conclusions: This study has identified the most influential articles on breast in the plastic surgery literature over the past 68 years and highlighted many important scientific breakthroughs and landmarks that have occurred during this time. PMID:25506534

  16. Applications Of Plastic Hollow Fibers In CO2 Laser Surgery

    NASA Astrophysics Data System (ADS)

    Kaplan, Isaac; Giller, Shamai; Dror, Jacob; Gannot, Israel; Croitoru, Nathan I.

    1989-06-01

    Plastic hollow fibers for the transmission of CO2 laser energy in curved path were produced by plating the inner face of plastic tubes with a metal film and a dielectric film. These fibers could transmit high power (25 watts) with low losses even through bendings. Bleeding ulcers in dogs' stomachs were successfully treated with the fibers which were inserted into the stomach through the oesophagus.

  17. [Bariatric and plastic surgery in obese adolescents: an alternative treatment].

    PubMed

    Dubern, Béatrice; Tounian, Patrice

    2014-06-01

    The increased frequency of extreme forms of obesity in adolescents and the disappointing results of conventional treatments are now leading pediatricians to consider bariatric or cosmetic surgery as the only real long-term effective therapeutic alternative. The two main techniques currently used for bariatric surgery in adolescents are gastric bypass and adjustable gastric banding. Whatever the technique, weight loss is significant with improvement of comorbidities and quality of life. In addition, the complications are identical to those in adults and equally frequent. However, because of the particularities of this age, caution is still required. Adolescence is indeed characterized by specific nutritional needs, but also changes in body image in which surgery could have a negative effect. Currently, all obese teenagers making a request for bariatric surgery should have a comprehensive assessment with global care for at least 6 months. The indication is then discussed on a case-by-case basis by multidisciplinary teams and experts. To date, the type of surgery (gastric banding, gastric sleeve, or bypass) is still widely discussed. Based on experience with adults, we believe that gastric sleeve and bypass should be preferred. In addition, obesity in adolescents almost always involves psychosocial consequences, while somatic complications are rare. Thus, the care of adipo- or gynecomastia, abdominal fat excess, and concealed penis is essential and therefore justifies cosmetic surgery. PMID:24815599

  18. Posttraumatic Stress Disorder: Reason for or Consequence of Facial Plastic Surgery?

    PubMed

    Ehlert, Ulrike

    2015-08-01

    Facial plastic surgery may be undertaken for a variety of reasons. Patients may have had traumatic experiences prior to surgery, such as an accident, a physical assault, or severe illness resulting in facial damage, and they may have used inadequate coping strategies. These patients usually appear suspicious toward medical staff and need special attention because they are at high risk of being unsatisfied with the outcome of surgery. Some patients may hold unrealistic assumptions about the outcome of plastic surgery. Yet other patients may suffer from complications of surgery and may thus experience facial plastic surgery as a trauma. In all such events these patients require special attention. First of all, careful exploration of traumatic experiences prior to surgery should take place even if this does not seem to be part of the standard treatment and requires additional time. Patients usually experience strong relief when their concerns are taken seriously, and treatment outcomes can thus be improved. Moreover, patients should be checked for acute stress disorder (ASD) or posttraumatic stress disorder (PTSD), and if so diagnosed, specialized treatment should be initiated postoperatively. Patients with ASD or PTSD will experience the surgical intervention and the treatment postsurgery with more confidence and greater satisfaction if the surgeon also engages in the psychosocial aspects of their history. PMID:26372715

  19. Impact of a weekly reading program on orthopedic surgery residents' in-training examination.

    PubMed

    Weglein, Daniel G; Gugala, Zbigniew; Simpson, Suzanne; Lindsey, Ronald W

    2015-05-01

    In response to a decline in individual residents' performance and overall program performance on the Orthopaedic In-Training Examination (OITE), the authors' department initiated a daily literature reading program coupled with weekly tests on the assigned material. The goal of this study was to assess the effect of the reading program on individual residents' scores and the training program's OITE scores. The reading program consisted of daily review articles from the Journal of the American Academy of Orthopaedic Surgeons, followed by a weekly written examination consisting of multiple-choice or fill-in-the-blank questions. All articles were selected and all questions were written by the departmental chair. A questionnaire was given to assess residents' perceptions of the weekly tests. As a result of implementing the reading program for a 10-month period, residents' subsequent performance on the OITE significantly improved (mean score increase, 4, P<.0001; percentile score increase, 11, P=.0007). The difference in mean score was significant for residents in postgraduate years 3, 4, and 5. A statistically significant correlation was found between weekly test scores and performance on the OITE, with a significant correlation between weekly test scores and OITE percentile ranking. The study results also showed a positive correlation between reading test attendance and weekly test scores. Residents' anonymous questionnaire responses also demonstrated the reading program to be a valuable addition to the residency training curriculum. In conclusion, the study strongly supports the benefits of a weekly reading and examination program in enhancing the core knowledge of orthopedic surgery residents. PMID:25970365

  20. Better to light a candle: Arthur Barsky and global plastic surgery.

    PubMed

    Hughes, Christopher D; Barsky, Emily; Hagander, Lars; Barsky, Arthur J; Meara, John G

    2013-08-01

    Plastic and reconstructive surgery has had a long history with international humanitarian efforts. As the field of global surgery continues to gain momentum in academic centers throughout the world, the role of the surgical subspecialist in the public health infrastructure of low-resource communities has also begun to gain a new sense of wonder and importance. Arthur Barsky, Jr was arguably one of the most influential forefathers of global plastic surgery. Throughout his notable career spanning most of the 20th century, Barsky remained dedicated to delivering plastic and reconstructive surgical care to the disadvantaged worldwide, as well as educating others to do the same. Although he was not the first surgeon with an interest in global health, Barsky's work was unique and influential in its originality, magnitude, and scope. An appreciation and understanding of Barsky's groundbreaking work will help inform the future development of sustainable surgical systems in resource-poor settings. PMID:22868314

  1. [Two French pioneers of plastic surgery: François Dubois and Raymond Passot].

    PubMed

    Derquenne, François

    2015-01-01

    After World War, especially during the interwar years, new plastic surgical techniques were highly developed by I two French surgeons: Dr Raymond Passot, a pupil of Pr Hippolyte Morestin, Head of surgery department in Val-de-Grâce military hospital, Father of the Gueules cassées and Dr François Dubois, a pupil of Pr Sébileau, head of ear nose throat disorders department at Lariboisière Hospital in Paris. By the way of papers, publications and interviews to media, they described new French cosmetic techniques (rhitidectomy, sutures, liposuccion) and extensively developed this outpatient surgery. They used to renove famous actresse's and actors' face and nose and those of hundreds of patients. They participate to French societies of plastic surgery meetings and publications. Their enthusiastic dare largely participated to the current success of cosmetic surgery in France. PMID:26050425

  2. Advanced technologies in plastic surgery: how new innovations can improve our training and practice.

    PubMed

    Grunwald, Tiffany; Krummel, Thomas; Sherman, Randy

    2004-11-01

    Over the last two decades, virtual reality, haptics, simulators, robotics, and other "advanced technologies" have emerged as important innovations in medical learning and practice. Reports on simulator applications in medicine now appear regularly in the medical, computer science, engineering, and popular literature. The goal of this article is to review the emerging intersection between advanced technologies and surgery and how new technology is being utilized in several surgical fields, particularly plastic surgery. The authors also discuss how plastic and reconstructive surgeons can benefit by working to further the development of multimedia and simulated environment technologies in surgical practice and training. PMID:15509950

  3. [Treatment of the human body : the possibilities and limits of plastic surgery].

    PubMed

    Bermes, C

    2015-01-01

    The desire for authenticity is often cited as a motive for making use of plastic surgery. This article aims to elaborate on the meaning of this particular authenticity. At the same time, it discusses reasons that justify or forbid a plastic surgery intervention in the light of ethics. For this purpose, a distinction is made between "objective body" (Krper) and "subjective body" (Leib), and the objectives of medical actions are questioned. Through the terminological differentiation between integrity (Integritt), prosperity (Wohlergehen), and well-being (Wohlbefinden), these objectives are qualified and the limits of medical actions are determined. PMID:25604537

  4. [Jean-Louis-Paul Denucé (1824-1889): A forgotten pioneer of plastic surgery].

    PubMed

    Marck, K W; Martin, D

    2016-02-01

    The authors propose to define as main characterization of plastic reconstructive surgery the conceptual thinking that leads to a rational choice of an operative treatment. Conceptual thinking in plastic surgery started halfway the nineteenth century with the first schematic representations of the operative procedures available at that time, in which Von Ammon and Baumgarten, Szymanowski and Denucé played a prominent role. These four authors and their works are presented with special attention for the less known of them, Jean-Paul Denucé, surgeon in Bordeaux. PMID:26612441

  5. The Imperative of Academia in the Globalization of Plastic Surgery.

    PubMed

    Nayar, Harry S; Bentz, Michael L; Baus, Gustavo Herdocia; Palacios, Jorge; Dibbell, David G; Noon, John; Poore, Samuel O; King, Timothy W; Mount, Delora L

    2015-06-01

    Although vertical health care delivery models certainly will remain a vital component in the provision of surgery in low-and-middle-income countries, it is clear now that the sustainability of global surgery will depend on more than just surgeons operating. Instead, what is needed is a comprehensive approach, that is, a horizontal integration that develops sustainable human resources, physical infrastructure, administrative oversight, and financing mechanisms in the developing world. We propose that such a strategy for development would necessarily involve an active role by academic institutions of high-income countries. PMID:26080135

  6. A Systematic Review of the Effects of Resident Duty Hour Restrictions in Surgery

    PubMed Central

    Devitt, Katharine S.; Keshet, Itay; Spicer, Jonathan; Imrie, Kevin; Feldman, Liane; Cools-Lartigue, Jonathan; Kayssi, Ahmed; Lipsman, Nir; Elmi, Maryam; Kulkarni, Abhaya V.; Parshuram, Chris; Mainprize, Todd; Warren, Richard J.; Fata, Paola; Gorman, M. Sean; Feinberg, Stan; Rutka, James

    2014-01-01

    Background: In 2003, the Accreditation Council for Graduate Medical Education (ACGME) mandated 80-hour resident duty limits. In 2011 the ACGME mandated 16-hour duty maximums for PGY1 (post graduate year) residents. The stated goals were to improve patient safety, resident well-being, and education. A systematic review and meta-analysis were performed to evaluate the impact of resident duty hours (RDH) on clinical and educational outcomes in surgery. Methods: A systematic review (1980–2013) was executed on CINAHL, Cochrane Database, Embase, Medline, and Scopus. Quality of articles was assessed using the GRADE guidelines. Sixteen-hour shifts and night float systems were analyzed separately. Articles that examined mortality data were combined in a random-effects meta-analysis to evaluate the impact of RDH on patient mortality. Results: A total of 135 articles met the inclusion criteria. Among these, 42% (N = 57) were considered moderate-high quality. There was no overall improvement in patient outcomes as a result of RDH; however, some studies suggest increased complication rates in high-acuity patients. There was no improvement in education related to RDH restrictions, and performance on certification examinations has declined in some specialties. Survey studies revealed a perception of worsened education and patient safety. There were improvements in resident wellness after the 80-hour workweek, but there was little improvement or negative effects on wellness after 16-hour duty maximums were implemented. Conclusions: Recent RDH changes are not consistently associated with improvements in resident well-being, and have negative impacts on patient outcomes and performance on certification examinations. Greater flexibility to accommodate resident training needs is required. Further erosion of training time should be considered with great caution. PMID:24662409

  7. History of the Oral and Maxillofacial Surgery Residency Program at Universidad el Bosque, Bogotá, Colombia.

    PubMed

    Castro-Núñez, Jaime

    2012-01-01

    The formal training of oral and maxillofacial surgeons in Colombia started in 1958 at Hospital Sanjos6, thanks to the titanic work of Waldemar Wilhelm, a German-born surgeon who settled in BogotA in 1950. Today there are seven institutions in Colombia that offer residency programs in oral and maxillofacial surgery. The aim of this article is to describe the history of the Oral and Maxillofacial Surgery Residency Program at Universidad El Bosque in Bogota. PMID:22916408

  8. A Systematic Review of Ethical Principles in the Plastic Surgery Literature

    PubMed Central

    Chung, Kevin C.; Pushman, Allison G.; Bellfi, Lillian T.

    2009-01-01

    Background: To perform a systematic review to identify articles that discuss ethical issues relating to the field of plastic and reconstructive surgery and to evaluate whether ethical issues are underrepresented in the plastic surgery literature. Methods: Four medical databases were selected to search through the medical literature with specific inclusion criteria to disqualify irrelevant articles from the study. Appropriate articles were extracted, and their quality and validity were assessed by multiple investigators to maximize reproducibility. The data were then synthesized and analyzed for associations amongst the ethical principles. Results: Out of a total library search of >100,000 plastic surgery oriented articles, only 110 clearly focused on ethical principles. Autonomy (53%) was the most common major theme, whereas distributive justice (15%) represented the least frequently emphasized ethical principle. The proportions of each ethical principle were tested against each other for equality using Cochran's Q test; the Q test reached statistical significance (Q = 67.04, df =3, P < 0.0001), indicating that the ethical principles were not discussed equally in plastic surgery literature, which was expected because autonomy represented 53% of the manuscripts whereas distributive justice represented only 15% of manuscripts. When examining both major and minor themes, over half of the articles (61%) addressed 2 or more ethical principles. Beneficence and nonmaleficence were strongly associated (Pearson's x2 = 55.38, df =1, P<0.0001). Conclusions: Despite the extensive amount of ethical issues that plastic surgeons face, a relatively small proportion of plastic surgery literature was dedicated to discussing ethical principles. PMID:20009860

  9. The Value of Postconditioning in Plastic and Reconstructive Surgery: A Systematic Review.

    PubMed

    Weng, Weidong; Zhang, Feng; Lineaweaver, William C; Gao, Weiyang; Yan, Hede

    2016-05-01

    Background Ischemia-reperfusion (I/R) injury by abrupt restoration of circulation after prolonged ischemia has still been an unsolved problem in plastic and reconstructive surgery. The concept of postconditioning (post-con), which has been well described in cardiovascular surgery, has been recently introduced in plastic and reconstructive surgery. As an "after-injury strategy," post-con may be a promising approach to reduce I/R injury and improve flap survival after ischemia. Methods A systematic review was performed by searching electronic databases of PubMed and web of science to identify all the studies regarding the application of the post-con technique in plastic and reconstructive surgery between 1950 and 2015. Inclusion criteria were English articles with clear reporting the post-con techniques and detailed outcomes. Results In total, 476 articles were identified and 18 studies reporting post-con in plastic and reconstructive surgery met the inclusion criteria in this review, including 11 studies of mechanical post-con, 3 studies of pharmacological post-con, 1 study of both mechanical and pharmacological post-con, and 3 studies of remote post-con. All these studies reported protective effects of any kind of post-con techniques in I/R injuries and could improve flap survivals. Conclusion In general, the strategy of post-con may effectively reduce I/R injury and improve the survival of flaps after ischemia in animal studies, yet no consensus regarding the exact technical details (intervention timing, cycles, intermittent duration, etc.) has been reached. Further studies aiming to explore its mechanisms as well as specific methodology are required before clinical application in plastic and reconstructive surgery. PMID:27019305

  10. Validity of NBME Parts I and II for the Selection of Residents: The Case of Orthopaedic Surgery.

    ERIC Educational Resources Information Center

    Case, Susan M.

    The predictive validity of scores on the National Board of Medical Examiners (NBME) Part I and Part II examinations for the selection of residents in orthopaedic surgery was investigated. Use of NBME scores has been criticized because of the time lag between taking Part I and entering residency and because Part I content is not directly linked to…

  11. Combined Soft and Hard Tissue Peri-Implant Plastic Surgery Techniques to Enhance Implant Rehabilitation: A Case Report

    PubMed Central

    Baltac?o?lu, Esra; Korkmaz, Fatih Mehmet; Ba???, Nilsun; Ayd?n, Gven; Yuva, P?nar; Korkmaz, Yavuz Tolga; Ba???, Bora

    2014-01-01

    This case report presents an implant-aided prosthetic treatment in which peri-implant plastic surgery techniques were applied in combination to satisfactorily attain functional aesthetic expectations. Peri-implant plastic surgery enables the successful reconstruction and restoration of the balance between soft and hard tissues and allows the option of implant-aided fixed prosthetic rehabilitation. PMID:25489351

  12. 76 FR 65200 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee: Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-20

    ... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee scheduled for December 1, 2011. The meeting was announced in the Federal Register of Friday, October 7, 2011 (76 FR 62419)....

  13. 75 FR 61507 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Amendment of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-05

    ... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee. This meeting was announced in the Federal Register of August 16, 2010 (75 FR 49940). The amendment is being made to reflect...

  14. Newer implications of medico-legal and consent issues in plastic surgery

    PubMed Central

    Shah, Atulkumar K.

    2014-01-01

    The social impact of entire cadre of medical graduates admitted through donation and management seats is yet to arrive. What has arrived are the burdens of complying with various acts and facing legal challengesduring medical practice. This article deals with some recent legal requirements for catering to plastic and cosmetic surgery patients. PMID:25190914

  15. Parents Speak Out: Facial Plastic Surgery for Children with Down Syndrome.

    ERIC Educational Resources Information Center

    Goeke, Jennifer

    2003-01-01

    This qualitative study examined comments of 250 parents of children with Down syndrome concerning facial plastic surgery as a means of improving the physical functioning, appearance, and social acceptance of these children. Most respondents viewed improvement of negative societal attitudes toward individuals with Down syndrome and futhering their

  16. Plastic hollow fibers employed for CO2 laser power transmission in oral surgery

    NASA Astrophysics Data System (ADS)

    Calderon, Shlomo; Gannot, Israel; Dror, Jacob; Dahan, Reuben; Croitoru, Nathan I.

    1991-07-01

    Plastic hollow fibers were developed and produced in a lab. The fiber structure was investigated by various methods. Correlation between the analysis results and the transmission characteristics was found. The fibers were used in maxillofacial surgery and excellent results of healing were achieved.

  17. Face recognition across makeup and plastic surgery from real-world images

    NASA Astrophysics Data System (ADS)

    Moeini, Ali; Faez, Karim; Moeini, Hossein

    2015-09-01

    A study for feature extraction is proposed to handle the problem of facial appearance changes including facial makeup and plastic surgery in face recognition. To extend a face recognition method robust to facial appearance changes, features are individually extracted from facial depth on which facial makeup and plastic surgery have no effect. Then facial depth features are added to facial texture features to perform feature extraction. Accordingly, a three-dimensional (3-D) face is reconstructed from only a single two-dimensional (2-D) frontal image in real-world scenarios. Then the facial depth is extracted from the reconstructed model. Afterward, the dual-tree complex wavelet transform (DT-CWT) is applied to both texture and reconstructed depth images to extract the feature vectors. Finally, the final feature vectors are generated by combining 2-D and 3-D feature vectors, and are then classified by adopting the support vector machine. Promising results have been achieved for makeup-invariant face recognition on two available image databases including YouTube makeup and virtual makeup, and plastic surgery-invariant face recognition on a plastic surgery face database is compared to several state-of-the-art feature extraction methods. Several real-world scenarios are also planned to evaluate the performance of the proposed method on a combination of these three databases with 1102 subjects.

  18. Parents Speak Out: Facial Plastic Surgery for Children with Down Syndrome.

    ERIC Educational Resources Information Center

    Goeke, Jennifer

    2003-01-01

    This qualitative study examined comments of 250 parents of children with Down syndrome concerning facial plastic surgery as a means of improving the physical functioning, appearance, and social acceptance of these children. Most respondents viewed improvement of negative societal attitudes toward individuals with Down syndrome and futhering their…

  19. Three-dimensional surface imaging in plastic surgery: foundation, practical applications, and beyond.

    PubMed

    Chang, Jessica B; Small, Kevin H; Choi, Mihye; Karp, Nolan S

    2015-05-01

    Three-dimensional surface imaging has gained clinical acceptance in plastic and reconstructive surgery. In contrast to computed tomography/magnetic resonance imaging, three-dimensional surface imaging relies on triangulation in stereophotography to measure surface x, y, and z coordinates. This study reviews the past, present, and future directions of three-dimensional topographic imaging in plastic surgery. Historically, three-dimensional imaging technology was first used in a clinical setting in 1944 to diagnose orthodontologic conditions. Karlan established its use in the field of plastic surgery in 1979, analyzing contours and documenting facial asymmetries. Present use of three-dimensional surface imaging has focused on standardizing patient topographic measurements to enhance preoperative planning and to improve postoperative outcomes. Various measurements (e.g., volume, surface area, vector distance, curvature) have been applied to breast, body, and facial topography to augment patient analysis. Despite the rapid progression of the clinical applications of three-dimensional imaging, current use of this technology is focused on the surgeon's perspective and secondarily the patient's perspective. Advancements in patient simulation may improve patient-physician communication, education, and satisfaction. However, a communal database of three-dimensional surface images integrated with emerging three-dimensional printing and portable information technology will validate measurements and strengthen preoperative planning and postoperative outcomes. Three-dimensional surface imaging is a useful adjunct to plastic and reconstructive surgery practices and standardizes measurements to create objectivity in a subjective field. Key improvements in three-dimensional imaging technology may significantly enhance the quality of plastic and reconstructive surgery in the near future. PMID:25835245

  20. Training in General Surgery Ward Call: A Resident-Student Buddy System

    PubMed Central

    Maurice, Andrew; Hann, Angus

    2015-01-01

    There is a paucity of literature regarding medical student experiences of after hours hospital ward call. It was observed at our institution that medical students had minimal experience in ward call, yet were required to undertake such shifts as interns after graduation. We implemented a buddy system in which a medical student shadowed a general surgery resident for a ward call shift. Final year medical students were recruited from the local university at a tertiary teaching hospital after institutional approval. Each student attended a 4 hour evening shift on a general surgery ward with a supervising resident. A survey detailing attitudes and expectations of ward call was completed before and after the experience. Nine students enrolled in the project. Familiarity of expectations of what is required of an intern on a ward call shift improved significantly after the experience (3.1/5 to 4.1/5, p = 0.002). After hours work experience was reported as useful both before and after the study (4.5/5 to 4.7/5, p = 0.47). Students and doctors involved unanimously felt the experience was worthwhile. After hours ward call experience is useful for a final year medical student. More studies are required to further define the role of after hours ward call experiences during medical training. PMID:26732229

  1. Do plastic surgery division heads and program directors have the necessary tools to provide effective leadership?

    PubMed Central

    Arneja, JS; McInnes, CW; Carr, NJ; Lennox, P; Hill, M; Petersen, R; Woodward, K; Skarlicki, D

    2014-01-01

    BACKGROUND: Effective leadership is imperative in a changing health care landscape driven by increasing expectations in a setting of rising fiscal pressures. Because evidence suggests that leadership abilities are not simply innate but, rather, effective leadership can be learned, it is prudent for plastic surgeons to evaluate the training and challenges of their leaders because there may be opportunities for further growth and support. OBJECTIVE: To investigate the practice profiles, education/training, responsibilities and challenges of leaders within academic plastic surgery. METHODS: Following research ethics board approval, an anonymous online survey was sent to division heads and program directors from all university-affiliated plastic surgery divisions in Canada. Survey themes included demographics, education/training, job responsibilities and challenges. RESULTS: A response rate of 74% was achieved. The majority of respondents were male (94%), promoted to their current position at a mean age of 48 years, did not have a leadership-focused degree (88%), directly manage 30 people (14 staff, 16 faculty) and were not provided with a job description (65%). Respondents worked an average of 65 h per week, of which 18% was devoted to their leadership role, 59% clinically and the remainder on teaching and research. A discrepancy existed between time spent on their leadership role (18%) and related compensation (10%). Time management (47%) and managing conflict (24%) were described as the greatest leadership challenges by respondents. CONCLUSIONS: Several gaps were identified among leaders in plastic surgery including predominance of male sex, limitations in formal leadership training and requisite skill set, as well as compensation and human resources management (emotional intelligence). Leadership and managerial skills are key core competencies, not only for trainees, but certainly for those in a position of leadership. The present study provides evidence that academic departments, universities and medical centres may benefit by re-evaluating how they train, promote and support their leaders in plastic surgery. PMID:25535461

  2. “iBIM” — Internet-based interactive modules: an easy and interesting learning tool for general surgery residents

    PubMed Central

    Azer, Nader; Shi, Xinzhe; de Gara, Chris; Karmali, Shahzeer; Birch, Daniel W.

    2014-01-01

    Background The increased use of information technology supports a resident-centred educational approach that promotes autonomy, flexibility and time management and helps residents to assess their competence, promoting self-awareness. We established a web-based e-learning tool to introduce general surgery residents to bariatric surgery and evaluate them to determine the most appropriate implementation strategy for Internet-based interactive modules (iBIM) in surgical teaching. Methods Usernames and passwords were assigned to general surgery residents at the University of Alberta. They were directed to the Obesity101 website and prompted to complete a multiple-choice precourse test. Afterwards, they were able to access the interactive modules. Residents could review the course material as often as they wanted before completing a multiple-choice postcourse test and exit survey. We used paired t tests to assess the difference between pre- and postcourse scores. Results Out of 34 residents who agreed to participate in the project, 12 completed the project (35.3%). For these 12 residents, the precourse mean score was 50 ± 17.3 and the postcourse mean score was 67 ± 14 (p = 0.020). Conclusion Most residents who participated in this study recommended using the iBIMs as a study tool for bariatric surgery. Course evaluation scores suggest this novel approach was successful in transferring knowledge to surgical trainees. Further development of this tool and assessment of implementation strategies will determine how iBIM in bariatric surgery may be integrated into the curriculum. PMID:24666457

  3. Plastic Surgery of the Breast: Keeping the Nipple Sensitive

    PubMed Central

    Riccio, Charles A.; Zeiderman, Matthew R.; Chowdhry, Saeed; Brooks, Ronald M.; Kelishadi, Shahrooz S.; Tutela, John Paul; Choo, Joshua; Yonick, David V.

    2015-01-01

    Introduction: Since its inception, reduction mammaplasty has matured considerably. Primary evolution in clinical research and practice has focused on preserving tissue viability. Surgery involves preserving not only tissue viability but also function and sensation. The nipple serves as the sensate unit of the breast and is a valuable part of women's psychological and sexual health, making preservation of nipple sensation of utmost important. Studies regarding primary innervation to the nipple are few and often contradictory. We propose an unsafe zone in which dissection during reduction mammoplasty ought to be avoided to preserve nipple sensation. Methods: Circumareolar dissection of 22 cadaveric breasts was performed. Primary nerve branches to the nipple-areola complex were identified and dissected to their origin. Results: Three to 5 branches of the fourth intercostal nerve primarily innervated the nipple on 18 of 22 breast dissections. Two breasts received innervation from the third intercostal nerve and 2 from the fifth intercostal nerve. In half of the specimens, accessory innervation from the third and fifth intercostal nerves provided medial branches to the nipple. Conclusions: The fourth intercostal nerve provides the major innervation to the nipple-areola complex. Avoiding dissection in inferolateral quadrant “unsafe zone” of the breast during reduction mammaplasty and other breast surgical procedures can reliably spare nipple sensation and maximize patient outcomes. PMID:26171100

  4. Portable and accurate 3D scanner for breast implant design and reconstructive plastic surgery

    NASA Astrophysics Data System (ADS)

    Rigotti, Camilla; Borghese, Nunzio A.; Ferrari, Stefano; Baroni, Guido; Ferrigno, Giancarlo

    1998-06-01

    In order to evaluate the proper breast implant, the surgeon relies on a standard set of measurements manually taken on the subject. This approach does not allow to obtain an accurate reconstruction of the breast shape and asymmetries can easily arise after surgery. The purpose of this work is to present a method which can help the surgeon in the choice of the shape and dimensions of a prosthesis allowing for a perfect symmetry between the prosthesis and the controlateral breast and can be used as a 3D visual feedback in plastic surgery.

  5. Prevalence and Cost of Full-Time Research Fellowships During General Surgery Residency – A National Survey

    PubMed Central

    Robertson, Charles M.; Klingensmith, Mary E.; Coopersmith, Craig M.

    2009-01-01

    Structured Abstract Objective To quantify the prevalence, outcomes, and cost of surgical resident research. Summary Background Data General surgery is unique among graduate medical education programs because a large percentage of residents interrupt their clinical training to spend 1-3 years performing full-time research. No comprehensive data exists on the scope of this practice. Methods Survey sent to all 239 program directors of general surgery residencies participating in the National Resident Matching Program. Results Response rate was 200/239 (84%). A total of 381 out of 1052 trainees (36%) interrupt residency to pursue full-time research. The mean research fellowship length is 1.7 years, with 72% of trainees performing basic science research. A significant association was found between fellowship length and post-residency activity, with a 14.7% increase in clinical fellowship training and a 15.2% decrease in private practice positions for each year of full-time research (p<0.0001). Program directors at 31% of programs reported increased clinical duties for research fellows as a result of ACGME work hour regulations for clinical residents, while a further 10% of programs are currently considering such changes. It costs $41.5 million to pay the 634 trainees who perform research fellowships each year, the majority of which is paid for by departmental funds (40%) and institutional training grants (24%). Conclusions Interrupting residency to perform a research fellowship is a common and costly practice among general surgery residents. While performing a research fellowship is associated with clinical fellowship training after residency, it is unclear to what extent this practice leads to the development of surgical investigators after post-graduate training. PMID:19106692

  6. Evidence-Based Plastic Surgery: Its Rise, Importance, and a Practical Guide.

    PubMed

    Agha, Riaz A; Orgill, Dennis P

    2016-03-01

    There is a perfect storm developing in 21st century healthcare; rising complexity and patient expectations in the context of fiscal restraint. Evidence-based medicine (EBM) may be the best-kept secret in dealing with the "storm." Such an approach prefers management pathways that deliver better outcomes at less relative cost. In this article, the rise of EBM, its significance, a guide to practicing it, and its future in the field of plastic, reconstructive, and aesthetic surgery are presented. PMID:26746230

  7. Plastic surgery after weight loss: current concepts in massive weight loss surgery.

    PubMed

    Gusenoff, Jeffrey A; Rubin, J Peter

    2008-01-01

    The authors begin their discussion of current concepts in massive weight loss (MWL) surgery by offering terminological guidelines that help define reconstructive and aesthetic concepts and procedures for the post-MWL patient. Measures for effective preoperative nutritional and metabolic screening include assessment of weight fluctuations over time, constitutional symptoms, and medications and nutritional supplements. Although there is no established body-mass index (BMI) threshold above which surgery should be refused, higher BMIs have been associated with increased complications. Residual medical problems and psychosocial issues require assessment before surgery, with appropriate specialist consultation as necessary. Consultation with patients concerning the different expectations for functional versus aesthetic procedures and issues such as postoperative scarring and the common incidence of wound healing problems is essential. Patient safety is paramount in decisions to combine multiple procedures and plan stages. The authors often recommend combining abdominoplasty and mastopexy. Surgeon experience, operative setting, and a patient's medical status are factors which influence how much surgery should be performed in the same operative setting. Centers of Excellence in body contouring that provide a team approach combining comprehensive patient evaluation, outcomes research, and surgical training may be the optimal approach for treating the massive weight loss patient. PMID:19083561

  8. Assessing the experience in complex hepatopancreatobiliary surgery among graduating chief residents: Is the operative experience enough?

    PubMed Central

    Sachs, Teviah E.; Ejaz, Aslam; Weiss, Matthew; Spolverato, Gaya; Ahuja, Nita; Makary, Martin A.; Wolfgang, Christopher L.; Hirose, Kenzo; Pawlik, Timothy M.

    2015-01-01

    Introduction Resident operative autonomy and case volume is associated with posttraining confidence and practice plans. Accreditation Council for Graduate Medical Education requirements for graduating general surgery residents are four liver and three pancreas cases. We sought to evaluate trends in resident experience and autonomy for complex hepatopancreatobiliary (HPB) surgery over time. Methods We queried the Accreditation Council for Graduate Medical Education General Surgery Case Log (2003–2012) for all cases performed by graduating chief residents (GCR) relating to liver, pancreas, and the biliary tract (HPB); simple cholecystectomy was excluded. Mean (±SD), median [10th–90th percentiles] and maximum case volumes were compared from 2003 to 2012 using R2 for all trends. Results A total of 252,977 complex HPB cases (36% liver, 43% pancreas, 21% biliary) were performed by 10,288 GCR during the 10-year period examined (Mean = 24.6 per GCR). Of these, 57% were performed during the chief year, whereas 43% were performed as postgraduate year 1–4. Only 52% of liver cases were anatomic resections, whereas 71% of pancreas cases were major resections. Total number of cases increased from 22,516 (mean = 23.0) in 2003 to 27,191 (mean = 24.9) in 2012. During this same time period, the percentage of HPB cases that were performed during the chief year decreased by 7% (liver: 13%, pancreas 8%, biliary 4%). There was an increasing trend in the mean number of operations (mean ± SD) logged by GCR on the pancreas (9.1 ± 5.9 to 11.3 ± 4.3; R2 = .85) and liver (8.0 ± 5.9 to 9.4 ± 3.4; R2 = .91), whereas those for the biliary tract decreased (5.9 ± 2.5 to 3.8 ± 2.1; R2 = .96). Although the median number of cases [10th:90th percentile] increased slightly for both pancreas (7.0 [4.0:15] to 8.0 [4:20]) and liver (7.0 [4:13] to 8.0 [5:14]), the maximum number of cases preformed by any given GCR remained stable for pancreas (51 to 53; R2 = .18), but increased for liver (38 to 45; R2 = .32). The median number of HPB cases that GCR performed as teaching assistants (TAs) remained at zero during this time period. The 90th percentile of cases performed as TA was less than two for both pancreas and liver. Conclusion Roughly one-half of GCR have performed fewer than 10 cases in each of the liver, pancreas, or biliary categories at time of completion of residency. Although the mean number of complex liver and pancreatic operations performed by GCR increased slightly, the median number remained low, and the number of TA cases was virtually zero. Most GCR are unlikely to be prepared to perform complex HPB operations. PMID:24953270

  9. Clinical applications of dynamic infrared thermography in plastic surgery: a systematic review

    PubMed Central

    John, Hannah Eliza; Niumsawatt, Vachara; Whitaker, Iain S.

    2016-01-01

    Background Infrared thermography (IRT) has become an increasingly utilized adjunct to more expensive and/or invasive investigations in a range of surgical fields, no more so than in plastic surgery. The combination of functional assessment, flow characteristics and anatomical localization has led to increasing applications of this technology. This article aims to perform a systematic review of the clinical applications of IRT in plastic surgery. Methods A systematic literature search using the keywords ‘IRT’ and ‘dynamic infrared thermography (DIRT)’ has been accomplished. A total of 147 papers were extracted from various medical databases, of which 34 articles were subjected to a full read by two independent reviewers, to ensure the papers satisfied the inclusion and exclusion criteria. Studies focusing on the use of IRT in breast cancer diagnosis were excluded. Results A systematic review of 29 publications demonstrated the clinical applications of IRT in plastic surgery today. They include preoperative planning of perforators for free flaps, post operative monitoring of free flaps, use of IRT as an adjunct in burns depth analysis, in assessment of response to treatment in hemangioma and as a diagnostic test for cutaneous melanoma and carpal tunnel syndrome (CTS). Conclusions Modern infrared imaging technology with improved standardization protocols is now a credible, useful non-invasive tool in clinical practice. PMID:27047781

  10. Big Data and Machine Learning in Plastic Surgery: A New Frontier in Surgical Innovation.

    PubMed

    Kanevsky, Jonathan; Corban, Jason; Gaster, Richard; Kanevsky, Ari; Lin, Samuel; Gilardino, Mirko

    2016-05-01

    Medical decision-making is increasingly based on quantifiable data. From the moment patients come into contact with the health care system, their entire medical history is recorded electronically. Whether a patient is in the operating room or on the hospital ward, technological advancement has facilitated the expedient and reliable measurement of clinically relevant health metrics, all in an effort to guide care and ensure the best possible clinical outcomes. However, as the volume and complexity of biomedical data grow, it becomes challenging to effectively process "big data" using conventional techniques. Physicians and scientists must be prepared to look beyond classic methods of data processing to extract clinically relevant information. The purpose of this article is to introduce the modern plastic surgeon to machine learning and computational interpretation of large data sets. What is machine learning? Machine learning, a subfield of artificial intelligence, can address clinically relevant problems in several domains of plastic surgery, including burn surgery; microsurgery; and craniofacial, peripheral nerve, and aesthetic surgery. This article provides a brief introduction to current research and suggests future projects that will allow plastic surgeons to explore this new frontier of surgical science. PMID:27119951

  11. 3D animation of facial plastic surgery based on computer graphics

    NASA Astrophysics Data System (ADS)

    Zhang, Zonghua; Zhao, Yan

    2013-12-01

    More and more people, especial women, are getting desired to be more beautiful than ever. To some extent, it becomes true because the plastic surgery of face was capable in the early 20th and even earlier as doctors just dealing with war injures of face. However, the effect of post-operation is not always satisfying since no animation could be seen by the patients beforehand. In this paper, by combining plastic surgery of face and computer graphics, a novel method of simulated appearance of post-operation will be given to demonstrate the modified face from different viewpoints. The 3D human face data are obtained by using 3D fringe pattern imaging systems and CT imaging systems and then converted into STL (STereo Lithography) file format. STL file is made up of small 3D triangular primitives. The triangular mesh can be reconstructed by using hash function. Top triangular meshes in depth out of numbers of triangles must be picked up by ray-casting technique. Mesh deformation is based on the front triangular mesh in the process of simulation, which deforms interest area instead of control points. Experiments on face model show that the proposed 3D animation facial plastic surgery can effectively demonstrate the simulated appearance of post-operation.

  12. Plastic surgery practice models and research aims under the Patient Protection and Affordable Care Act.

    PubMed

    Giladi, Aviram M; Yuan, Frank; Chung, Kevin C

    2015-02-01

    As the health care landscape in the United States changes under the Affordable Care Act, providers are set to face numerous new challenges. Although concerns about practice sustainability with declining reimbursement have dominated the dialogue, there are more pressing changes to the health care funding mechanism as a whole that must be addressed. Plastic surgeons, involved in various practice models each with different relationships to hospitals, referring physicians, and payers, must understand these reimbursement changes to dictate adequate compensation in the future. In this article, the authors discuss bundle payments and accountable care organizations, and how plastic surgeons might best engage in these new system designs. In addition, the authors review the value of a focused and driven health-services research agenda in plastic surgery, and the importance of this research in supporting long-term financial stability for the specialty. PMID:25626805

  13. Plastic Surgery Practice Models and Research Aims Under the Patient Protection and Affordable Care Act

    PubMed Central

    Giladi, Aviram M.; Yuan, Frank; Chung, Kevin C.

    2014-01-01

    As the healthcare landscape in the United States changes under the Affordable Care Act (ACA), providers are set to face numerous new challenges. Although concerns about practice sustainability with declining reimbursement have dominated the dialogue, there are more pressing changes to the healthcare funding mechanism as a whole that must be addressed. Plastic surgeons, involved in various practice models each with different relationships to hospitals, referring physicians, and payers, must understand these reimbursement changes in order to dictate adequate compensation in the future. Here we discuss bundle payments and Accountable Care Organizations (ACOs), and how plastic surgeons might best engage in these new system designs. In addition, we review the value of a focused and driven health-services research agenda in plastic surgery, and the importance of this research in supporting long-term financial stability for the specialty. PMID:25626805

  14. A report of the ASPS Task Force on regenerative medicine: opportunities for plastic surgery.

    PubMed

    D'Amico, Richard A; Rubin, J Peter; Neumeister, Michael W; Del Vecchio, Daniel A; Cederna, Paul S; Seward, William; Shoaf, Lori

    2013-02-01

    In 2011, the American Society of Plastic Surgeons (ASPS) created the Task Force on Regenerative Medicine to address the Society's strong interest in the emerging field of regenerative medicine, particularly cell- and tissue-based therapies applicable to plastic surgery procedures. The Task Force's U.S. Food and Drug Administration's Workgroup is informing ASPS interactions with the U.S. Food and Drug Administration's Center for Biologics Evaluation and Research. Engaging in dialogue with the agency to determine which research protocols will produce scientific data necessary to determine safety and efficacy for regenerative cellular therapies can allow research to be targeted to gather data that prove safety and efficacy of specific categories of therapies and/or products. This article reviews the regulatory backdrop of regenerative medicine, briefly reviews the history of regenerative medicine, and then looks at current research and potential future areas of research and clinical application. The historic ability of plastic surgeons to innovate and apply translational research positions the specialty of plastic surgery as a strong leader in clinical applications of regenerative medicine therapies. PMID:23358001

  15. [Some similarities between the work of M.C. Escher and plastic surgery].

    PubMed

    Marck, K W

    2002-12-21

    At first sight there would appear to be no similarities between the work of the Dutch graphic artist M.C. Escher and plastic surgery. M.C. Escher was a gifted graphic artist who produced a large collection of work. Most of his fame is due to the works that play with symmetry, space and infinity and leave the viewer astounded. However, how Escher came to produce these works is less well known. A theory which he developed himself formed the basis of the regular plane division. It later became apparent that this theory almost completely agreed with the mathematics of plane division. Two movements (isometries) defined in mathematics, translation and rotation, are equivalent to two techniques for transferring local skin in plastic surgery, namely, advancement and transposition. Escher's performance on the plane of a sheet of paper and a plastic surgeon's performance on the plane of the skin, therefore have a similar mathematical background. Escher has visualised these mathematical rules in an unusual and artistic manner, whereas plastic surgeons apply these rules in the grace of an elastic and healing nature. PMID:12534105

  16. Cataract Surgery

    MedlinePlus

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  17. The burn disease: a disease of great value in the cultural heritage of plastic surgery

    PubMed Central

    Mazzoleni, F.

    2014-01-01

    Personal introduction In 1961 I began my career as a plastic surgeon at the Department of Plastic Surgery of the Civic Hospital of Padua. In those years, the department was headed by its founder, Prof. G. Dogo, who had just gained his independence to work within the discipline of surgery. Its key feature consisted, at its core, in an entirely new section for those times: the Burn Centre, later known as the “Intensive Care Unit for Acute Burn Victims.” At that time, Prof. Masellis, the founder of the Mediterranean Burn Club, was also working among us. The department was still dealing with the disastrous traumatic pathologies that the Italian population had from the Second World War. The beds were still largely occupied by patients suffering from war injuries caused by bomb explosions and fires. These were the reason for the creation of the Burn Centre and subsequently for the promotion of the establishment of a department of plastic surgery. I therefore had the opportunity to see a multitude of different clinical cases and to experiment with the various operation techniques known to plastic surgeons at the time. But it was not only the surgical aspect that fascinated me; I was fascinated by the burn as a disease – the extraordinary problems of their pathophysiology and the logic of treating them, generally and locally – no longer as had been suggested by vague suppositions, but by suggestive hypotheses based on clinical and experimental observations. Over the years, the skills involved in plastic surgery have expanded: its numerous therapeutic procedures have been applied to the treatment of many other diseases. But the burn-as-disease was always at the top of my cultural interests. It always had something to teach me, whether clinically, scientifically or ethically. Yes, even ethically, because the burn patient, like few others who are ill, truly challenges his physician’s ethical core and moral strength. The contents of this piece of writing stem from “opinions” that the author has had in the practice of his profession while “listening and reading” everything that has happened to him during his work as a plastic surgeon over half a century. These opinions formed bit by bit; only now am I attempting to verify and justify them, intentionally seeking the bibliographic testimony and opinions of others. PMID:26170778

  18. Levels of Evidence in the Plastic Surgery Literature: A Citation Analysis of the Top 50 'Classic' Papers

    PubMed Central

    Joyce, Cormac W; Kelly, John C; Kelly, Jack L; Carroll, Sean M

    2015-01-01

    Background The plastic surgery literature is vast, consisting of a plethora of diverse articles written by a myriad of illustrious authors. Despite this considerable archive of published material, it remains nebulous as to which precise papers have had the greatest impact on our specialty. The aim of this study was to identify the most cited papers in the plastic surgery literature and perform a citation analysis paying particular attention to the evidence levels of the clinical studies. Methods We identified the 50 most cited papers published in the 20 highest impact plastic surgery journals through the Web of Science. The articles were ranked in order of number of citations acquired and level of evidence assessed. Results The top 50 cited papers were published in six different journals between the years 1957 and 2007. Forty-two of the papers in the top 50 were considered as level IV or V evidence. No level I or II evidence was present in the top 50 list. The average level of evidence of the top 50 papers was 4.28. Conclusions In the plastic surgery literature, no positive correlation exists between a high number of citations and a high level of evidence. Anatomical reconstructive challenges tend to be the main focus of plastic surgery rather than pathologic diseases and consequently, papers with lower levels of evidence are relatively more valuable in plastic surgery than many other specialties. PMID:26217560

  19. Effects of managed care on teaching, research, and clinical practice in academic plastic surgery.

    PubMed

    Ta, Kent T; Persing, John A; Chauncey, Henry; Bradley, Bat H; Miller, Stephen H

    2002-04-01

    The aim of this study was to determine: 1) if there have been changes in teaching, research, and clinical practice in academic plastic surgery in recent years; and 2) if there have been, are they associated with changes in the managed care environment? Gaining a clearer perspective on how managed care affects academic plastic surgery will enable academicians to define better the problems and opportunities they face mutually and to respond effectively to these issues. This study used a cross-sectional study design. Reference time periods were the premanaged care era (1990-1991) versus the current time (1997-1998). Data were collected by questionnaires sent to 94 academic program directors in plastic surgery. The main independent variable of managed care was measured as the difference in the percent of income from health maintenance organizations generated by each program in 1990 to 1991 versus 1997 to 1998. The dependent variables of teaching, research, and clinical practice were measured by the percentage of time spent in each category, the number of work hours per week, the number of staff personnel, the location of teaching, the number of grants and publications, and the percentage of reconstructive and cosmetic cases in 1990 to 1991 versus 1997 to 1998. Univariate analysis, paired Student's t-test, Fisher's exact test, Pearson's correlation, Spearman's correlation, and linear regression were used to establish significance (alpha = 0.05) of the effects of managed care on dependent variables. Sixty-six questionnaires were completed and returned (70% response rate). There were significant changes in the managed care environment, clinical practice (operating room and clinics), and research in academic plastic surgery from 1990 to 1997. The percentage of income generated from managed care increased from 9.8% (of total revenue) in 1990 to 23.6% in 1997 (an increase of 13.8%; p < 0.0001). Academic plastic surgeons were found to spend significantly more time in clinical practice (3% more of total time spent; 5.3 hours more per week in 1997; p < 0.016). This change correlated significantly with the increase in managed care (p < 0.015). In addition, the percentage of cosmetic cases increased from 18.0% in 1990 to 28.3% in 1997 (p < 0.001), and that of reconstructive surgery was reduced proportionately (p < 0.001). Also, a significant decrease in the time spent for research was observed (mean reduction, 2.8 hours less per week; p < 0.001). Although the trend was to a lower number, there were no significant changes in the amount of time spent in teaching (p > 0.08) and in administrative duty (p > 0.06), or in the number of personnel employed in the teaching programs (p > 0.05). In summary, these findings suggest that: 1) a greater percentage of revenue was generated from managed care in 1997 than in 1990, indicating a growing fiscal influence by managed care on academic plastic surgery; 2) furthermore, this change is associated with academic plastic surgeons devoting more time to clinical practice and less time to research endeavors; and 3) although managed care policies do affect teaching adversely, this effect has not yet reached significance for the period examined during this study. PMID:12068214

  20. Bassett healthcare rural surgery experience.

    PubMed

    Borgstrom, David C; Heneghan, Steven J

    2009-12-01

    The surgical training at Bassett is naturally broader than in many university settings, with a survey showing that nearly 70% of graduates who practice general surgery remain in a rurally designated area. Rural surgery experience falls into 3 categories: undergraduate, graduate, and postgraduate. The general surgery training program has no competing fellowships or subspecialty residencies; residents get significant experience with endoscopy; ear, nose, and throat; plastic and hand surgery; and obstetrics and gynecology. The rural setting lifestyle is valued by the students, residents, and fellows alike. It provides an ideal setting for recognizing the specific nuances of small-town American life, with a high-quality education and surgical experience. PMID:19944814

  1. Implications for human adipose-derived stem cells in plastic surgery

    PubMed Central

    Banyard, Derek A; Salibian, Ara A; Widgerow, Alan D; Evans, Gregory R D

    2015-01-01

    Adipose-derived stem cells (ADSCs) are a subset of mesenchymal stem cells (MSCs) that possess many of the same regenerative properties as other MSCs. However, the ubiquitous presence of ADSCs and their ease of access in human tissue have led to a burgeoning field of research. The plastic surgeon is uniquely positioned to harness this technology because of the relative frequency in which they perform procedures such as liposuction and autologous fat grafting. This review examines the current landscape of ADSC isolation and identification, summarizes the current applications of ADSCs in the field of plastic surgery, discusses the risks associated with their use, current barriers to universal clinical translatability, and surveys the latest research which may help to overcome these obstacles. PMID:25425096

  2. Elective plastic surgery in a Jehovah's Witness: a case series and review of the literature.

    PubMed

    Centeno, R F; Long, C D; Granick, M S

    2000-09-01

    "Bloodless" plastic surgery in the Jehovah's Witness patient is an area that has received little attention in the surgical literature. Given the unique and firmly held beliefs of this group of patients, caring for them can be particularly challenging for the plastic surgeon. The authors report a case of bilateral breast reconstruction with saline-filled implants complicated by a postoperative hematoma and one involving a staged approach to massive breast reduction, both in Jehovah's Witness patients. A third patient involving a staged panniculectomy for a complicated wound infection is also described. The historical background, philosophical views, ethical issues, legal aspects, surgical outcomes, and management techniques relevant to caring for this unique patient population are also reviewed in detail. PMID:10987524

  3. Clinical Application of Three-Dimensional Printing Technology in Craniofacial Plastic Surgery

    PubMed Central

    Kim, Namkug

    2015-01-01

    Three-dimensional (3D) printing has been particularly widely adopted in medical fields. Application of the 3D printing technique has even been extended to bio-cell printing for 3D tissue/organ development, the creation of scaffolds for tissue engineering, and actual clinical application for various medical parts. Of various medical fields, craniofacial plastic surgery is one of areas that pioneered the use of the 3D printing concept. Rapid prototype technology was introduced in the 1990s to medicine via computer-aided design, computer-aided manufacturing. To investigate the current status of 3D printing technology and its clinical application, a systematic review of the literature was conducted. In addition, the benefits and possibilities of the clinical application of 3D printing in craniofacial surgery are reviewed, based on personal experiences with more than 500 craniofacial cases conducted using 3D printing tactile prototype models. PMID:26015880

  4. Clinical application of three-dimensional printing technology in craniofacial plastic surgery.

    PubMed

    Choi, Jong Woo; Kim, Namkug

    2015-05-01

    Three-dimensional (3D) printing has been particularly widely adopted in medical fields. Application of the 3D printing technique has even been extended to bio-cell printing for 3D tissue/organ development, the creation of scaffolds for tissue engineering, and actual clinical application for various medical parts. Of various medical fields, craniofacial plastic surgery is one of areas that pioneered the use of the 3D printing concept. Rapid prototype technology was introduced in the 1990s to medicine via computer-aided design, computer-aided manufacturing. To investigate the current status of 3D printing technology and its clinical application, a systematic review of the literature was conducted. In addition, the benefits and possibilities of the clinical application of 3D printing in craniofacial surgery are reviewed, based on personal experiences with more than 500 craniofacial cases conducted using 3D printing tactile prototype models. PMID:26015880

  5. Applications of platelet-rich fibrin matrix in facial plastic surgery.

    PubMed

    Sclafani, Anthony P

    2009-11-01

    Platelet concentrates enjoyed some clinical popularity in facial plastic surgery several years ago. However, interest waned due to expense, amount of blood required, equipment, space, and staff needed, and lack of clinically significant benefit. A novel, simple method of preparing an autologous platelet derivative (Selphyl; Aesthetic Factors, Princeton, NJ) allows rapid and inexpensive generation of a platelet-rich fibrin matrix (PRFM) that can be used to enhance healing after facial procedures as well as to rejuvenate the face without tissue manipulation. PRFM provides autologous, natural, but concentrated platelet growth factor release and stimulation of surrounding tissue. This article describes its use for cosmetic facial applications. PMID:19924600

  6. Basic Plastic Surgery Skills Training Program on Inanimate Bench Models during Medical Graduation

    PubMed Central

    Denadai, Rafael; Toledo, Andréia Padilha; Martinhão Souto, Luis Ricardo

    2012-01-01

    Due to ethical and medical-legal drawbacks, high costs, and difficulties of accessibility that are inherent to the practice of basic surgical skills on living patients, fresh human cadaver, and live animals, the search for alternative forms of training is needed. In this study, the teaching and learning process of basic surgical skills pertinent to plastic surgery during medical education on different inanimate bench models as a form of alternative and complementary training to the teaching programs already established is proposed. PMID:23326659

  7. Children's art as a helpful index of anxiety and self-esteem with plastic surgery.

    PubMed

    Lukash, Frederick N

    2002-05-01

    Children often cannot adequately express their feelings about physical issues that may be affecting them emotionally. Nonverbal communication with art has been a time-tested tool in understanding and interpreting the feelings of children under stress. For 27 years, the author has used art as a helpful index of anxiety and self-esteem in children undergoing plastic surgery for congenital, traumatic, and aesthetic problems. A child psychiatrist and an art therapist evaluated 200 drawings. The evaluations corroborated the need to "listen" to our patients no matter what their size. PMID:11994573

  8. The Current Role of Three-Dimensional Printing in Plastic Surgery.

    PubMed

    Kamali, Parisa; Dean, David; Skoracki, Roman; Koolen, Pieter G L; Paul, Marek A; Ibrahim, Ahmed M S; Lin, Samuel J

    2016-03-01

    Since the advent of three-dimensional printing in the 1980s, it has become possible to produce physical objects from digital files and create three-dimensional objects by adding one layer at a time following a predetermined pattern. Because of the continued development of inexpensive and easy-to-use three-dimensional printers and bioprinting, this technique has gained more momentum over time, especially in the field of medicine. This article reviews the current and possible future application of three-dimensional printing technology within the field of plastic and reconstructive surgery. PMID:26910689

  9. Plastic surgery in 17th century Europe. case study: Nicolae Milescu, the snub-nosed.

    PubMed

    Dumbravă, Daniela; Luchian, Stefan

    2013-01-01

    The rising and the existence of plastic and aesthetic surgery in early modern Europe did not have a specific pattern, but was completely different from one nation to another. Colleges of Physicians could only be found in some places in Europe; different Parliaments of Europe's nations did not always elevate being a surgeon to the dignity of a profession, and being a surgeon did not always come with corporate and municipal privileges, or with attractive stipends. Conversely, corporal punishments for treacherous surgeons were ubiquitous. Rhinoplasty falls into the category of what Ambroise Paré named "facial plastic surgery". The technique is a medical source from which many histories derive, one more fascinating than the other: the history of those whose nose was cut off (because of state betrayal, adultery, abjuration, or duelling with swords), the history of those who invented the surgery of nose reconstruction (e.g. SuSruta-samhita or Tagliacozzi?), the history of surgeries kept secret in early modern Europe (e.g. Tropea, Calabria, Leiden, Padua, Paris, Berlin), and so on. Where does the history of Nicolae Milescu the Snub-nosed fall in all of this? How much of this history do the Moldavian Chronicles record? Is there any "scholarly gossip" in the aristocratic and diplomatic environments at Constantinople? What exactly do the British ambassadors learn concerning Rhinoplasty when they meet Milescu? How do we "walk" within these histories, and why should we be interested at all? What is their stike for modernity? Such are the interrogations that this article seeks to provoke; its purpose is to question (and eventually, synchronise) histories, and not exclusively history, both in academic terms but also by reassessing the practical knowledge of the 17th century. PMID:24502038

  10. A review of prophylactic antibiotics use in plastic surgery in China and a systematic review.

    PubMed

    Li, Ge-hong; Hou, Dian-ju; Fu, Hua-dong; Guo, Jing-ying; Guo, Xiao-bo; Gong, Hui

    2014-12-01

    The purpose of this study was to investigate the use of antibiotic prophylaxis for plastic surgical procedures at our hospital, and to perform a systematic literature review of randomized controlled trials evaluating the use of prophylactic antibiotics in plastic surgery. The records of patients who received plastic surgical procedures with Class I surgical incisions between 2009 and 2010 were retrospectively reviewed. A systematic literature review was conducted for studies examining the use of prophylactic antibiotics for Class I surgical wounds. A total of 13,997 cases with Class I surgical incisions were included. Prophylactic antibiotics were given in 13,865 cases (99.1%). The antibiotics used were primarily cefuroxime, clindamycin, metronidazole, cefoxitin sodium, and gentamicin. The average duration of administration was 4.84 ± 3.07 (range, 1-51) days. Antibiotics were administered postoperatively in >99% of cases while preoperative antibiotic administration was only given in 32 cases (0.23%). Wound infections occurred in 21 cases for an overall infection rate of 0.15%. Fourteen studies met the inclusion criteria of the systematic review. There was marked variation in the timing of antibiotic administration with antibiotics given pre-, peri-, and postoperatively. Of studies that compared the use of prophylactic antibiotics with placebo, a reduction in wound infections was noted in 4 trials and no difference was noted in 6 trials. No significant difference in infection rates was shown between the prophylactic and postoperative arms. In conclusion, prophylactic antibiotics are overused in plastic surgical procedures. Evidence-based guidelines for the use of prophylactic antibiotics in plastic surgical procedures are needed. PMID:25448649

  11. A study of the personal use of digital photography within plastic surgery.

    PubMed

    McG Taylor, D; Foster, E; Dunkin, C S J; Fitzgerald, A M

    2008-01-01

    The advent of digital photography has greatly increased the use of medical illustration within specialties dealing with visible pathologies. It offers improved communication between medical professionals, education and counselling of their patients and forms an important aspect of their medical records. With the increased availability of digital cameras there is an increased tendency for clinicians to take digital photographs of patients themselves. In doing so, clinicians take on the responsibility to act in accordance with the regulations governing this practice issued by the UK Department of Health. This study sought to investigate the prevalence of this practice by way of an anonymous questionnaire distributed to three representative plastic surgery units within the UK. It looked at the awareness of and compliance with the present governing regulations. The results showed that of the 60 distributed questionnaires, 30 of 42 respondents took digital photographs of patients themselves. Photographs were taken for the purposes of inclusion in the medical records, education, development of personal libraries and publication. Consent was usually taken but was often only in a verbal form. Processing, storage and security measures highlighted potential risks for breaches in confidentiality. Knowledge relating to the NHS Confidentiality Code of Practice, the Data Protection Act and the need for registration with the Data Commissioner when acting in a private capacity were often not known. This small study highlights a number of important points surgeons need to be aware of when taking photographs of patients themselves and makes recommendations for its practice within a plastic surgery department. PMID:17766207

  12. The clinical applications of human amnion in plastic surgery.

    PubMed

    Fairbairn, N G; Randolph, M A; Redmond, R W

    2014-05-01

    Since the early 1900s, human amnion has been applied to a wide variety of clinical scenarios including burns, chronic ulcers, dural defects, intra-abdominal adhesions, peritoneal reconstruction, genital reconstruction, hip arthroplasty, tendon repair, nerve repair, microvascular reconstruction, corneal repair, intra-oral reconstruction and reconstruction of the nasal lining and tympanic membrane. Amnion epithelial and mesenchymal cells have been shown to contain a variety of regulatory mediators that result in the promotion of cellular proliferation, differentiation and epithelialisation and the inhibition of fibrosis, immune rejection, inflammation and bacterial invasion. The full repertoire of biological factors that these cells synthesise, store and release and the mechanisms by which these factors exert their beneficial effects are only now being fully appreciated. Although many commercially available biological and synthetic alternatives to amnion exist, ethical, religious, and financial constraints may limit the widespread utilisation of these products. Amnion is widely available, economical and is easy to manipulate, process and store. Although many clinical applications are of historical interest only, amnion offers an alternative source of multi-potent or pluripotent stem cells and therefore may yet have a great deal to offer the plastic surgery and regenerative medicine community. It is the purpose of this article to review the clinical applications of human amnion relevant to plastic surgery. PMID:24560801

  13. Cosmetic Surgery

    MedlinePlus

    ... should be certified by the American Board of Plastic Surgery. How many years has the doctor performed this ... of Plastic Surgeons (ASPS)/ The American Board of Plastic Surgery (ABPS) – All of the surgeons listed through this ...

  14. Patient Protection and Affordable Care Act: implications for pediatric plastic surgery.

    PubMed

    Abbott, Megan M; Meara, John G

    2012-01-01

    Passage of the Patient Protection and Affordable Care Act (PPACA) has stimulated wide debate in the medical and surgical community. Endorsed by the American Medical Association and a number of primary care-focused organizations, the American College of Surgeons (ACS) and nearly all other surgical associations opposed the bill. This divergence stems not from direct disagreement over provisions in the bill but from opposition to or support of certain provisions with direct implications for the physicians represented by a given organization, as well as the relative importance of provisions for which these organizations share a common opinion. Regarding the field of pediatric plastic surgery, the surgical perspective of the ACS and the American Society of Plastic Surgeons and the medical perspective of the American Academy of Pediatrics align on many issues. Given the lack of specificity of any of the provisions for a field as specialized as pediatric plastic surgery, this review will focus on broader implications of the PPACA both for medical and surgical needs of pediatric patients and for the surgeons providing their care. The provisions of the PPACA are distributed along an implementation timeline, with some major changes having already occurred. The popularity of some of the early provisions, many pertaining to the pediatric population, has implications for any attempt at repeal of the law as a whole in coming years. Despite its daunting length, the PPACA can be approached by considering its provisions in 4 major categories: increased consumer protections, increased accountability for insurers, increased access to affordable care, and quality and cost improvement. PMID:22337412

  15. Catheter-Based Educational Experiences: A Canadian Survey of Current Residents and Recent Graduates in Cardiac Surgery.

    PubMed

    Juanda, Nadzir; Chan, Vincent; Chan, Ryan; Rubens, Fraser D

    2016-03-01

    The past decade has witnessed significant developments in the use of catheter-based therapies in cardiovascular medicine. We sought to assess the educational opportunities for cardiac surgery trainees to determine their readiness for participation in these strategies. A web-based survey was distributed to current residents, recent graduates, and program directors in Canadian cardiac surgery residency programs from 2008-2013. The survey was distributed to 110 residents and graduates. Forty-five percent completed the survey. Thirty-five percent expressed that they experienced resistance organizing their rotations because they had to compete with non-cardiac surgery colleagues, and 6 were denied local cardiac catheterization rotations. By the end of the rotation, 56% were comfortable performing a diagnostic cardiac catheterization independently. Exposure to being the operator performing diagnostic catheterization was significantly associated with the positive perception of being able to perform a diagnostic catheterization independently (odds ratio [OR], 5.14; 95% confidence interval [CI], 1.33-19.81; P = 0.017). Eighty-eight percent of respondents expressed the need for more exposure in catheter-based rotations. Seven of 11 program directors completed the survey. All believed such rotations should be mandatory and foresaw a bigger role for hybrid catheter-based/cardiac surgery procedures in the future. Trainees and program directors perceive that increased exposure to catheter-based therapies is important to career development as a cardiac surgeon. This survey will contribute to the development of a cardiac surgery training curriculum as we foresee more hybrid and team procedures. PMID:26577894

  16. Why we are here: early reflections on the role of reconstructive plastic surgery in the 2013 Boston marathon bombings.

    PubMed

    Carty, Matthew J; Caterson, Edward J; Caterson, Stephanie A; Chun, Yoon S; Erdmann-Sager, Jessica; Hadad, Ivan; Halvorson, Eric G; Orgill, Dennis P; Sampson, Christian E; Talbot, Simon G; Theman, Todd; Eriksson, Elof

    2013-12-01

    The 2013 Boston Marathon bombings resulted in a large and unexpected influx of patients requiring acute multidisciplinary surgical care. The authors describe the surgical management experience of these patients at Brigham & Women's Hospital and Brigham & Women's Faulkner Hospital, with a particular focus on the important role played by reconstructive plastic surgery. The authors suggest that this experience illustrates the value of reconstructive plastic surgery in the treatment of these patients specifically and of trauma patients in general, and argue for the increasing importance of promoting our identity as a specialty. PMID:24281588

  17. Self-perceived video-assisted thoracic surgery lobectomy proficiency by recent graduates of North American thoracic residencies.

    PubMed

    Boffa, Daniel J; Gangadharan, Sidharta; Kent, Michael; Kerendi, Faraz; Onaitis, Mark; Verrier, Edward; Roselli, Eric

    2012-06-01

    Minimally invasive surgical techniques offer several advantages over traditional open procedures, yet the pathway to minimally invasive proficiency can be difficult to navigate. As a part of an effort of the Joint Council of Thoracic Surgical Education to increase access to this skill set in the general thoracic community, recent graduates of thoracic residencies were surveyed to determine the self-reported achievement of video-assisted thoracic surgery (VATS) lobectomy proficiency and the merits of various educational opportunities. The objective of this study was to estimate the comfort level of recent graduates with the minimally invasive approach, as this demographic not only reflects the current status of training, but represents the future of the specialty. Surgeons graduating North American thoracic residencies between 2006 and 2008 identifying themselves as practitioners of general thoracic surgery were surveyed. A total of 271 surgeons completed training between 2006 and 2008 and indicated general thoracic to be a part of their practice (84 dedicated thoracic and 187 mixed). One hundred and forty-six surgeons completed the survey (54%) including 74 of 84 (88%) dedicated thoracic surgeons. Overall, 58% of recent graduates who perform general thoracic procedures consider themselves proficient in VATS lobectomies (86% of dedicated thoracic surgeons and 28% of surgeons with a mixed practice, P < 0.0001). Of surgeons considering themselves to be proficient at VATS lobectomies, 66% felt thoracic residency was critical or very important to achieving proficiency. Fellowships after completing board residency, animal labs, and follow-up VATS courses put on by experts were much less consistently beneficial. The vast majority of the 25 dedicated general thoracic surgeons who graduate each year consider themselves proficient in VATS lobectomies, largely due to training in their thoracic residencies. On the other hand, the minority of surgeons performing general thoracic procedures as a part of a mixed practice consider themselves proficient in VATS lobectomies. Further study is warranted to enhance the VATS lobectomy experience of mixed practice surgeons particularly during their thoracic residencies. PMID:22381653

  18. Development of Standardized Clinical Assessment and Management Plans (SCAMPs) in Plastic and Reconstructive Surgery

    PubMed Central

    Singh, Mansher; Orgill, Dennis; Ghazinouri, Roya; Ciociolo, George; Laskowski, Karl; Greenberg, Jeffery O.

    2015-01-01

    Background: With rising cost of healthcare, there is an urgent need for developing effective and economical streamlined care. In clinical situations with limited data or conflicting evidence-based data, there is significant institutional and individual practice variation. Quality improvement with the use of Standardized Clinical Assessment and Management Plans (SCAMPs) might be beneficial in such scenarios. The SCAMPs method has never before been reported to be utilized in plastic surgery. Methods: The topic of immediate breast reconstruction was identified as a possible SCAMPs project. The initial stages of SCAMPs development, including planning and implementation, were entered. The SCAMP Champion, along with the SCAMPs support team, developed targeted data statements. The SCAMP was then written and a decision-tree algorithm was built. Buy-in was obtained from the Division of Plastic Surgery and a SCAMPs data form was generated to collect data. Results: Decisions pertaining to “immediate implant-based breast reconstruction” were approved as an acceptable topic for SCAMPs development. Nine targeted data statements were made based on the clinical decision points within the SCAMP. The SCAMP algorithm, and the SDF, required multiple revisions. Ultimately, the SCAMP was effectively implemented with multiple iterations in data collection. Conclusions: Full execution of the SCAMP may allow better-defined selection criteria for this complex patient population. Deviations from the SCAMP may allow for improvement of the SCAMP and facilitate consensus within the Division. Iterative and adaptive quality improvement utilizing SCAMPs creates an opportunity to reduce cost by improving knowledge about best practice. PMID:26495223

  19. Video Capture of Plastic Surgery Procedures Using the GoPro HERO 3+

    PubMed Central

    Graves, Steven Nicholas; Shenaq, Deana Saleh; Langerman, Alexander J.

    2015-01-01

    Background: Significant improvements can be made in recoding surgical procedures, particularly in capturing high-quality video recordings from the surgeons point of view. This study examined the utility of the GoPro HERO 3+ Black Edition camera for high-definition, point-of-view recordings of plastic and reconstructive surgery. Methods: The GoPro HERO 3+ Black Edition camera was head-mounted on the surgeon and oriented to the surgeons perspective using the GoPro App. The camera was used to record 4 cases: 2 fat graft procedures and 2 breast reconstructions. During cases 1-3, an assistant remotely controlled the GoPro via the GoPro App. For case 4 the GoPro was linked to a WiFi remote, and controlled by the surgeon. Results: Camera settings for case 1 were as follows: 1080p video resolution; 48 fps; Protune mode on; wide field of view; 16:9 aspect ratio. The lighting contrast due to the overhead lights resulted in limited washout of the video image. Camera settings were adjusted for cases 2-4 to a narrow field of view, which enabled the cameras automatic white balance to better compensate for bright lights focused on the surgical field. Cases 2-4 captured video sufficient for teaching or presentation purposes. Conclusions: The GoPro HERO 3+ Black Edition camera enables high-quality, cost-effective video recording of plastic and reconstructive surgery procedures. When set to a narrow field of view and automatic white balance, the camera is able to sufficiently compensate for the contrasting light environment of the operating room and capture high-resolution, detailed video. PMID:25750851

  20. [Avoidance of complications in oncological surgery of the pelvic region : combined oncosurgical and plastic reconstruction measures].

    PubMed

    Beier, J P; Croner, R S; Lang, W; Arkudas, A; Schmitz, M; Göhl, J; Hohenberger, W; Horch, R E

    2015-03-01

    Prevention of perioperative and postoperative complications resulting from surgical oncology in the pelvic region remains a major interdisciplinary challenge. With modern interdisciplinary concepts joining forces of various surgical specialties, tumor resection can be sufficiently carried out with wide margins and the patients benefit from reduced morbidity even in complex situations. As an example chronic fistulation and secretion from the presacral cavity and sinus may result as potential sequelae from intra-abdominal and intrapelvic tumor resection, especially when neoadjuvant multimodal therapies have been applied. This can be prevented by simultaneous transplantation of for example transpelvic vertical rectus abdominis myocutaneous (VRAM) flap transfer, while extensive perineal skin and soft tissue defects may also be simultaneously reconstructed. In cases of malignant soft tissue tumors in the pelvic region a staged surgical procedure can be performed with a period of time between tumor resection and reconstruction. Thus, a histological R0 status can be secured prior to plastic reconstruction surgery in order to increase oncological safety. In cases of postresectional exposition of e. g. pelvic or femoral vessels or intrapelvic and intra-abdominal organs simultaneous flap procedure is mandatory.The reconstructive armamentarium of the plastic surgeon should contain not only pedicled but also free microsurgical flaps so that no compromise in terms of the extent of the oncological resection has to be accepted. At the same time perioperative and postoperative complications may be avoided and the patient quality of life can be preserved even in more complex cases. PMID:25620285

  1. Orthopedic surgery fellowships: the effects of interviewing and how residents establish a rank list.

    PubMed

    Niesen, Matthew C; Wong, Jeffrey; Ebramzadeh, Edward; Sangiorgio, Sophia; SooHoo, Nelson Fong; Luck, James V; Eckardt, Jeffrey

    2015-03-01

    The Orthopaedic Fellowship Match was established in 2008 to streamline and improve the process of matching residents and fellowships. The purpose of this study was to quantify the factors that affect the application process and to determine how residents establish a rank list. The Orthopaedic Fellowship Match has improved the ability of residents and programs to consider their options more carefully and to focus on finding the best match. However, this process introduces new factors for all parties involved to consider. The costs of the interview process and time away from service for residents may be larger than anticipated. Ultimately, residents value operative experience and staff members at a fellowship more than all other factors when selecting a fellowship. PMID:25760497

  2. Student Teachers' Evaluations of Slides of Children with Down Syndrome: Impact of Facial Plastic Surgery, Labelling and Factual Knowledge.

    ERIC Educational Resources Information Center

    Elkabetz, R.; And Others

    1990-01-01

    This study examined the impact of facial plastic surgery, labeling (mentally retarded, normal, Down's syndrome), and level of knowledge of Down's syndrome on 127 student teachers' evaluations of slides of persons with such characteristics. Although there was no overall significant main effect for the pre-post operation condition, there was a

  3. [Strategies to ensure careers of young academics in plastic surgery - analysis of the current situation and future perspectives].

    PubMed

    Horch, R E; Vogt, P M; Schaller, H E; Stark, G B; Lehnhardt, M; Kneser, U; Giunta, R E

    2013-08-01

    Recruitment problems in surgical disciplines have become an increasingly debated topic. On the one hand current career prospects appear to be less attractive than those were seen for the previous generation. On the other hand the demands for a so-called "work-life balance" have changed and the proportion of female students and colleagues in medicine has risen and will continue to increase. Although Plastic Surgery currently seems to be less affected by these problems than other surgical disciplines, securing a qualified supply of young academics in Plastic Surgery is a prerequisite for the further development of this discipline. The traditional model of mentoring is discussed and the role of coaching in a sense of helping the mentorees examine what they are doing in the light of their intentions and goals is reflected. The present article tries to analyze the current status of academic Plastic Surgery from the viewpoint of German university senior surgeons in academic plastic surgery, and aims to highlight the specific prospects for young academics against the backdrop of an often one-sided and superficial perception of this profession. PMID:23881363

  4. Student Teachers' Evaluations of Slides of Children with Down Syndrome: Impact of Facial Plastic Surgery, Labelling and Factual Knowledge.

    ERIC Educational Resources Information Center

    Elkabetz, R.; And Others

    1990-01-01

    This study examined the impact of facial plastic surgery, labeling (mentally retarded, normal, Down's syndrome), and level of knowledge of Down's syndrome on 127 student teachers' evaluations of slides of persons with such characteristics. Although there was no overall significant main effect for the pre-post operation condition, there was a…

  5. 76 FR 42713 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Amendment of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-19

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Amendment of Notice AGENCY: Food and Drug Administration, HHS. ACTION: Notice. The Food and Drug Administration (FDA)...

  6. 75 FR 47606 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-06

    ...The meeting of the General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee scheduled for August 26, 2010, is postponed. The meeting was announced in the Federal Register of June 24, 2010 (75 FR 36102). The meeting is postponed so that FDA can review and consider additional information that was submitted. A future meeting date will be announced in the Federal......

  7. 78 FR 16684 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-18

    ... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Devices Panel of the Medical Devices Advisory Committee. General Function of the Committee: To provide... special needs. If you require special accommodations due to a disability, please contact AnnMarie...

  8. 76 FR 39882 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-07

    ... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Devices Panel of the Medical Devices Advisory Committee. General Function of the Committee: To provide..., please contact AnnMarie Williams, Conference Management Staff, 301-796-5966, at least 7 days in...

  9. 77 FR 20642 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-05

    ... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Devices Panel of the Medical Devices Advisory Committee. General Function of the Committee: To provide..., and vote on information related to the premarket approval application, sponsored by Dune...

  10. 78 FR 30928 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-23

    ... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Devices Panel of the Medical Devices Advisory Committee. General Function of the Committee: To provide..., please contact AnnMarie Williams, Committee Management Staff, at 301-796-5966 or...

  11. 75 FR 49940 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-16

    ... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Devices Panel of the Medical Devices Advisory Committee. General Function of the Committee: To provide..., please contact AnnMarie Williams, Conference Management Staff, 301-796-5966, at least 7 days in...

  12. 75 FR 36102 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-24

    ... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Devices Panel of the Medical Devices Advisory Committee. General Function of the Committee: To provide... you require special accommodations due to a disability, please contact AnnMarie Williams,...

  13. 76 FR 62419 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-07

    ... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Devices Panel of the Medical Devices Advisory Committee. General Function of the Committee: To provide... a disability, please contact AnnMarie Williams, Conference Management Staff, 301-796-5966, at...

  14. 76 FR 14415 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-16

    ... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Devices Panel of the Medical Devices Advisory Committee. General Function of the Committee: To provide... special accommodations due to a disability, please contact AnnMarie Williams, Conference Management...

  15. Anticipating benefits and decreasing burdens: the responsibility inherent in pediatric plastic surgery.

    PubMed

    Aspinall, Cassandra L

    2010-09-01

    Working with child patients and their families in the practice of plastic and reconstructive surgery is rewarding and risky. Technical training is understandably intensive. However, the importance of the work that is needed before an operation does not always attract the same attention. Surgery that is done to change a child's body results in a change in that person's identity and cannot be taken lightly. A review of the overall benefit and burden of both the untreated condition and the proposed changes must be considered to support a change so that it does not damage an individual's identity development. By taking the time to understand what the patient's perspective is, surgical change can become a process that a person is part of, instead of it being something that is done to them. This helps to set up a situation where the change will be directly beneficial to the patient, and that change will be sustained over a long period. When evaluating surgical options with children, the influences and pressures that exist within families and throughout society must also be considered. A young child and his/her future must not get lost in the difficult negotiations between parents/guardians, surgeons, and society. By taking more time to consider the tremendous meaning that your work has outside the operating room and in the context of who the patient is becoming, you will have a greater chance of not just enhancing someone's appearance, but also improving his/her quality of life. PMID:20856017

  16. Appropriate roles for the subscriber, publisher, editor, author, and reviewer in the archives of plastic surgery.

    PubMed

    Hwang, Kun

    2013-11-01

    Authors, editors and reviewers, publishers, and subscribers all play their role in scientific journals. These 5 stakeholders are essential to journals. In this paper, firstly, I briefly summarize the role of each journal stakeholder and their respective goals. Secondly, the status of each participant in the Archives of Plastic Surgery is described. Finally, I propose an appropriate role and plan for each of them. Specific roles and responsibilities include the following: subscribers should welcome and submit the critiques of published papers in letters to the editor. Publishers should trust editors and provide them with adequate financial support for ongoing quality improvement of the journal. The editor-in-chief should be given a sufficient period of time-several years-to build up journal quality and train the incoming editor. The editors, including section editors, are also responsible for increasing the author pool. One editor might be designated a 'devil's referee', that is, a kind of devil's advocate with the responsibility of examining the originality of the manuscript, taking a skeptical view of the manuscript, and looking for holes in the methods and results of reported experiments. Authors' responsibilities include submitting manuscripts with scientific integrity and being ready to take responsibility for their articles even long after publication. Finally, reviewers' responsibilities include identifying similar articles not cited. Reviewers are also welcome to write a discussion on the article they review. PMID:24286037

  17. Medical borderlands: engineering the body with plastic surgery and hormonal therapies in Brazil.

    PubMed

    Edmonds, Alexander; Sanabria, Emilia

    2014-01-01

    This paper explores medical borderlands where health and enhancement practices are entangled. It draws on fieldwork carried out in the context of two distinct research projects in Brazil on plastic surgery and sex hormone therapies. These two therapies have significant clinical overlap. Both are made available in private and public healthcare in ways that reveal the class dynamics underlying Brazilian medicine. They also have an important experimental dimension rooted in Brazil's regulatory context and societal expectations placed on medicine as a means for managing women's reproductive and sexual health. Off-label and experimental medical use of these treatments is linked to experimental social use: how women adopt them to respond to the pressures, anxieties and aspirations of work and intimate life. The paper argues that these experimental techniques are becoming morally authorized as routine management of women's health, integrated into mainstream Ob-Gyn healthcare, and subtly blurred with practices of cuidar-se (self-care) seen in Brazil as essential for modern femininity. PMID:25175295

  18. [Medical borderlands: engineering the body with plastic surgery and hormonal therapies in Brazil].

    PubMed

    Edmonds, Alexander; Sanabria, Emilia

    2016-03-01

    This paper explores medical borderlands where health and enhancement practices are entangled. It draws on fieldwork carried out in the context of two distinct research projects in Brazil on plastic surgery and sex hormone therapies. These two therapies have significant clinical overlap. Both are made available in private and public healthcare in ways that reveal the class dynamics underlying Brazilian medicine. They also have an important experimental dimension rooted in Brazil's regulatory context and societal expectations placed on medicine as a means for managing women's reproductive and sexual health. Off-label and experimental medical use of these treatments is linked to experimental social use: how women adopt them to respond to the pressures, anxieties and aspirations of work and intimate life. The paper argues that these experimental techniques are becoming morally authorized as routine management of women's health, integrated into mainstream Ob-Gyn healthcare, and subtly blurred with practices of cuidar-se (self-care) seen in Brazil as essential for modern femininity. PMID:27008081

  19. The temporary use of allograft for complicated wounds in plastic surgery.

    PubMed

    Moerman, E; Middelkoop, E; Mackie, D; Groenevelt, F

    2002-10-01

    A retrospective analysis was performed on the use of glycerol-preserved allografts (GPA) in the preparation of complicated wounds for secondary wound closure. All files from the plastic surgery department in the period 1992-1998 were screened. Thirty-three patients within a total 85 GPA treatments were selected and screened for indication of use of GPA, frequency of GPA changes, duration of treatment and whether or not subsequent autografting was possible. GPA was used as a biological cover for the following indications: problematic wound healing, 13 cases; non-healing burns, 12 cases; carcinoma, 4 cases; unstable scar, 2 cases; shortage of skin, 2 cases. The average frequency of GPA application was 2.6 times, with a mean duration of 5 days per application. In 84 cases (32 patients) the wound was successfully covered with autograft. In conclusion, GPA was used with good results as a temporary cover for complicated wounds. We postulate that angiogenic effects of this biological dressing may have contributed to the improved healing conditions and successful secondary wound closure. PMID:12237058

  20. Medical borderlands: engineering the body with plastic surgery and hormonal therapies in Brazil

    PubMed Central

    Edmonds, Alexander; Sanabria, Emilia

    2014-01-01

    This paper explores medical borderlands where health and enhancement practices are entangled. It draws on fieldwork carried out in the context of two distinct research projects in Brazil on plastic surgery and sex hormone therapies. These two therapies have significant clinical overlap. Both are made available in private and public healthcare in ways that reveal the class dynamics underlying Brazilian medicine. They also have an important experimental dimension rooted in Brazil's regulatory context and societal expectations placed on medicine as a means for managing women's reproductive and sexual health. Off-label and experimental medical use of these treatments is linked to experimental social use: how women adopt them to respond to the pressures, anxieties and aspirations of work and intimate life. The paper argues that these experimental techniques are becoming morally authorized as routine management of women's health, integrated into mainstream Ob-Gyn healthcare, and subtly blurred with practices of cuidar-se (self-care) seen in Brazil as essential for modern femininity. PMID:25175295

  1. A Review of the Use of Medicare Claims Data in Plastic Surgery Outcomes Research

    PubMed Central

    Mahmoudi, Elham; Kotsis, Sandra V.

    2015-01-01

    Summary: With a growing national emphasis in data transparency and reporting of public health data, it is essential for researchers to know more about Medicare claims data, the largest and most reliable source of health-care utilization and expenditure for individuals older than 65 years in the United States. This article provides an overview of Medicare claims data for plastic surgery outcomes research. We highlight essential information on various files included in Medicare claims data, strengths and limitations of the data, and ways to expand the use of existing data for research purposes. As of now, Medicare data are limited in providing adequate information regarding severity of diagnosed conditions, health status of individuals, and health outcomes after certain procedures. However, the data contain all health-care utilization and expenditures for services that are covered by Medicare Parts A, B, and D (inpatient, outpatient, ambulatory-based and physician-based services, and prescription drugs). Additionally, Medicare claims data can be used for longitudinal analysis of variations in utilization and cost of health-care services at the patient level and provider level. Linking Medicare claims data with other national databases and utilizing the ICD-10 coding system would further expand the use of these datasets in health services research. PMID:26579336

  2. [Aesthetic/Plastic Surgery in Children as Seen from the Perspective of Child and Adolescent Psychiatry and Psychotherapy].

    PubMed

    Kölch, M; Izat, Y

    2015-12-01

    Physical deformities may cause psychological stress and lead to psychological disorders in children and adolescents. On the other hand, the correction of non-pathological conditions is a legal issue in patients unable to consent, a group that is partly made up of minors. This article provides an overview on available evidence on the psychological consequences of physical deformities, psychiatric contraindications for plastic surgery due to psychological disorders, and on the issue of minors' ability to consent. PMID:26562008

  3. 75 FR 1395 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Amendment of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-11

    ...The Food and Drug Administration (FDA) is announcing an amendment to the notice of a meeting of the General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee. This meeting was announced in the Federal Register of November 17, 2009 (74 FR 59194). The amendment is being made to reflect a change in the Contact Person and Procedure portions of the document, and to provide......

  4. What Is Refractive Surgery?

    MedlinePlus

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  5. LASIK - Laser Eye Surgery

    MedlinePlus

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  6. Alternative Refractive Surgery Procedures

    MedlinePlus

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  7. Comparing resident cataract surgery outcomes under novice versus experienced attending supervision

    PubMed Central

    Puri, Sidharth; Kiely, Amanda E; Wang, Jiangxia; Woodfield, Alonzo S; Ramanathan, Saras; Sikder, Shameema

    2015-01-01

    Purpose To determine whether supervision by an attending who is new to surgical teaching, or an experienced attending measurably influences intraoperative complications rates or outcomes in phacoemulsification performed by ophthalmology residents. Setting Single tertiary hospital. Design Retrospective cohort study. Methods Resident-performed phacoemulsification cases supervised by one novice attending (N=189) and experienced attending (N=172) over 1 year were included. Data included: resident year, patient age, sex, preoperative risk factors (4+ on the four point scale for dense/white/brunescent cataracts, Flomax, zonular dialysis, pseudoexfoliation, glaucoma risk, post-vitrectomy), intraoperative risk factors (Trypan blue, iris hooks), and intraoperative complications (capsule tears, vitreous loss, zonular dialysis, zonular dehiscence, burns, nuclear fragment loss, Descemet’s tear). Experienced attending data were compared against those of the novice attending. Results Regarding preoperative risks, experienced attending cases more likely involved 4+ cataract (P=0.005), Flomax (P<0.001), or glaucoma risk (P=0.001). For intraoperative risks, novice attending cases more likely involved Trypan blue (P<0.001). Regarding complications, novice attending cases were associated with vitreous loss (P=0.002) and anterior capsule tears (P<0.001). When comparing total complications, the novice attending was more likely to have both increased number of cases with complications and total complications than the experienced attending. The novice attending’s overall complication rate trended downward (rate from 28% in first 25 cases to 6.67% in last 15). Conclusion Early cases for the novice attending were accompanied by greater complications (vitreous loss and anterior capsule tear), likely due to a learning curve. Surgical judgment in the operating room likely develops with experience. Training programs may focus on these specific areas to aid new instructors. PMID:26396493

  8. Plastic and Reconstructive Surgery in the Treatment of Oncological Perineal and Genital Defects

    PubMed Central

    Brodbeck, Rebekka; Horch, Raymund E.; Arkudas, Andreas; Beier, Justus P.

    2015-01-01

    Defects of the perineum may result from ablative procedures of different malignancies. The evolution of more radical excisional surgery techniques resulted in an increase in large defects of the perineum. The perineogenital region per se has many different functions for urination, bowel evacuation, sexuality, and reproduction. Up-to-date individual and interdisciplinary surgical treatment concepts are necessary to provide optimum oncological as well as quality of life outcome. Not only the reconstructive method but also the timing of the reconstruction is crucial. In cases of postresectional exposition of e.g., pelvic or femoral vessels or intrapelvic and intra-abdominal organs, simultaneous flap procedure is mandatory. In particular, the reconstructive armamentarium of the plastic surgeon should include not only pedicled flaps but also free microsurgical flaps so that no compromise in terms of the extent of the oncological resection has to be accepted. For intra-abdominally and/or pelvic tumors of the rectum, the anus, or the female reproductive system, which were resected through an abdominally and a sacrally surgical access, simultaneous vertical rectus abdominis myocutaneous (VRAM) flap reconstruction is recommendable. In terms of soft tissue sarcoma of the pelvic/caudal abdomen/proximal thigh region, two-stage reconstructions are possible. This review focuses on the treatment of perineum, genitals, and pelvic floor defects after resection of malignant tumors, giving a distinct overview of the different types of defects faced in this region and describing a number of reconstructive techniques, especially VRAM flap and pedicled flaps like antero-lateral thigh flap or free flaps. Finally, this review outlines some considerations concerning timing of the different operative steps. PMID:26500887

  9. Breast Microsurgery in Plastic Surgery Literature: A 21-Year Analysis of Publication Trends.

    PubMed

    Daly, Lauren Tracy; Mowlds, Donald; Brodsky, Merrick A; Abrouk, Michael; Gandy, Jessica R; Wirth, Garrett A

    2016-05-01

    Introduction Microsurgical reconstruction of the breast represents an area of continual evolution, as new autologous flaps are introduced and principles are refined. This progression can be demonstrated by bibliometric analysis of the scientific literature. Methods The top 10 plastic surgery journals were determined by impact factor (IF). Each issue of every journal from 1993 to 2013 was accessed directly, and all articles discussing microsurgery on the female breast were classified by authors' geographic location, study design, and level of evidence (LOE, I-V). The productivity index and productivity share of each geographic region was calculated based on number of articles published and IF. Results A total of 706 breast microsurgery articles were analyzed. There was a significant increase in microsurgical breast research (p < 0.01), with an average 33.6 ± 31.1 articles per year and a mean increase of 4.4 articles per year. Most research was of lower LOE, with level I constituting 0.14% and level II constituting 5.21% of all articles. United States contributed the most research with 336.4 articles, followed by Western Europe with 242.2. However, Western Europe experienced the greatest increase in productivity share, with + 0.50 ± 0.29 growth, while United States demonstrated the greatest decrease in productivity share with - 1.23 ± 0.31 growth. Among autologous flaps, transverse rectus abdominis muscle research had the greatest yearly publication volume until 2002, when overtaken by deep inferior epigastric perforator flap research. Conclusion Over the 21-year study period, the United States not only contributed the greatest volume of research on female breast microsurgery but also demonstrated the greatest decline in research productivity. Efforts should be made to increase the LOE in breast microsurgery research. PMID:26645157

  10. “I’ve never asked one question.” Understanding the barriers among orthopedic surgery residents to screening female patients for intimate partner violence

    PubMed Central

    Conn, Lesley Gotlib; Young, Aynsely; Rotstein, Ori D.; Schemitsch, Emil

    2014-01-01

    Background Intimate partner violence (IPV) is a global public health problem. Orthopedic surgery residents may identify IPV among injured patients treated in fracture clinics. Yet, these residents face a number of barriers to recognizing and discussing IPV with patients. We sought to explore orthopedic surgery residents’ knowledge of IPV and their preparedness to screen patients for IPV in academic fracture clinic settings with a view to developing targeted IPV education and training. Methods We conducted focus groups with junior and intermediate residents. Discussions explored residents’ knowledge of and experiences with IPV screening and preparedness for screening and responding to IPV among orthopedic patients. Data were analyzed iteratively using an inductive approach. Results Residents were aware of the issue of abuse generally, but had received no specific information or training on IPV in orthopedics. Residents did not see orthopedics faculty screen patients for IPV or advocate for screening. They did not view IPV screening or intervention as part of the orthopedic surgeon’s role. Residents’ clinical experiences emphasized time management and surgical intervention by effectively “getting through clinic” and “dealing with the surgical problem.” Communication with patients about other health issues was minimal or nonexistent. Conclusion Orthopedic surgery residents are entering a career path where IPV is well documented. They encounter cultural and structural barriers preventing the incorporation of IPV screening into their clinical and educational experiences. Hospitals and academic programs must collaborate in efforts to build capacity for sustainable IPV screening programs among these trainees. PMID:25421078

  11. Urology residents experience comparable workload profiles when performing live porcine nephrectomies and robotic surgery virtual reality training modules.

    PubMed

    Mouraviev, Vladimir; Klein, Martina; Schommer, Eric; Thiel, David D; Samavedi, Srinivas; Kumar, Anup; Leveillee, Raymond J; Thomas, Raju; Pow-Sang, Julio M; Su, Li-Ming; Mui, Engy; Smith, Roger; Patel, Vipul

    2016-03-01

    In pursuit of improving the quality of residents' education, the Southeastern Section of the American Urological Association (SES AUA) hosts an annual robotic training course for its residents. The workshop involves performing a robotic live porcine nephrectomy as well as virtual reality robotic training modules. The aim of this study was to evaluate workload levels of urology residents when performing a live porcine nephrectomy and the virtual reality robotic surgery training modules employed during this workshop. Twenty-one residents from 14 SES AUA programs participated in 2015. On the first-day residents were taught with didactic lectures by faculty. On the second day, trainees were divided into two groups. Half were asked to perform training modules of the Mimic da Vinci-Trainer (MdVT, Mimic Technologies, Inc., Seattle, WA, USA) for 4 h, while the other half performed nephrectomy procedures on a live porcine model using the da Vinci Si robot (Intuitive Surgical Inc., Sunnyvale, CA, USA). After the first 4 h the groups changed places for another 4-h session. All trainees were asked to complete the NASA-TLX 1-page questionnaire following both the MdVT simulation and live animal model sessions. A significant interface and TLX interaction was observed. The interface by TLX interaction was further analyzed to determine whether the scores of each of the six TLX scales varied across the two interfaces. The means of the TLX scores observed at the two interfaces were similar. The only significant difference was observed for frustration, which was significantly higher at the simulation than the animal model, t (20) = 4.12, p = 0.001. This could be due to trainees' familiarity with live anatomical structures over skill set simulations which remain a real challenge to novice surgeons. Another reason might be that the simulator provides performance metrics for specific performance traits as well as composite scores for entire exercises. Novice trainees experienced substantial mental workload while performing tasks on both the simulator and the live animal model during the robotics course. The NASA-TLX profiles demonstrated that the live animal model and the MdVT were similar in difficulty, as indicated by their comparable workload profiles. PMID:26753619

  12. One-Stop Clinic Utilization in Plastic Surgery: Our Local Experience and the Results of a UK-Wide National Survey

    PubMed Central

    Gorman, Mark; Coelho, James; Gujral, Sameer; McKay, Alastair

    2015-01-01

    Introduction. “See and treat” one-stop clinics (OSCs) are an advocated NHS initiative to modernise care, reducing cancer treatment waiting times. Little studied in plastic surgery, the existing evidence suggests that though they improve care, they are rarely implemented. We present our experience setting up a plastic surgery OSC for minor skin surgery and survey their use across the UK. Methods. The OSC was evaluated by 18-week wait target compliance, measures of departmental capacity, and patient satisfaction. Data was obtained from 32 of the 47 UK plastic surgery departments to investigate the prevalence of OSCs for minor skin cancer surgery. Results. The OSC improved 18-week waiting times, from a noncompliant mean of 80% to a compliant 95% average. Department capacity increased 15%. 95% of patients were highly satisfied with and preferred the OSC to a conventional service. Only 25% of UK plastic surgery units run OSCs, offering varying reasons for not doing so, 42% having not considered their use. Conclusions. OSCs are underutilised within UK plastic surgery, where a significant proportion of units have not even considered their benefit. This is despite associated improvements in waiting times, department capacity, and levels of high patient satisfaction. We offer our considerations and local experience instituting an OSC service. PMID:26236502

  13. Negative Appendectomy: an Audit of Resident-Performed Surgery. How Can Its Incidence Be Minimized?

    PubMed

    Joshi, Mohit Kumar; Joshi, Richa; Alam, Shaan E; Agarwal, Sarla; Kumar, Sunil

    2015-12-01

    Negative appendectomy remains a concern in current surgical practice. Data from the developing world is scarce. Data of appendectomies during the last 5 years were analyzed. Interval and incidental appendectomies were excluded. The demographic details, presenting complaints, clinical signs, and investigations performed were recorded in a predesigned proforma. The data were critically analyzed. Six hundred eighty-five appendectomies were performed during the period. One hundred eighty-five patients with a normal appendix were identified on histopathology. Sixty-seven patients with incidental or interval appendectomies were excluded. Thus, 118 patients had appendectomies performed erroneously. All these patients with presumed diagnosis of acute appendicitis were operated on by resident surgeons. Records of 17 patients could not be retrieved. The most common symptom was abdominal pain (100 %), and the commonest sign was right iliac fossa tenderness (93 %). Most of the patients underwent USG to supplement the diagnosis. CT scan and diagnostic laparoscopy were not performed. The negative appendectomy rate was 17.2 % (12.4 % in males; 33.3 % in females). The highest incidence of negative appendectomy was in females aged 11-20 years (66.7 %). The rate of negative appendectomy at our institute is comparable with the world statistics. More diligence is required in making the clinical diagnosis of acute appendicitis, especially in young females. The use of C-reactive protein and CT scan may decrease the negative appendectomy rate. PMID:27011482

  14. Comparison of propofol–hydromorphone and propofol–dexmedetomidine in patients with intubation after maxillofacial plastic surgery

    PubMed Central

    Peng, Wei; Zhang, Tiejun; Wang, Yanlin

    2016-01-01

    Objective To compare the sedation and analgesic effects between propofol–hydromorphone and propofol–dexmedetomidine in patients with postoperative intubation after maxillofacial plastic surgery. Methods Forty-two patients undertaking maxillofacial plastic surgery with intubation were randomly assigned into propofol plus hydromorphone (P–H) group or propofol plus dexmedetomidine (P–D) group, receiving intravenous infusion of P–H or P–D, respectively. Cerebral state index, Ramsay sedation score, arterial blood gas analysis, and physiology indices were recorded before admission (T0), 30 minutes (T1), 1 hour (T2), 2 hours (T3), 6 hours (T4), and 12 hours after admission (T5) to intensive care unit, and 10 minutes after extubation (T6). Blood interleukin-6 was measured with enzyme-linked immunosorbent assay. Results There was no significant difference in arterial blood gas analysis, oxygen saturation, mean arterial pressure, and respiratory rate between two groups at all time-points (P>0.05). The changes of heart rate (at T4, T5, and T6), cerebral state index (T1, T2, T3, T4, and T5), and Ramsay score (at T3) in P–H group were significantly different from that in P–D group (P<0.05). The plasma interleukin-6 at T4 in P–H group was significantly lower than that in P–D group (P<0.05). Conclusion The P–H approach takes advantages over P–D approach in relieving the pain and discomfort, reducing the overstimulation of sympathetic nerve and the stress level, and enhancing the tolerance of postoperative intubation after maxillofacial plastic surgery. PMID:27022268

  15. Synthesis of new sulfonated mono- and diphthalocyanines d- and f-elements and perspectives of their application for plastic surgery

    NASA Astrophysics Data System (ADS)

    Tomilova, Larisa G.; Podgaetsky, Vitaly M.; Dyumaev, Kirill; Omelchenko, Alexander I.; Sviridov, Alexander P.; Sobol, Emil N.

    1996-01-01

    We carried out the synthesis of the new compounds -- sulfonated mono- and diphthalocyanines of d- and f-elements (sPcM, sPc2M). The unusual geometry of these compounds leads to the appearance of new properties -- they are highly water soluble, non- toxic and in contrast to porphyrines they strongly absorb clinically useful light. Suitable methods for synthesis of unknown before water soluble Ga, In and Ti phthalocyanines have been developed. Our investigations show that these compounds are prospects for plastic surgery.

  16. The impact of surgical resident participation in breast reduction surgery--outcome analysis from the 2005-2011 ACS-NSQIP datasets.

    PubMed

    Fischer, John P; Wes, Ari M; Kovach, Stephen J

    2014-10-01

    Breast reduction surgery is a common and effective surgical technique for treating symptomatic macromastia. There is limited data on the impact of resident involvement on outcomes. This study uses the ACS-NSQIP datasets to assess the impact of surgical resident participation in breast reduction surgery. This study reviewed the 2005-2011 ACS-NSQIP databases identifying primary encounters for reduction mammaplasty with CPT code "19318". It characterised surgical complications into three groups: any, major, and wound complications. Propensity scoring and matched analysis were used to account for non-randomised assignment. In total, 4328 patients underwent reduction mammoplasty during the study period. Resident participation was identified in 56.3% of cases. Logistic regression analysis determined the following factors independently associated with resident participation: class II obesity (OR = 0.73, p < 0.001), class III obesity (OR = 0.68, p < 0.001), dyspnea (OR = 1.59, p = 0.04), and ASA physical status of 3 (OR = 1.51, p < 0.001). A propensity score was assigned based on probability of resident involvement and matched cohorts were created and analyzed. A logistic regression analysis of the matched cohort data revealed that resident participation was independently associated with major surgical complications (OR = 2.18, p = 0.008). Prolonged operative (>2 SD) was associated with any (OR = 3.3, p = 0.039) and wound (OR = 10.2, p = 0.028) complications. A separate logistic regression analysis of the unmatched cohort using stratified PGY experience demonstrated that junior PGY was most highly associated with any (OR = 1.93, p = 0.013), major (OR = 2.4, p = 0.034), and wound (OR = 1.9, p = 0.04) complications. Resident participation was associated with added risk of surgical morbidity, and PGY experience was inversely related to risk of surgical complications in breast reduction surgery. PMID:24479791

  17. EURAPS at 20 years. A brief history of European Plastic Surgery from the Société Européenne de Chirurgie Structive to the European Association of Plastic Surgeons (EURAPS).

    PubMed

    Mazzola, Riccardo F; Kon, Moshe

    2010-06-01

    By the end of WWI, plastic surgery had reached unexpected heights. The high quality of the work done for soldiers with facial injuries and burns, either as an emergency or as a delayed procedure, demonstrated that this new discipline was honourable, worthwhile and socially crucial, thus deserving official recognition and independence. The establishment of new plastic surgery centres, scientific societies and specialised journals were the key to success for the achievement of this goal. In 1936, the Belgian Maurice Coelst (1894-1963) founded the Société Européenne de Chirurgie Structive, the first supranational society, with the aim of gathering once a year all those interested in this new branch of surgery and favouring confrontation of ideas by showing innovative clinical procedures. The very successful first Congress with a large international participation was held in Brussels, with Coelst as the president, the second in London, in 1937, organised by Kilner and the third in Milano, in 1938, arranged by Sanvenero Rosselli. Even live surgery was performed during the meetings. The beginning of the WWII stopped the Societé's activities, which were never resumed. In the late 1980s, when plastic surgery reached its zenith, the necessity was felt to create a new supranational society, different in its purpose from the existing European Section of IPRAS, later European Society of Plastic Reconstructive and Aesthetic Surgery (ESPRAS), an organisation where all the official European plastic surgery societies merged automatically. The aim was to promote the excellence of plastic surgery in Europe, to furnish an annual forum for the selection of the best scientific works presented at national societies and to stimulate research and education at a European level. Established in 1989, 53 years after the foundation of the Société Européenne de Chirurgie Structive, it was named the European Association of Plastic Surgeons (EURAPS). The first scientific meeting took place in Strasbourg, France, city of the Council of Europe, on 7-9 June 1990. Based on the high scientific level of the clinical and aesthetic presentations, EURAPS soon ranked among the leading associations in Europe for plastic surgery and this leadership is now recognised all over the world. The EURAPS successfully celebrated its 20th anniversary in 2009. PMID:19913471

  18. The Legal Doctrine on 'Limitation of Liability' in the Precedent Analysis on Plastic Surgery Medical Malpractice Lawsuits

    PubMed Central

    Kang, So Ra

    2015-01-01

    This study intended to review the precedents on plastic surgery medical malpractice lawsuits in lower-court trials, classify the reasons of 'limitation of liability' by type, and suggest a standard in the acknowledgement of limitation of liability ratio. The 30 lower-court's rulings on the cases bearing the medical negligence of the defendants acknowledged the liability ratio of the defendants between 30% and 100%. Ten cases ruled that the defendants were wholly responsible for the negligence or malpractice, while 20 cases acknowledged the limitation of liability principle. In the determination of damage compensation amount, the court considered the cause of the victim side, which contributed in the occurrence of the damage. The court also believed that it is against the idea of fairness to have the assailant pay the whole compensation, even there is no victim-side cause such as previous illness or physical constitution of the patient, and applies the legal doctrine on limitation of liability, which is an independent damage compensation adjustment system. Most of the rulings also limited the ratio of responsibility to certain extent. When considering that the legal doctrine on limitation of liability which supports concrete validity for the fair sharing of damage, the tangible classification of causes of limitation of liability suggested in this study would be a useful tool in forecasting the ruling of a plastic surgery medical malpractice lawsuit. PMID:26713045

  19. The Legal Doctrine on 'Limitation of Liability' in the Precedent Analysis on Plastic Surgery Medical Malpractice Lawsuits.

    PubMed

    Park, Bo Young; Pak, Ji-Hyun; Hong, Seung-Eun; Kang, So Ra

    2015-12-01

    This study intended to review the precedents on plastic surgery medical malpractice lawsuits in lower-court trials, classify the reasons of 'limitation of liability' by type, and suggest a standard in the acknowledgement of limitation of liability ratio. The 30 lower-court's rulings on the cases bearing the medical negligence of the defendants acknowledged the liability ratio of the defendants between 30% and 100%. Ten cases ruled that the defendants were wholly responsible for the negligence or malpractice, while 20 cases acknowledged the limitation of liability principle. In the determination of damage compensation amount, the court considered the cause of the victim side, which contributed in the occurrence of the damage. The court also believed that it is against the idea of fairness to have the assailant pay the whole compensation, even there is no victim-side cause such as previous illness or physical constitution of the patient, and applies the legal doctrine on limitation of liability, which is an independent damage compensation adjustment system. Most of the rulings also limited the ratio of responsibility to certain extent. When considering that the legal doctrine on limitation of liability which supports concrete validity for the fair sharing of damage, the tangible classification of causes of limitation of liability suggested in this study would be a useful tool in forecasting the ruling of a plastic surgery medical malpractice lawsuit. PMID:26713045

  20. Surgical Training and Education in Promoting Professionalism: a comparative assessment of virtue-based leadership development in otolaryngology-head and neck surgery residents

    PubMed Central

    Schulz, Kristine; Puscas, Liana; Tucci, Debara; Woodard, Charles; Witsell, David; Esclamado, Ramon M.; Lee, Walter T.

    2013-01-01

    Introduction Surgical Training and Education in Promoting Professionalism (STEPP) was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of this research was: (i) to compare the virtue profiles of our residents with that of the military cohort using a standardized virtue assessment tool; and (ii) to assess the value of virtue education on residents. Methods As part of STEPP, otolaryngology residents participated in a virtue-based validated assessment tool called Virtue in Action (VIA) Inventory. This was completed at the initiation of STEPP in July 2011 as well as 1 year later in June 2012. Comparison of the VIA to a military cohort was performed. Leadership ‘Basic Training’ is a series of forums focused on virtues of initiative, integrity, responsibility, self-discipline, and accountability. A pre- and post-test was administered assessing resident perceptions of the value of this ‘Basic Training’. Results Virtues are shared between otolaryngology residents (n=9) and military personnel (n=2,433) as there were no significant differences in strength scores between two military comparison groups and otolaryngology-head and neck surgery (OHNS) residents. There was a significant improvement (p<0.001) in the understanding of components of the leadership vision and a significant improvement in the understanding of key leadership concepts based on ‘Basic Training’. All residents responded in the post-test that the STEPP program was valuable, up from 56%. Conclusions A virtue-based approach is valued by residents as a part of leadership training during residency. PMID:24172053

  1. Factors Impacting Successfully Competing for Research Funding: An Analysis of Applications Submitted to The Plastic Surgery Foundation

    PubMed Central

    Hume, Keith M.; Giladi, Aviram M.; Chung, Kevin C.

    2016-01-01

    BACKGROUND Federal research funding is decreasing, forcing specialty organizations to have an increasingly important position in developing and fostering research.1,2 As the research and innovation arm of the American Society of Plastic Surgeons, The Plastic Surgery Foundation (PSF) has a key role in supporting promising plastic surgery research. Understanding the grant review process, as well as factors that contribute to funding well-written grant funding applications, is paramount for aspiring academic surgeons. METHODS All research grant applications submitted to The PSF in 2012 and 2013 were evaluated. Each reviewer comment was independently assessed by two study team members and classified into key weakness categories. Chi-square test compared results between funded and unfunded grants. Linear regression identified which critique elements corresponded to changes in scores, and logistic regression identified elements that predicted funding. RESULTS We analyzed 1,764 comments from 240 applications. Of these, 55 received funding. Funded grants had significantly fewer reviewer comments in 4 of 5 weakness categories. As expected, funded grants received better (lower) scores. Concerns in the categories of “plan for execution” and “other elements/granstmanship” significantly affected score as well as odds of funding. CONCLUSION Ensuring that a grant addresses all required elements is important for receiving a low reviewer score. Our study demonstrates that “plan for execution” and “grantsmanship” influence reviewer scoring more than others. Investigators must clearly address items associated with conducting their experiments and performing the analysis. Investigators must also give equal attention to elements of overall quality and completeness to optimize chances of funding. PMID:25626827

  2. Periodontal Plastic Surgery to Improve Aesthetics in Patients with Altered Passive Eruption/Gummy Smile: A Case Series Study

    PubMed Central

    Cairo, Francesco; Graziani, Filippo; Franchi, Lorenzo; Defraia, Efisio; Pini Prato, Giovan Paolo

    2012-01-01

    Altered passive eruption/gummy smile is a common challenge in patients requiring aesthetic treatment. A specific surgical protocol was designed and tested in patients with altered passive eruption. Standardized preoperative X-rays were used to assess crown length at baseline and to place submarginal incisions. Osseous respective therapy was performed to achieve biological width. Clinical outcomes were recorded 6 months after surgery. Eleven patients with a total of 58 teeth were treated with flap surgery and osseous resective therapy at upper anterior natural teeth. At the last followup, a significant and stable improvement of crown length was obtained when compared to the baseline (P < 0.0001). All patients rated as satisfactory in the final outcomes (final VAS value = 86.6). In conclusion, this study showed that periodontal plastic surgery including osseous resection leads to predictable outcomes in the treatment of altered passive eruption/gummy smile: A careful preoperative planning avoids unpleasant complications and enhances postsurgical stability of the gingival margin. PMID:23056049

  3. Establishing a profitable skin care practice in a facial plastic surgery office.

    PubMed

    Cortez, Edwin A

    2010-11-01

    Facial plastic surgeons seeking information about establishing and maintaining a first-rate skin care program and practice in their office will learn practice management tips and business advice. This content begins with presenting steps in patient evaluation and continues through development of a care plan. Discussion includes approach to skin care products, sunscreen, and related preventive and restorative methods. Detailed discussion is included of developing a personalized skin care plan. The content concludes with essential business tips and marketing advice for the facial plastic surgeon to include skin care in the surgical practice, including the way in which these are handled in the author's practice. PMID:20974397

  4. Shame and self-acceptance in continued flux: qualitative study of the embodied experience of significant weight loss and removal of resultant excess skin by plastic surgery.

    PubMed

    Smith, Fran; Farrants, Jacqui R

    2013-09-01

    This study explored the embodied experience of body change using a qualitative design. Eight previous plastic surgery patients of a London hospital took part in in-depth, semi-structured interviews 1 year post a plastic surgery procedure to remove excess skin around their abdomen, resulting from weight loss. Participant interviews were analysed using Interpretative Phenomenological Analysis. Two sub-themes titled 'Shame of the hidden body' and 'Lack of acceptance; the future focused body' are presented in this article. Findings are considered in relation to theories of 'Body Shame' and in the current cultural context. PMID:23104996

  5. Certificate-of-Need regulation in outpatient surgery and specialty care: implications for plastic surgeons.

    PubMed

    Pacella, Salvatore J; Comstock, Matthew; Kuzon, William M

    2005-09-15

    For plastic surgeons, independent development of outpatient surgical centers and specialty facilities is becoming increasingly common. These facilities serve as important avenues not only for increasing access and efficiency but in maintaining a sustainable, competitive specialty advantage. Certificate of Need regulation represents a major hurdle to plastic surgeons who attempt to create autonomy in this fashion. At the state level, Certificate of Need programs were initially established in an effort to reduce health care costs by preventing unnecessary capital outlays for facility expansion (i.e., managing supply of health care resources) in addition to assisting with patient safety and access to care. The purpose of this study was to examine the effect of Certificate of Need regulations on health care costs, patient safety, and access to care and to discuss specific implications of these regulations for plastic surgeons. Within Certificate of Need states, these regulations have done little, if anything, to control health care costs or affect patient safety. Presently, Certificate of Need effects coupled with recent provisions in the Medicare Modernization Act banning development of specialty hospitals may restrict patient access to ambulatory surgical and specialty care. For the plastic surgeon, these effects not only act as an economic barrier to entry but can threaten the efficiencies gained from providing surgical care in an ambulatory setting. An appreciation of these effects is critical to maintaining specialty autonomy and access to fiscal policy. PMID:16163102

  6. Initial assessment of patient handoff in accredited general surgery residency programs in the United States and Canada: a cross-sectional survey

    PubMed Central

    Saleem, Abdulaziz M.; Paulus, Jessica K.; Vassiliou, Melina C.; Parsons, Susan K.

    2015-01-01

    Background Communication errors are considered one of the major causes of sentinel events. Our aim was to assess the process of patient handoff among junior surgical residents and to determine ways in which to improve the handoff process. Methods We conducted nationwide surveys that included all accredited general surgery residency programs in the United States and Canada. Results Of the 244 American and 17 Canadian accredited surgical residency programs contacted, 65 (27%) and 12 (71%), respectively, participated in the survey. Of the American and Canadian respondents, 66% and 69%, respectively, were from postgraduate year (PGY) 1, and 32% and 29%, respectively, were from PGY 2; 85 (77%) and 50 (96%), respectively, had not received any training about patient handoff before their surgical residency, and 27% and 64%, respectively, reported that the existing handoff system at their institutions did not adequately protect patient safety. Moreover, 29% of American respondents and 37% of Canadian respondents thought that the existing handoffs did not support continuity of patient care. Of the American residents, 67% and 6% reported receiving an incomplete handoff that resulted in minor and major patient harm, respectively. These results mirrored those from Canadian residents (63% minor and 7% major harm). The most frequent factor reported to improve the patient handoff process was standardization of the verbal handoff. Conclusion Our survey results indicate that the current patient handoff system contributes to patient harm. More efforts are needed to establish standardized forms of verbal and written handoff to ensure patient safety and continuity of care. PMID:26204366

  7. Parents' and Doctors' Attitudes toward Plastic Facial Surgery for Persons with Down Syndrome.

    ERIC Educational Resources Information Center

    Katz, Shlomo; Kravetz, Shlomo; Marks, Yoval

    1997-01-01

    A study of 42 Israeli parents of children with Down syndrome and 48 family doctors found no differences between the parents and doctors regarding support for facial surgery. However, parents who showed less acceptance of their child expressed more support for the operation than parents who showed more acceptance. (Author/CR)

  8. American Society of Plastic Surgeons

    MedlinePlus

    ... Male Specific Gynecomastia Surgery Hair Replacement Men and Plastic Surgery Minimally Invasive Botulinum Toxin Chemical Peel Dermabrasion Dermal ... E. Patient Safety Do Your Homework Dangers of Plastic Surgery Tourism Patient and Consumer Information Before & After Find ...

  9. The Use of In-Situ Simulation to Improve Safety in the Plastic Surgery Office: A Feasibility Study

    PubMed Central

    Shapiro, Fred E.; Pawlowski, John B.; Rosenberg, Noah M.; Liu, Xiaoxia; Feinstein, David M.; Urman, Richard D.

    2014-01-01

    Objective: Simulation-based interventions and education can potentially contribute to safer and more effective systems of care. We utilized in-situ simulation to highlight safety issues, regulatory requirements, and assess perceptions of safety processes by the plastic surgery office staff. Methods: A high-fidelity human patient simulator was brought to an office-based plastic surgery setting to enact a half-day full-scale, multidisciplinary medical emergency. Facilitated group debriefings were conducted after each scenario with special consideration of the principles of team training, communication, crisis management, and adherence to evidence-based protocols and regulatory standards. Abbreviated AHRQ Medical Office Safety Culture Survey was completed by the participants before and after the session. Results: The in-situ simulations had a high degree of acceptance and face validity according to the participants. Areas highlighted by the simulation sessions included rapid communication, delegation of tasks, location of emergency materials, scope of practice, and logistics of transport. The participant survey indicated greater awareness of patient safety issues following participation in simulation and debriefing exercises in 3 areas (P < 0.05): the need to change processes if there is a recognized patient safety issue (100% vs 75%), openness to ideas about improving office processes (100% vs 88%), and the need to discuss ways to prevent errors from recurring (88% vs 62%). Conclusions: Issues of safety and regulatory compliance can be assessed in an office-based setting through the short-term (half-day) use of in-situ simulation with facilitated debriefing and the review of audiovisual recordings by trained facilities inspectors. PMID:24501616

  10. Wall Street's assessment of plastic surgery--related technology: a clinical and financial analysis.

    PubMed

    Krieger, L M; Shaw, W W

    2000-02-01

    Many plastic surgeons develop technologies that are manufactured by Wall Street-financed companies. Others participate in the stock market as investors. This study examines the bioengineered skin industry to determine whether it integrates clinical and financial information as Wall Street tenets would predict, and to see whether the financial performance of these companies provides any lessons for practicing plastic surgeons. In efficient markets, the assumptions on which independent financial analysts base their company sales and earnings projections are clinically reasonable, the volatility of a company's stock price does not irrationally differ from that of its industry sector, and the buy/sell recommendations of analysts are roughly congruent. For the companies in this study, these key financial parameters were compared with a benchmark index of 69 biotech companies of similar age and annual revenues (Student's t test). Five bioengineered skin companies were included in the study. Analysts estimated that each company would sell its product to between 24 and 45 percent of its target clinical population. The average stock price volatility was significantly higher for study companies than for those in the benchmark index (p < 0.05). Similarly, buy/sell recommendations of analysts for the study companies were significantly less congruent than those for the benchmark companies (p < 0.05). These results indicate clinically unrealistic projections for market penetration, significantly high price volatility, and significantly high discordance among professional analysts. In all cases, the market is inefficient-an unusual finding on Wall Street. A likely explanation for this market failure is a cycle of poor clinical correlation when assigning sales projections, which in turn leads to price volatility and discordance of buy/sell recommendations. This study's findings have implications for plastic surgeons who develop new technology or who participate in the equities markets as investors. Plastic surgeons who develop new medical devices or technology cannot universally depend on the market to drive clinically reasonable financial performance. Although inflated sales estimates have benefits in the short term, failure to meet projections exacts severe financial penalties. Plastic surgeons who invest in the stock market, because of their unique clinical experience, may sometimes be in the position to evaluate new technologies and companies better than Wall Street experts. Well-timed trades that use this expertise can result in opportunities for profit. PMID:10697168

  11. Globalization of Craniofacial Plastic Surgery: Foreign Mission Programs for Cleft Lip and Palate.

    PubMed

    Laub, Donald R

    2015-06-01

    International Humanitarian Interchanges are a bona fide component of surgery and medicine. Additionally, these programs also provide substantial benefit both to the doers and the recipients.The foreign mission program is potentially a weapon of foreign policy which is underutilized and underestimated.Physician job dissatisfaction is increasing. However, the happiness and satisfaction of the participants in the short-term multidisciplinary trips, repeated, well-organized and respectful, with rather complete integration of the surgical system of the sister countries ("Plan B"), approaches 100%.The theory of the International Humanitarian Interchanges is based on substance, on medical theory. These trips are particularly successful in interchanges with medium-resourced countries.Furthermore, the academic visiting professor ("Plan A": hi-resource place to hi-resource place), the One Man Can Save the World model ("Plan C": to the low-resource place), and the intriguing Horton Peace Plan have possibilities for long-term benefit to the doer, recipient, the field of surgery, and the body of knowledge. In all of these, our country and the family of nations advance.The theoretical basis is not always religious nor the grand strategy plan; both have either proselytizing or political dominance as primary motives, and are mentioned as historically helpful. PMID:26080114

  12. A computational tool for preoperative breast augmentation planning in aesthetic plastic surgery.

    PubMed

    Georgii, Joachim; Eder, Maximilian; Bürger, Kai; Klotz, Sebastian; Ferstl, Florian; Kovacs, Laszlo; Westermann, Rüdiger

    2014-05-01

    Breast augmentation was the most commonly performed cosmetic surgery procedure in 2011 in the United States. Although aesthetically pleasing surgical results can only be achieved if the correct breast implant is selected from a large variety of different prosthesis sizes and shapes available on the market, surgeons still rely on visual assessment and other subjective approaches for operative planning because of lacking objective evaluation tools. In this paper, we present the development of a software prototype for augmentation mammaplasty simulation solely based on 3-D surface scans, from which patient-specific finite-element models are generated in a semiautomatic process. The finite-element model is used to preoperatively simulate the expected breast shapes using physical soft-tissue mechanics. Our approach uses a novel mechanism based on so-called displacement templates, which, for a specific implant shape and position, describe the respective internal body forces. Due to a highly efficient numerical solver we can provide immediate visual feedback of the simulation results, and thus, the software prototype can be integrated smoothly into the medical workflow. The clinical value of the developed 3-D computational tool for aesthetic breast augmentation surgery planning is demonstrated in patient-specific use cases. PMID:24132029

  13. The characteristics of Mohs surgery performed by dermatologists who learned the procedure during residency training or through postgraduate courses and observational preceptorships

    PubMed Central

    Clever, Henry; Dixon, Anthony

    2016-01-01

    Little is known about the practice characteristics of Mohs surgery performed by physicians who learned the procedure during their dermatology residency training or through postresidency courses and observational preceptorships. All published reports have investigated Mohs surgeons trained in postresidency fellowships. This report presents the results of a multicenter prospective cohort study evaluating 1834 consecutive Mohs surgery cases performed during the same 6-month period by 9 Mohs surgeons who learned the technique in residency or in postresidency courses and observational preceptorships. One major complication was reported, a hematoma requiring outpatient drainage in an emergency room. There were 54 (2.9%) short-term complications, including 20 (1.1%) infections, 17 (0.9%) wound dehiscences, 9 (0.5%) cases of skin flap necrosis, and 8 (0.4%) hematomas or postoperative bleeding episodes. These complication rates and the data evaluating tumor type, anatomic location, primary vs. recurrent tumor status, tumor size, postoperative wound size, number of Mohs surgery stages, and repair type compare favorably to previously published reports. PMID:27034540

  14. New and emerging uses of barbed suture technology in plastic surgery.

    PubMed

    Rosen, Allen D

    2013-09-01

    Barbed sutures first received US Food and Drug Administration approval for soft tissue approximation in 2005 and early adopters readily embraced this device to develop new techniques. It has become apparent that the advantages are more than just "skin deep." Superficial and deep fascia, cartilage, tendon, joint capsule, and fibrous periprosthetic capsules can also be manipulated. Barbed sutures have revolutionized our approach to facial rejuvenation and body contouring by enhancing our ability to quilt and powerfully lift tissue. The elimination of surgical drains and shorter surgical times has made this a true boon for plastic surgeons as well as many other surgical specialists. This article summarizes some of the current and evolving applications of this exciting new tool. PMID:24084885

  15. [Three-dimensional imaging in plastic surgery. Application to the carpal bones and skull].

    PubMed

    Moutet, F; Raphaël, B; Lebeau, J; Cinquin, P; Bonnier, L; Le Bescond, Y

    1990-01-01

    Since 1987, the authors have developed three-dimensional (3D) imaging of the carpus. This new application of imaging allows spatial visualization of the complex shapes of the carpal skeleton from all angles and from all illuminations. The development of this technique should lead to a better understanding of the intimate physiology of the carpus, allowing the construction of a model of the wrist enabling precise planning of operative procedures. It also helps to elucidate complex pathological images which are sometimes difficult to interpret on computed tomography scans. In parallel, the same process has been developed for the skull. It is particularly useful in cranio-facial surgery, especially in congenital deformities. Progress in this technique should allow surgical simulation on a video screen in the very near future. PMID:1702950

  16. From Residency to Lifelong Learning.

    PubMed

    Brandt, Keith

    2015-11-01

    The residency training experience is the perfect environment for learning. The university/institution patient population provides a never-ending supply of patients with unique management challenges. Resources abound that allow the discovery of knowledge about similar situations. Senior teachers provide counseling and help direct appropriate care. Periodic testing and evaluations identify deficiencies, which can be corrected with future study. What happens, however, when the resident graduates? Do they possess all the knowledge they'll need for the rest of their career? Will medical discovery stand still limiting the need for future study? If initial certification establishes that the physician has the skills and knowledge to function as an independent physician and surgeon, how do we assure the public that plastic surgeons will practice lifelong learning and remain safe throughout their career? Enter Maintenance of Certification (MOC). In an ideal world, MOC would provide many of the same tools as residency training: identification of gaps in knowledge, resources to correct those deficiencies, overall assessment of knowledge, feedback about communication skills and professionalism, and methods to evaluate and improve one's practice. This article discusses the need; for education and self-assessment that extends beyond residency training and a commitment to lifelong learning. The American Board of Plastic Surgery MOC program is described to demonstrate how it helps the diplomate reach the goal of continuous practice improvement. PMID:26517466

  17. Analysis of the increasing prevalence of necrotising fasciitis referrals to a regional plastic surgery unit: a retrospective case series.

    PubMed

    Hodgins, N; Damkat-Thomas, L; Shamsian, N; Yew, P; Lewis, H; Khan, K

    2015-03-01

    Necrotising Fasciitis is a destructive infection of the skin and subcutaneous tissues associated with significant mortality and morbidity. Survival from the condition often necessitates patient referral for appropriate reconstructive surgery and supportive medical management. The aim of our study was to identify emerging patterns, characteristics and outcomes of necrotising fasciitis in Northern Ireland. A retrospective analysis of all patients referred to the Regional Plastic Surgery Service in Belfast between 2007 and 2012 was performed. Forty-six patients were identified with clinical, intraoperative and histopathological confirmation of necrotising fasciitis. Mean patient age was 59.4 years (range 32-88) with a 25:21 male to female ratio. 13 patients died from the disease. Smoking, obesity, diabetes and immunocompromise were the most prevalent co-morbidities identified. 37 patients had no identifiable mechanism of infection initiation in the history. Painful cellulitis (44/46), skin necrosis (26/46), skin blistering (8/46) and subcutaneous emphysema (3/46) were the most common presenting features. The median LRINEC score at presentation was 7 (range 2-12). The mean serum lactate at presentation was 4.0mmol/L (range 1.6-13.5). LRINEC scores and serum lactate at presentation exhibited diagnostic sensitivities of 65% and 90% respectively. The lower extremity was the most commonly affected anatomical site (16/46). Group A Streptococcus was the most frequently isolated causative bacterium from debrided tissue cultures (16/46). The prevalence of necrotising fasciitis in the population studied is increasing, particularly in relation to patient cases caused by Group A Streptococcal infection. Increasing bacterial virulence and levels of patient immunocompromise may explain this increasing trend. The LRINEC scoring system lacked diagnostic sensitivity. Elevated serum lactate was supported as both a diagnostic and prognostic indicator. The findings of our study are somewhat limited in their application to other regions and highlight the need for a national analysis of necrotising fasciitis in the UK. PMID:25444278

  18. Implications of Rheumatic Disease and Biological Response-Modifying Agents in Plastic Surgery.

    PubMed

    Tsai, David M; Borah, Gregory L

    2015-12-01

    The preoperative evaluation for any reconstructive or aesthetic procedure requires a detailed history of existing medical conditions and current home medications. The prevalence of rheumatic diseases such as rheumatoid arthritis, gout, and psoriasis is high, but the impact of these chronic illnesses on surgical outcome and the side effects of the powerful medications used for treatment are often underappreciated. In this review, the authors highlight key perioperative considerations specific to rheumatologic diseases and their associated pharmacologic therapies. In particular, the authors discuss the perioperative management of biological response-modifying agents, which have largely become the new standard of therapy for many rheumatic diseases. The literature reveals three key perioperative concerns with biological therapy for rheumatic disease: infection, wound healing delays, and disease flare. However, data on specific perioperative complications are lacking, and it remains controversial whether withholding biological therapy before surgery is of benefit. The risk of these adverse events is influenced by several factors: age, sex, class of biological agent, duration of exposure, dosage, onset and severity of disease, and type of surgical procedure. Overall, it remains best to develop an individualized plan. In younger patients with recent onset of biological therapy, it is reasonable to withhold therapy based on 3 to 5 half-lives of the specific agent. In older patients with a substantial history of rheumatic disease, the decision to discontinue therapy must be weighed and decided carefully in conjunction with the rheumatologist. PMID:26595025

  19. Cosmetic breast surgery - discharge

    MedlinePlus

    ... Higdon KK. Reduction mammoplasty. In: Neligan PC, ed. Plastic Surgery . 3rd ed. Philadelphia, PA: Elsevier; 2013:chap 8. ... Gabriel A. Breast augmentation. In: Neligan PC, ed. Plastic Surgery . 3rd ed. Philadelphia, PA: Elsevier; 2013:chap 2.

  20. L-PRP/L-PRF in esthetic plastic surgery, regenerative medicine of the skin and chronic wounds.

    PubMed

    Cieslik-Bielecka, Agata; Choukroun, Joseph; Odin, Guillaume; Dohan Ehrenfest, David M

    2012-06-01

    The use of platelet concentrates for topical use is of particular interest for the promotion of skin wound healing. Fibrin-based surgical adjuvants are indeed widely used in plastic surgery since many years in order to improve scar healing and wound closure. However, the addition of platelets and their associated growth factors opened a new range of possibilities, particularly for the treatment of chronic skin ulcers and other applications of regenerative medicine on the covering tissues. In the 4 families of platelet concentrates available, 2 families were particularly used and tested in this clinical field: L-PRP (Leukocyte- and Platelet-rich Plasma) and L-PRF (Leukocyte- and Platelet-Rich Fibrin). These 2 families have in common the presence of significant concentrations of leukocytes, and these cells are important in the local cleaning and immune regulation of the wound healing process. The main difference between them is the fibrin architecture, and this parameter considerably influences the healing potential and the therapeutical protocol associated to each platelet concentrate technology. In this article, we describe the historical evolutions of these techniques from the fibrin glues to the current L-PRP and L-PRF, and discuss the important functions of the platelet growth factors, the leukocyte content and the fibrin architecture in order to optimize the numerous potential applications of these products in regenerative medicine of the skin. Many outstanding perspectives are appearing in this field and require further research. PMID:21740368

  1. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution.

    PubMed

    Zuhr, Otto; Bäumer, Daniel; Hürzeler, Markus

    2014-04-01

    Soft tissue replacement grafts have become a substantial element to increase tissue volume in plastic periodontal and implant surgery. Autogenous subepithelial connective tissue grafts are increasingly applied in aesthetic indications like soft tissue thickening, recession treatment, ridge preservation, soft tissue ridge augmentation and papilla re-construction. For the clinical performance of connective tissue graft harvesting and transplantation, a fundamental understanding of the anatomy at the donor sites and a sound knowledge of tissue integration and re-vascularization processes are required. Possible donor sites are the anterior and posterior palate including the maxillary tuberosity, providing grafts of distinct geometric shape and histologic composition. The selective clinical application of different grafts depends on the amount of required tissue, the indication and the personal preference of the treating surgeon. One of the main future challenges is to volumetrically evaluate and compare the efficacy and long-term stability of soft tissue autografts and their prospective substitutes. The aim of this review was to discuss the advantages and shortfalls of different donor sites, substitute materials and harvesting techniques. Although standardized recommendations regarding treatment choice and execution can hardly be given, guidelines for predictable and successful treatment outcomes are provided based on clinical experience and the available scientific data. PMID:24640997

  2. Dynamics of shock waves and cavitation bubbles in bilinear elastic-plastic media, and the implications to short-pulsed laser surgery

    NASA Astrophysics Data System (ADS)

    Brujan, E.-A.

    2005-01-01

    The dynamics of shock waves and cavitation bubbles generated by short laser pulses in water and elastic-plastic media were investigated theoretically in order to get a better understanding of their role in short-pulsed laser surgery. Numerical simulations were performed using a spherical model of bubble dynamics which include the elastic-plastic behaviour of the medium surrounding the bubble, compressibility, viscosity, density and surface tension. Breakdown in water produces a monopolar acoustic signal characterized by a compressive wave. Breakdown in an elastic-plastic medium produces a bipolar acoustic signal, with a leading positive compression wave and a trailing negative tensile wave. The calculations revealed that consideration of the tissue elasticity is essential to describe the bipolar shape of the shock wave emitted during optical breakdown. The elastic-plastic response of the medium surrounding the bubble leads to a significant decrease of the maximum size of the cavitation bubble and pressure amplitude of the shock wave emitted during bubble collapse, and shortening of the oscillation period of the bubble. The results are discussed with respect to collateral damage in short-pulsed laser surgery.

  3. [Surgery].

    PubMed

    Roulin, D; Hbner, M; Demartines, N

    2013-01-16

    In 2012, an innovative approach for staged in situ liver transection was proposed that could allow for even more aggressive major hepatectomies. Otherwise, after 25 years, laparoscopy became "traditional" and other minimally invasive techniques continue to be developed but their indications deserve further investigation. Less aggressive treatment in non-complicated diverticulitis becomes more popular, and even antibiotic treatment has been challenged by a randomized study. In colorectal oncology, local resection or observation only seems to become a valuable approach in selected patients with complete response after neo adjuvant chemoradiation. Finally, enhanced recovery pathways (ERAS) have been validated and is increasingly accepted for colorectal surgery and ERAS principles are successfully applied in other surgical fields. PMID:23409643

  4. Periodontal Plastic Surgery

    MedlinePlus

    ... Financing How to Get a Great Smile FAQ Implants FAQ Teeth Whitening FAQ Veneers FAQ Smile Zone Give Back a Smile Find a Dentist Dental Implants Dentures Direct Bonding Implants versus Bridges Orthodontics and ...

  5. Periodontal Plastic Surgery Procedures

    MedlinePlus

    ... Disease and Heart Disease Gum Disease and Other Systemic Diseases Gum Disease and Women Gum Disease and Men ... Disease and Heart Disease Gum Disease and Other Systemic Diseases Gum Disease and Women Gum Disease and Men ...

  6. Plastic and Cosmetic Surgery

    MedlinePlus

    ... or set protruding ears back closer to the head Eyes: Correct drooping upper eyelids or remove puffy bags below the eyes Face: Remove facial wrinkles, creases or acne scars Hair: Fill in balding areas with one's own hair ...

  7. The Role of Obesity Training in Medical School and Residency on Bariatric Surgery Knowledge in Primary Care Physicians

    PubMed Central

    Stanford, Fatima Cody; Johnson, Erica D.; Claridy, Mechelle D.; Earle, Rebecca L.; Kaplan, Lee M.

    2015-01-01

    Objective. US primary care physicians are inadequately educated on how to provide obesity treatment. We sought to assess physician training in obesity and to characterize the perceptions, beliefs, knowledge, and treatment patterns of primary care physicians. Methods. We administered a cross-sectional web-based survey from July to October 2014 to adult primary care physicians in practices affiliated with the Massachusetts General Hospital (MGH). We evaluated survey respondent demographics, personal health habits, obesity training, knowledge of bariatric surgery care, perceptions, attitudes, and beliefs regarding the etiology of obesity and treatment strategies. Results. Younger primary care physicians (age 20–39) were more likely to have received some obesity training than those aged 40–49 (OR: 0.08, 95% CI: 0.008–0.822) or those 50+ (OR: 0.03, 95% CI: 0.004–0.321). Physicians who were young, had obesity, or received obesity education in medical school or postgraduate training were more likely to answer bariatric surgery knowledge questions correctly. Conclusions. There is a need for educational programs to improve physician knowledge and competency in treating patients with obesity. Obesity is a complex chronic disease, and it is important for clinicians to be equipped with the knowledge of the multiple treatment modalities that may be considered to help their patients achieve a healthy weight. PMID:26339506

  8. Manpower goals in American surgery. Implications for residency training. Future surgical manpower in the framework of total United States physicians.

    PubMed Central

    Moore, F D

    1976-01-01

    Constraints on manpower are intrinsic in the establishment of standards of excellence. When such constraints are exerted by individual Boards, Societies, Colleges or Academies they should act to improve the quality of care; their weakness lies in their lack of control over non-members, or those who have failed to pass the examinations. Such manpower constraints become specific objectives or goals when the number of accredited specialists is specifically related to the size of the population served. Any such manpower planning must recognize the many uncertainties in the future of American medicine, and maintain wide elasticity in the planning process. Social and economic pressures render the consideration of specific manpower goals essential at this time. Data from the national surgical study (SOSSUS) make it possible to consider such goals. Manpower objectives for surgery or any other branch of medicine should be considered as a part of the total medical manpower outlook for the United States. Pressures to reduce the number of surgeons entering practice are notable at this time. These should be evaluated against other pressures to maintain or increase the number of hospital-based specialists in all fields as the total number of practitioners undergoes a major expansion over the next 25 years, and the pressure for specialty care is thereby increased. A reasonable balance between these two pressures would be a manpower goal for surgery that allowed a modest growth rate over the next 25-50 years. An example of such is the goal of limiting surgical practitioner growth to a 1% increase in the ratio to population, every 5 years. This would be in sharp contrast to the continuous explosive growth of numbers of surgeons, since World War II. PMID:952562

  9. [The application of multichannel electrostimulation and nivalin electrophoresis for the rehabilitative treatment of the patient following plastic surgery in the facial region].

    PubMed

    Lazarenko, N N; Gerasimenko, M Iu

    2011-01-01

    This paper describes for the first time the combined treatment of the patients who underwent plastic surgery for the correction of cosmetic defects in the form of grade II and III senile atrophy of the skin in conjunction with complicated neuropathies of the facial nerve. The essence of the proposed combined treatment consists in using lymphatic drainage massage, medicinal electrophoresis of a nivalin solution, multichannel electrostimulation, and microcurrent therapy with bipolar pulsed currents. The method made it possible to significantly improve the properties of the skin in the facial region, neuro-muscular conductivity, general microcirculation and cerebral circulation in the treated patients. PMID:22165146

  10. Comparison of Ultrasound and Nerve Stimulation Techniques for Interscalene Brachial Plexus Block for Shoulder Surgery in a Residency Training Environment: A Randomized, Controlled, Observer-Blinded Trial

    PubMed Central

    Thomas, Leslie C.; Graham, Sean K.; Osteen, Kristie D.; Porter, Heather Scuderi; Nossaman, Bobby D.

    2011-01-01

    Background The ability to provide adequate intraoperative anesthesia and postoperative analgesia for orthopedic shoulder surgery continues to be a procedural challenge. Anesthesiology training programs constantly balance the time needed for procedural education versus associated costs. The administration of brachial plexus anesthesia can be facilitated through nerve stimulation or by ultrasound guidance. The benefits of using a nerve stimulator include a high incidence of success and less cost when compared to ultrasonography. Recent studies with ultrasonography suggest high success rates and decreased procedural times, but less is known about the comparison of these procedural times in training programs. We conducted a prospective, randomized, observer-blinded study with inexperienced clinical anesthesia (CA) residents—CA-1 to CA-3—to compare differences in these 2 guidance techniques in patients undergoing interscalene brachial plexus block for orthopedic surgery. Methods In this study, 41 patients scheduled for orthopedic shoulder surgery were randomly assigned to receive an interscalene brachial plexus block guided by either ultrasound (US group) or nerve stimulation (NS group). Preoperative analgesics and sedatives were controlled in both groups. Results The US group required significantly less time to conduct the block (4.3 ± 1.5 minutes) than the NS group (10 ± 1.5 minutes), P  =  .009. Moreover, the US group achieved a significantly faster onset of sensory block (US group, 12 ± 2 minutes; NS group, 19 ± 2 minutes; P  =  .02) and motor block (US group, 13.5 ± 2.3 minutes; NS group, 20.2 ± 2.1 minutes; P  =  .03). Success rates were high for both techniques and were not statistically different (US group, 95%; NS group, 91%). No differences were found in operative times, postoperative pain scores, need for rescue analgesics, or incidences of perioperative or postdischarge side effects. Conclusion On the basis of our results with inexperienced residents, we found that using US in guiding the interscalene approach to the brachial plexus significantly shortened the duration of intervals in conduction of the block and onset of anesthesia when compared with NS; moreover, these times could have significant cost savings for the institution. Finally, the use of US technology in an academic medical center facilitates safe, cost-effective, quality care. PMID:21960758

  11. IOL Implants: Lens Replacement and Cataract Surgery (Intraocular Lenses)

    MedlinePlus

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  12. [From plastic surgery to space conquest. First microsurgical procedure and first surgical procedure in man during weightlessness].

    PubMed

    Martin, D; de Coninck, L; Pinsolle, V; Delia, G

    2008-12-01

    The authors present their experience of surgery in weightlessness conditions. Russians and Americans already focused on that subject but two questions were still unsolved: what was the limit of human skill in these extreme conditions and was it possible to operate a human under total safety? Between 2003 and 2007, using a 0G plane for our experiment, we focused on two goals: firstly, the conception of a microsurgical module to test complex microsurgical procedures in rats and secondly, the construction of a surgical workstation with specific air filtration device and define surgical and anaesthetic protocols to carry on a surgery in man. In September 2003, we succeeded to perform the microscopic report of a 0,5mm artery (which is the smallest we can suture in terrestrial conditions) by using seven stitches of 10 x 0 monofilament suture. The 27th of September 2007, we removed a lipoma from the forearm of a 47-year-old man. These experiments take place in a wide program of development of telesurgery controlled through satellite transmission with all forthcoming civil, military and humanitarian applications. PMID:18930573

  13. Beauty is in the eye of the beholder: body dysmorphic disorder in ophthalmic plastic and reconstructive surgery.

    PubMed

    McConnell, Lindsay K; Lee, Wendy W; Black, Donald W; Shriver, Erin M

    2015-01-01

    Despite the fact that up to 15% of patients in an aesthetic surgery practice have body dysmorphic disorder (BDD), little has been written about the condition in the oculoplastic literature. The authors describe 3 patients with suspected BDD who presented with perceived periocular defects. To appear "Asian," a 39-year-old Hispanic woman underwent over 30 surgeries. She developed disfiguring scars and lagophthalmos with corneal scarring, remained unsatisfied, and tragically committed suicide. A 52-year-old woman with moderate dermatochalasis underwent a blepharoplasty to improve her vision and appearance and help her gain employment. Despite a good outcome, she remained dissatisfied and blamed the surgeon for her unemployment. Finally, a 73-year-old woman presented demanding treatment for brow rhytids causing severe emotional distress. She was denied intervention due to unrealistic expectations. These patients are suspected to be suffering from BDD. Increased awareness is critical as BDD patients often remain unsatisfied after surgical intervention and are in need of psychiatric care. PMID:24833442

  14. Operation Iraqi freedom: A report on a series of soldiers treated with free tissue transfer by a plastic surgery service.

    PubMed

    Chattar-Cora, Deowall; Perez-Nieves, Roberto; McKinlay, Alexander; Kunasz, Markian; Delaney, Richard; Lyons, Robert

    2007-02-01

    Free flaps in combat wounds are predisposed to failure. Few reports are available on their use in American military combat wounds. We present our experience with free flaps during Operation Iraqi Freedom. This is a retrospective review of soldiers treated by plastic surgeons at Brooke Army Medical Center. Eight free flaps were for soft tissue coverage in which local tissue was not available. Causes of the wounds: 2 from a rocket-propelled grenade, 4 from explosive devices, 1 from a fall, and 1 from a helicopter crash. Indications for the flaps were 2 exposed calvaria, 3 lower-extremity fractures, 2 upper-extremity wounds, and 1 exposed Achilles tendon. Four latissimus dorsi muscle flaps and 4 radial forearm fasciocutaneous flaps were used. All flaps were successful. Three flap-related complications required operative intervention. Free flaps can be used successfully in combat wounds, with minimal morbidity, and should be considered in American soldiers with complex wounds. PMID:17245149

  15. What makes a "great resident": the resident perspective.

    PubMed

    Nemani, Venu M; Park, Caroline; Nawabi, Danyal H

    2014-06-01

    Orthopedic surgery residency training is a difficult endeavor, and the selection of residents that will perform well in a rigorous training program is challenging for residency program directors. Even defining a "great" resident is a difficult endeavor. However, there are certain qualities that anecdotally are associated with high-performing residents, which include being trustworthy, hard-working and efficient, self-directed learners, detail-oriented, and personable. These qualities are difficult to teach and are likely learned by an individual during their early years of education and groomed during college and medical school. Individuals possessing these characteristics are more likely to bring a high-level of professionalism to their work as residents and to perform well on objective measures of success in residency such as high OITE scores, good faculty evaluations, and peer-reviewed publications. We discuss the available, but limited, literature on what makes a "great" resident and share the resident perspective on this topic. PMID:24648060

  16. Rhabdomyosarcoma: Surgery

    MedlinePlus

    ... on an arm or leg. Some types of surgery might need to be done by special surgeons. For example, removing tumors in the head and neck area may require surgical teams with ENT (ear, nose, and throat) surgeons, plastic surgeons, maxillofacial surgeons, and neurosurgeons. If a tumor is large ...

  17. The Role of Wound Healing and Its Everyday Application in Plastic Surgery: A Practical Perspective and Systematic Review

    PubMed Central

    Ireton, Jordan E.; Unger, Jacob G.

    2013-01-01

    Background: After surgery it is often recommended that patients should refrain from strenuous physical activity for 4–6 weeks. This recommendation is based on the time course of wound healing. Here, we present an overview of incisional wound healing with a focus on 2 principles that guide our postoperative recommendations: the gain of tensile strength of a wound over time and the effect of mechanical stress on wound healing. Methods: A systematic search of the English literature was conducted using OVID, Cochrane databases, and PubMed. Inclusion criteria consisted of articles discussing the dynamics of incisional wound healing, and exclusion criteria consisted of articles discussing nonincisional wounds. Results: Experiments as early as 1929 laid the groundwork for our postoperative activity recommendations. Research using animal models has shown that the gain in tensile strength of a surgical wound is sigmoidal in trajectory, reaching maximal strength approximately 6 weeks postoperatively. Although human and clinical data are limited, the principles gained from laboratory investigation have provided important insights into the relationship among mechanical stress, collagen dynamics, and the time course of wound healing. Conclusion: Our postoperative activity recommendations are based on a series of animal studies. Clinical research supporting these recommendations is minimal, with the most relevant clinical data stemming from early motion protocols in the orthopedic literature. We must seek to establish clinical data to support our postoperative activity recommendations so that we can maximize the physiologic relationships between wound healing and mechanical stress. PMID:25289204

  18. The political, legal, and financial issues that plastic surgery is facing and how to develop a plan to cope.

    PubMed

    Luria, L William

    2002-01-01

    Our specialty has been a creative wonder and an outright blessing to mankind. We have honed the arts of soft-tissue reconstruction to a level never thought possible just 100 years ago. We have found solutions to wound problems long after others have given up. We have restored the destroyed features of people ravaged by disease, life circumstances, and the acts of war. We have treated the deformed child, the patient with cancer, and reversed the signs of age. But as Thomas Sowell states in his article in 1994 in Forbes Magazine on the 100th anniversary of the birth of Fredrich Hayek, the author of The Road to Serfdom, the rule of law, which Hayek saw as crucial to the economy and to the survival of freedom, is nowhere in greater danger than in the supreme court of the United States. Sowell warned of the process going on that would bring socialism to our health care delivery system. He goes on to assert that it will be paid for by "loss of freedom to make our own decisions about medical care that are literally questions of life and death. The key to the future of medicine is now in our hands. This key will open the door to every doctor's dream of having the technologies that will allow physicians to diagnose and treat all the physical ills of the human race. Or the key, on the other hand, could open the exit door through which the best and brightest will leave medicine, feeling that they no longer can take on the legal and the financial risks to themselves and their families. The road to freedom from the controlling factors noted will require a change in culture. Knowing these facts will allow the plastic surgeon in practice to accept these factors and work with them to provide better care for their patients. PMID:11827366

  19. In vitro and in vivo biocompatibility, bioavailability and tolerance of an injectable vehicle for adipose-derived stem/stromal cells for plastic surgery indications.

    PubMed

    Lequeux, Charlotte; Rodriguez, Jonathan; Boucher, Fabien; Rouyer, Ondine; Damour, Odile; Mojallal, Ali; Auxenfans, Céline

    2015-11-01

    Soft tissue reconstruction is a challenge in plastic surgery, when replacing lost materials and correcting contour defects. Many permanent and temporary fillers have been used to restore the volume of these lesions, but often with poor results and even complications. Adipose-derived stem/stromal cells (ASCs) and adipose tissue engineering have been suggested as valuable alternatives. In order to inject these cultured cells, it was essential to find a suitable vehicle. The purpose of this study was to evaluate Cytocare(®), an injectable medical device, composed of hyaluronic acid plus amino acids, vitamins and mineral salts. First, ASC viability and bioavailability in the 3 different available Cytocare(®) formulations using the MTT test were assessed; then an animal experiment, testing the tolerance after intradermal injections of both Cytocare(®) alone and with ASCs was carried out. Our in vitro results demonstrate a high biocompatibility of Cytocare(®) resulting in a better viability of ASCs when cultured in Cytocare(®) compared to culture medium (p < 0.05, Mann and Whitney). Cytocare(®) also permits their bioavailability and proliferation, making it a potential transfer vehicle that can retain the cells before their integration around the recipient site. Finally, our animal experiment shows that the ASC + Cytocare(®) combination is well tolerated. In conclusion, Cytocare(®) can be used as a biocompatible scaffold for cultured ASCs in therapeutic treatments, ensuring ASC bioavailability, as well as evidence of excellent tolerance in nude mice. PMID:26282247

  20. A retrospective study of 572 patients with hand burns treated at the Department of Plastic Surgery Kosovo during the period 2000-2010

    PubMed Central

    Arifi, Hysni M; Duci, Shkelzen B; Zatriqi, Violeta K; Ahmeti, Hasan R; Haxhiu, Isa I; Mekaj, Agon Y; Gashi, Musli M; Buja, Zejn A; Derguti, Shkelqim H

    2014-01-01

    Hands participate in everyday human activities and they are the most vulnerable parts of a human body. The objective of this study is to understand the common causes of hand burns, the methods of surgical interventions, duration of hospitalization and distribution of hand burns in 11 year period regarding the age. This is a retrospective study that included 572 patients with hand burns treated at the Department of Plastic Surgery Kosovo during the period 2000-2010. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Data processing was done with the statistical package InStat 3. From statistical parameters were calculated structural index, arithmetic median and standard deviation. Data testing is done with X 2 test and the difference is significant if P<0.05. The Ministry of Health of our country should make efforts to organize training for health workers about treatment for minor burns in order to reduce the number of referral patients from other primary (Familiar Medicine) and secondary centers (regional Hospitals). PMID:24624309

  1. Epidemiology and outcome of burns at the Saud Al Babtain Burns, Plastic Surgery and Reconstructive Center, Kuwait: our experience over five years (from 2006 to 2010)

    PubMed Central

    Khashaba, H.A.; Al-Fadhli, A.N.; Al-Tarrah, K.S.; Wilson, Y.T.; Moiemen, N.

    2012-01-01

    Summary Aim To determine the epidemiology and clinical presentation, and any contributing factors responsible for burns and outcome of care in Kuwait over the 5-yr period January 2006 to December 2010. Patients and methods. The study reviewed 1702 burn patients admitted over the study period to the Saud Al Babtain Burns, Plastic and Reconstructive Surgery Center, Kuwait. Patient characteristics, including age, sex, type of burn, nationality, total body surface area (TBSA) burn, hospital stay in days, and mortality were recorded. Results. Seventy-one per cent of the 1702 burn patients admitted were males; 540 were children. The majority of patients (64%) had less than 15% TBSA burns and only 14% had more than 50% TBSA burns. Flame burns were the most common cause of burn injuries (60%), followed by scalds (29%). Scalds were most common in children. The mortality rate was 5.75%. Flame burn was the leading cause of mortality. Lethal dose 50 (% TBSA at which a certain group has a 50% chance of survival) for adults (16-40 yr) and for the elderly (>65 yr) was 76.5% and 41.8% TBSA respectively. Conclusion. Burn injury is an important public health concern and is associated with high morbidity and mortality. Flame and scald burns are commonly a result of domestic and occupational accidents and they are preventable. Effective initial resuscitation, infection control, and adequate surgical treatment improve outcomes. PMID:23766750

  2. [New possibilities in practical education of surgery].

    PubMed

    Kormos, Katalin; Sándor, József; Haidegger, Tamás; Ferencz, Andrea; Csukás, Domokos; Bráth, Endre; Szabó, Györgyi; Wéber, György

    2013-10-01

    The fast spread of laparoscopic surgery in the surgical community also required introduction of new methods of surgical education of these techniques. Training boxes applied for this reason meant a considerable help. The technique of the virtual reality introduced simulation, which is a new possibility in education. For the first time in the history of surgery we can measure medical students' or residents' dexterity and one can get acquainted with a surgical procedure in the form of "serious games". By application of the up-to-date imaging methods we can plan the movements of the surgeon's hand even before the planned operation, practice and repeating can contribute to the safety of the real procedure. Open surgical procedures can be practiced on plastic phantoms mimicking human anatomy and the use of interactive touch devices and e-learning can also contribute to practical education of surgery. PMID:24144818

  3. Program Strengths and Opportunities for Improvement Identified by Residents During ACGME Site Visits in 5 Surgical Specialties.

    PubMed

    Caniano, Donna A; Hamstra, Stanley J

    2016-05-01

    Background There is limited information about how residents in surgical specialties view program strengths and opportunities for improvement (OFIs). Objective This study aggregated surgical residents' perspectives on program strengths and OFIs to determine whether there was agreement in perspectives among residents in 5 surgical specialties. Methods Resident consensus lists of program strengths and areas for improvement were aggregated from site visits reports during 2012 and 2013 for obstetrics and gynecology, orthopaedic surgery, otolaryngology, plastic surgery, and surgery programs. Four trained individuals coded each strength or OFI in 1 of 3 categories: (1) factors common to all specialties; (2) program or institutional resources; and (3) factors unique to surgical specialties. Themes were classified as most frequent when listed by residents in more than 20% of the programs and less frequent when listed by residents in less than 20% of the programs. Results This study included a total of 359 programs, representing 27% to 49% of the Accreditation Council for Graduate Medical Education accredited programs in the 5 specialties. The most frequent strengths were progressive autonomy, collegiality, program leadership, and operative volume. Improving research and didactics, increasing faculty teaching and attendance at educational sessions, and increasing the number of nurse practitioners and physician assistants were common OFIs. Conclusions Factors identified as important by surgical residents related to their learning environment, their educational program, and program and institutional support. Across programs in the study, similar attributes were listed as both program strengths and OFIs. PMID:27168889

  4. The Rhetorical Limits of the "Plastic Body"

    ERIC Educational Resources Information Center

    Jordan, John W.

    2004-01-01

    This essay analyzes the "plastic body" as it is produced in the discourse of plastic surgery. The contemporary industry has constructed a popular image of plastic surgery as a readily available and personally empowering means to resolve body image issues, on the presumption that any body can become a "better" body. The ideology underlying the

  5. The Rhetorical Limits of the "Plastic Body"

    ERIC Educational Resources Information Center

    Jordan, John W.

    2004-01-01

    This essay analyzes the "plastic body" as it is produced in the discourse of plastic surgery. The contemporary industry has constructed a popular image of plastic surgery as a readily available and personally empowering means to resolve body image issues, on the presumption that any body can become a "better" body. The ideology underlying the…

  6. Cleft lip and palate surgery in La Ceiba, Honduras.

    PubMed

    Smith, H W; Keen, M; Edwards, E

    1991-12-01

    The volume of experience in the surgical repair of cleft lip and palate deformities is limited in many areas of the United States. This deficit in experience exists not only for those in resident training programs but also for those who practice at universities or are in private practice. Physicians are performing too few operations to maintain their surgical skills in cleft lip and palate surgery. This deficit is also encountered by physicians in the major specialties of plastic surgery, oral surgery, and otolaryngology who perform cleft lip and palate surgery. Physicians from the United States can gain surgical experience in other countries through groups like the Medical Group Mission Christian Medical and Dental Society. Surgical experience is available in Central and South America, India, China, and Africa through similar organizations. The complexity of providing service to under-privileged people through organizations such as the Medical Group Mission Christian Medical and Dental Society is described. PMID:1845261

  7. Transitioning from residency to private practice.

    PubMed

    Brandt, M Todd

    2008-02-01

    A resident in oral and maxillofacial surgery must prepare for the inevitable transition from residency training to practice as a private practitioner, an officer in the military, an academician, or as a fellow in a postresidency training program. Each career path offers distinct challenges and rewards. This article reviews the issues that face a chief resident embarking on a career in private practice in oral and maxillofacial surgery. PMID:18194732

  8. [Aesthetic surgery and history].

    PubMed

    Glicenstein, J

    2003-10-01

    The history of aesthetic surgery is linked to that of the 20th century. The first operations allowed by the progress of anesthesia and asepsis are the correction of "prominent ears" by Ely then rhinoplasty with endonasal incision by Roe. Considered by some as a precursor and a quack by others, C.C. Miller was the first surgeon to specialize and write books on the subject. Before world war I, aesthetic surgery was seldom practiced and publications were few. The war was at the origin of several units of maxillo-facial surgery created for the huge number of casualties with face trauma due to trench warfare. Many of those who will become great names in plastic surgery operated in these units: Blair, Davis, Léon Dufourmentel, Virenque, Morestin and Gillies. After the war, American surgeons were regrouped in scientific societies. Plastic surgery was privileged and aesthetic surgery was lifted for "quacks". In France, several surgeons such as Suzanne Noël, Passot, Bourguet, Dartigues showed an important creativity and described several techniques that inspired recent ones. The Dujarier case discredited French aesthetic surgery but did not stop the creation of the first French Society of Plastic Surgery in 1930. World war II led to new orientations. In England, the East Grinstead center with Gillies and McIndoe during and after the war was at the origin of many vocations. After the war, many national and international societies of plastic surgery started to appear. The French Society of Plastic Surgery was born in 1952. PMID:14599899

  9. Permanent resident

    PubMed Central

    Fisher, John F.

    2016-01-01

    The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff. PMID:27193992

  10. Robotic surgery

    MedlinePlus

    Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance ... Robotic surgery is similar to laparoscopic surgery. It can be performed through smaller cuts than open surgery. ...

  11. Thyroid Surgery

    MedlinePlus

    ... Ways to Donate American Thyroid Association » Thyroid Surgery Thyroid Surgery Thyroid operations are advised for patients who ... Thyroid Nodules Thyroid Surgery Thyroid and Weight Thyroiditis Thyroid Surgery Resources Thyroid Surgery Brochure PDF Thyroid Surgery ...

  12. Rural general surgery training: the Gundersen Lutheran approach.

    PubMed

    Cogbill, Thomas H; Jarman, Benjamin T

    2009-12-01

    This article outlines the approach taken at Gundersen Lutheran Medical Foundation to prepare general surgery residents for rural general surgery practice. The methods focus on strong core training in general and minimally invasive surgery, additional technical skill sets, rural surgery electives, outcomes-based research experience, practice management education, and maintenance of relationships with graduates after residency. PMID:19944812

  13. Cosmetic Surgery

    MedlinePlus

    ... Looking and feeling your best Cosmetic surgery Cosmetic surgery Teens might have cosmetic surgery for a number ... my body? What are the risks of cosmetic surgery? top People who have cosmetic surgery face many ...

  14. [Tumor surgery].

    PubMed

    Hausamen, J E

    2000-05-01

    Surgery is still the primary therapeutic approach in treatment of tumors in the head and neck area, dating back to the early nineteenth century. More than 150 years ago, hemimaxillectomies and mandibular resections as well as hemiglossectomies were already performed by leading surgeons. The block principle we are now following dates back to Crile, who also established the principle of cervical lymph node dissection. Ablative oncologic surgery has always been closely linked with plastic and reconstructive surgery, rendering radical surgical interventions possible without disfiguring patients. The development of facial reconstructive surgery proceeded in stages, in the first instance as secondary reconstruction using tube pedicled flaps. The change to the concept of primary reconstruction occurred via arterialized skin flaps and myocutaneous flaps to the widely accepted and performed free tissue transfer. Free bone grafting, inaugurated earlier and still representing the majority of bone grafting, has been supplemented for certain reconstructive purposes by free vascularized bone transfer from various donor sites. Although the five-year-survival rate of carcinoma of the oral cavity has remained unchanged in the past 30 years, distinctive improvements in tumor surgery can be recorded. This is primarily based on improved diagnostics such as modern imaging techniques and the refinement of surgical techniques. The DOSAK has worked out distinctive guidelines for effective ablative oncologic surgery. Surgical approaches offering wide exposure and carrying low morbidity play a decisive role in radical resections. For this reason, midfacial degloving offers an essential improvement for the resection of midface tumors, especially from an aesthetic point of view. Tumors situated deep behind the viscerocranium at the skull base can be clearly exposed either through a lateral approach following a temporary osteotomy of the mandibular ramus or a transmandibular, transmaxillar, or transfacial approach with minimal morbidity. Concerning the concept of neck dissection, radical techniques are more and more abandoned in favor of a more conservative procedure. Actual inquiries concerning present surgical procedures as to the surgical strategy in "N(o)-neck" or marginal and segmental resection in mandibular adherent carcinomas demand scientific clarification. PMID:10938654

  15. Teaching professionalism in orthopaedic residency.

    PubMed

    Cornwall, R

    2001-04-01

    Two residents, wearing white coats with their names and "Department of Orthopaedics" conspicuously embroidered on them, boarded a hospital elevator crowded with physicians, employees, and visitors. In a clearly audible voice, one resident began a story: "You should have seen the patient I saw in my clinic the other day. She was beautiful. I should send her to see Dr. W. He would love to see her!" This comment drew the undivided attention of everyone in the elevator and cast a ghastly silence over the rest of the ride. In recent years, interest has expanded regarding professionalism and its importance in medicine and surgery. Orthopaedic surgery is no exception, as the topic has recently reached prominence in our literature and policies. It is unlikely that professionalism is a universal and innate characteristic of college students entering medical school, yet it becomes a necessary value in medical practice. Somewhere in the ongoing process of medical education, the issue must be addressed. PMID:11315802

  16. Plastic Jellyfish.

    ERIC Educational Resources Information Center

    Moseley, Christine

    2000-01-01

    Presents an environmental science activity designed to enhance students' awareness of the hazards of plastic waste for wildlife in aquatic environments. Discusses how students can take steps to reduce the effects of plastic waste. (WRM)

  17. Heart Surgery

    MedlinePlus

    ... heart with a healthy heart from a donor Traditional heart surgery, often called open-heart surgery, is ... off-pump, or beating heart, surgery. It's like traditional open-heart surgery because the chest bone is ...

  18. Lung surgery

    MedlinePlus

    ... Lung tissue removal; Pneumonectomy; Lobectomy; Lung biopsy; Thoracoscopy; Video-assisted thoracoscopic surgery; VATS ... do surgery on your lungs are thoracotomy and video-assisted thoracoscopic surgery (VATS). Lung surgery using a ...

  19. Obesity surgery: French medico-legal aspects.

    PubMed

    Manaouil, Cecile; Gignon, Maxime; Jardé, Olivier

    2011-06-01

    The demand for bariatric surgery is expected to increase. It is a procedure that carries a high surgical risk, and a risk of postoperative complications due to the pathologies associated with obesity. Obesity surgery is not classified as plastic surgery, but may subsequently lead to plastic surgery-type operations. Malpractices in the field of obesity surgery are most frequently at the pre-operative stage. In the absence of any fault, a patient may obtain indemnification by "national solidarity". Physicians and surgeons have an obligation to be able to prove that they informed their patients properly. PMID:21877467

  20. Plastic surgery and burns disasters. What impact do major civilian disasters have upon medicine? Bradford City Football Club stadium fire, 1985, King's Cross Underground fire, 1987, Piper Alpha offshore oil rig disaster, 1988.

    PubMed

    Vaghela, Kalpesh R

    2009-06-01

    Major disasters involving multiple casualties are neither new nor infrequent. Such events have important implications for medicine and can provide crucial lessons for the future. However, while the medical aspects of war have received considerable attention, rather less is known about civilian disasters. To redress this imbalance, this article reviews three major British disasters of the 1980s where serious burns injury was a significant feature of the human casualty: the Bradford City Football Club fire of 1985, the King's Cross Underground fire of 1987 and the Piper Alpha oil rig disaster of 1988. Four related themes are used to examine in detail the ways in which these events impacted on medicine: plastics and reconstructive surgery, clinical psychology, disaster management and long-term structural change. Drawing on articles in specialist burns and psychiatric journals, together with the personal communications and recollections of surgeons and psychiatrists involved, it is revealed that while ground-breaking advances are a relative rarity in medicine, numerous small but significant lessons did emerge from these events, although often in subtle and highly specialised fields of medicine. PMID:19181578

  1. Surgery in Italy.

    PubMed

    Angelini, L; Eleuteri, E; Coppola, M

    2001-11-01

    During the past 15 years, surgery in Italy has undergone significant developments in health care services at the teaching and organizational levels. In 1987, the new teaching regulations of medical and surgical schools came into force with the introduction of integrated courses that converge into educational and training areas with precise objectives. For more than a decade, postgraduate schools have had a common guideline throughout the European community--becoming real "residencies." Surgical activity is provided by university hospital facilities and hospitals with a business administration that is completely autonomous as far as organization, income, management, technique, and accounts are concerned. Research guidelines for future developments are mainly addressed toward optimization of organization and use of the most recent technology. The widespread application of day surgery and video-assisted surgery substantiates this evolution of surgery in Italy. PMID:11695980

  2. Outpatient Surgery

    MedlinePlus

    Policymakers | Members | Patients | News Media Anesthesia 101 Patient Safety Stories Resources About Home » Patients » Preparing For Surgery » Types of Surgery » Outpatient Surgery Share this Page Preparing For ...

  3. Tourniquets in orthopedic surgery

    PubMed Central

    Sharma, Jai Prakash; Salhotra, Rashmi

    2012-01-01

    Tourniquets are commonly used in limb surgeries, be it orthopedic or plastic surgeries. But the inflation pressures, the duration, and release guidelines are still not clear. According to a survey, majority of orthopedic surgeons inflate the tourniquet to fixed pressures for the upper and the lower limbs without considering the baseline blood pressure of the patient on whom the tourniquets are being applied. This review was designed to recall and review the safe use of tourniquets and the various techniques that can be employed to minimize the complications of tourniquet use. Google, science direct, and pubmed were searched for appropriate literature and relevant articles were identified. PMID:22912509

  4. The generation gap in modern surgery: a new era in general surgery.

    PubMed

    Craven, James E

    2002-03-01

    General surgery remains one of the most respected residencies available to medical students today. At the same time, the number of medical school graduates applying for general surgery residencies continues to decline. Despite this decline, we still search for those individuals exhibiting qualities shared by general surgeons who excel. Although the field of general surgery is constantly evolving, these qualities remain the same. While intellect and good technical skills are essential, they alone do not ensure success as a surgery resident. Confidence, stamina, tenacity, and patience are imperative. Good leadership, motivational, and decision-making skills are also vital characteristics. Finally, the importance of dedication to patient care cannot be overstated. Because disease, injury, and pain are not scheduled events, general surgery residents regularly spend long hours, day and night, caring for and worrying about their patients. To ensure that we continue to add a sufficient number of general surgery residents each year without lowering our standards, those of us in general surgery must attempt to determine why fewer medical school graduates are applying for general surgery residencies. Then we must find ways in which we can improve the residency programs and, probably more important, emphasize to students the things about this field that led us to devote our lives to its practice. PMID:11888444

  5. Asian cosmetic facial surgery.

    PubMed

    Kwak, Edward S

    2010-05-01

    Within the past decade, Asian economies have grown exponentially, resulting in increased personal wealth and subsequent consumption of cosmetic procedures. Asian cosmetic surgery procedures in Western countries have also seen a growth pattern parallel to Asia. As this growth continues, facial plastic surgeons in Western nations will inevitably witness increased Asians in their patient population base. To meet this demand, the surgeon must incorporate a set of different aesthetic norms from the traditional Western philosophies. In addition, the plastic surgeon must also understand the unique cultural motivations for surgery. The Asian face has distinguishing features that are unique. As such, surgical techniques and aesthetic goals for a particular cosmetic procedure will be different than those for other ethnic groups. This article will review three of the most common cosmetic procedures unique to the Asian face: Asian blepharoplasty, lower facial contouring, and Asian rhinoplasty. PMID:20446204

  6. [Humanitarian aesthetic surgery].

    PubMed

    Knipper, P

    2003-10-01

    Must a face be disfigured by a terrible tropical disease, in order to make us realise that the well being of our gesture is aesthetically acceptable? Must our reparative motivation remain the only trace of our skill and our humanity? During a plastic surgery mission, so-called humanitarian mission, can this surgery be aesthetic? Can aesthetic surgery be humanitarian? We learnt from aesthetic surgery on humanitarian missions, that aesthetic is only a technic to assist the reparation aspect. There is no need to justify aesthetic by reconstruction, because aesthetic belongs, in its entirety, to reparation. There is no need either to feel guilty, when our technical gesture is aesthetic, since what really motivates our intervention is not for us to decide. Is the reparation of the cleft lip of a little Asian girl, a reparation gesture or only an aesthetic approach? You may think that this will be a reparation gesture, because it will be more "popular" or because you will reconstruct the muscular belt. This child will most probably look for a more beautiful or aesthetic lip (in any case, she ignores the intricacies of facial growth principles). Therefore, it will be an aesthetic intervention. Never mind the motivation, since your technic will be the same, and you will try to do your very best and the most aesthetically you can. Only the very intention behind an intervention will decide whether it is an aesthetic or a plastic intervention, whereas your technical gesture will remain the same. All this illustrates that our definitions are of a minor importance, compared with the mere satisfaction of our little Asian girl, which, hopefully, will be a "beautiful" satisfaction. In fact, we have learnt not to do aesthetic surgery, but to give an aesthetic approach to our surgery, even during our humanitarian missions. The form aesthetic surgery will take is very subjective and only the final result will have the last say. Hopefully this surgical result will be aesthetically and humanly acceptable. PMID:14599904

  7. Smartphones and the plastic surgeon.

    PubMed

    Al-Hadithy, Nada; Ghosh, Sudip

    2013-06-01

    Surgical trainees are facing limited training opportunities since the introduction of the European Working Time Directive. Smartphone sales are increasing and have usurped computer sales for the first time. In this context, smartphones are an important portable reference and educational tool, already in the possession of the majority of surgeons in training. Technology in the palm of our hands has led to a revolution of accessible information for the plastic surgery trainee and surgeon. This article reviews the uses of smartphones and applications for plastic surgeons in education, telemedicine and global health. A comprehensive guide to existing and upcoming learning materials and clinical tools for the plastic surgeon is included. E-books, podcasts, educational videos, guidelines, work-based assessment tools and online logbooks are presented. In the limited resource setting of modern clinical practice, savvy plastic surgeons can select technological tools to democratise access to education and best clinical care. PMID:23523169

  8. Complications from international surgery tourism.

    PubMed

    Melendez, Mark M; Alizadeh, Kaveh

    2011-08-01

    Medical tourism is an increasing trend, particularly in cosmetic surgery. Complications resulting from these procedures can be quite disruptive to the healthcare industry in the United States since patients often seek treatment and have no compensation recourse from insurance. Despite the increasing number of plastic surgery patients seeking procedures abroad, there have been little reported data concerning outcomes, follow-up, or complication rates. Through a survey of American Society of Plastic Surgeons (ASPS) members, the authors provide data on trends to help define the scope of the problem. PMID:21813883

  9. EPDM plasticizers

    SciTech Connect

    Godail, M.J.

    1983-08-01

    The properties of paraffinic, naphthenic, and aromatic extender oils used as EPDM plasticizers are discussed in detail. Particular attention is given to viscosity, volatility, specific gravity, and aromatic content.

  10. Resident evaluation of orthodontic programs in Canada.

    PubMed

    Noble, James; Hechter, Frank J; Karaiskos, Nicholas E; Wiltshire, William A

    2009-02-01

    The purpose of this study was to investigate the satisfaction of Canadian orthodontic residents with their programs and determine the scope of their training. An anonymous online questionnaire was sent to all Canadian orthodontic residents in November 2006. Data were assembled and categorized by different variables, and chi-square comparative analyses were performed. Forty-four out of fifty-four residents responded, giving a participation rate of 81.48 percent. Overall, 86.36 percent of responding residents were satisfied with their program. Respondents said they felt they received the appropriate amount of formal didactic teaching sessions and dedicated and protected academic time. All residents indicated their programs offered training in numerous treatment philosophies: 93.18 percent said they have sufficient clinically based training, and 72.73 percent indicated that their research-based training was sufficient. All responding residents indicated they will complete more than thirty patients from start to finish, and 25 percent estimated completion of more than seventy patients by graduation. Residents said they will complete on average five orthognathic surgery, twenty-four extraction, thirty-one non-extraction, eight adult, and thirteen patients in the mixed dentition. Only 50 percent said their programs contained care for disabled or underserved patients. Most (86.36 percent) said they feel they will be adequately prepared to provide unsupervised orthodontic care after graduation. These orthodontic residents indicated they collaborate most with the disciplines of oral surgery, periodontics, and prosthodontics. However, only 52.27 percent indicated they have a formal interdisciplinary program for treating patients. We conclude from the study that Canadian orthodontic residents are satisfied with the didactic, clinical, and research aspects of their programs. They receive comprehensive instruction with the opportunity to complete a significant number of patients, employing a variety of treatment approaches. PMID:19234075

  11. Malformation and plastic surgery in childhood

    PubMed Central

    Siegert, Ralf; Magritz, Ralph

    2014-01-01

    Malformations of the head and neck show a huge variety of clinical symptoms with functional and esthetic consequences. Often times its rehabilitation requires multi-staged and multi-disciplinary procedures and concepts. These must consider eating, speech, mimic expression, hearing and “esthetics” or at least “normality”. A survey of the most common head and neck malformations and their treatment options are presented here. PMID:25587361

  12. [Plastic surgery treatment of blepharochalasia with ptosis].

    PubMed

    Härtel, P

    1996-01-01

    Ptosiform blepharochalasis is not only an esthetic but also a functional problem for the elderly patient. In clinical terms there is an extension of the lid skin over upper-lid margin, a relaxation of the orbicularis muscle and a large amount of periorbital fat. The operation involves resection of the excess skin by an elliptical excision, shortening of the orbicularis muscle, and resection of the fat pads from two compartments. Postoperatively there is only edema, but no pain, which is important for the elderly. PMID:9101795

  13. Reliability and Accuracy of Surgical Resident Peer Ratings.

    ERIC Educational Resources Information Center

    Lutsky, Larry A.; And Others

    1993-01-01

    Reliability and accuracy of peer ratings by 32, 28, 33 general surgery residents over 3 years were examined. Peer ratings were found highly reliable, with high level of test-retest reliability replicated across three years. Halo effects appear to pose greatest threat to rater accuracy, though chief residents tended to exhibit less halo effect than

  14. Reliability and Accuracy of Resident Evaluations of Surgical Faculty.

    ERIC Educational Resources Information Center

    Risucci, Donald A.; And Others

    1992-01-01

    The reliability and accuracy of evaluations of 126 surgical faculty made by 47 general surgery residents over 2 years were examined. The general accuracy and reliability over both years indicate that anonymous ratings of surgical faculty by groups of residents can be a valuable evaluation method. (SLD)

  15. Reliability and Accuracy of Surgical Resident Peer Ratings.

    ERIC Educational Resources Information Center

    Lutsky, Larry A.; And Others

    1993-01-01

    Reliability and accuracy of peer ratings by 32, 28, 33 general surgery residents over 3 years were examined. Peer ratings were found highly reliable, with high level of test-retest reliability replicated across three years. Halo effects appear to pose greatest threat to rater accuracy, though chief residents tended to exhibit less halo effect than…

  16. Facility Focus: Residence Halls.

    ERIC Educational Resources Information Center

    College Planning & Management, 1999

    1999-01-01

    Describes four college residence halls that have successfully combined a comfortable, aesthetically pleasing, and socially stimulating atmosphere for its residents. Photographs and interior-design line drawings are included. (GR)

  17. Plastic condoms.

    PubMed

    1968-01-01

    Only simple equipment, simple technology and low initial capital investment are needed in their manufacture. The condoms can be made by people who were previously unskilled or only semi-skilled workers. Plastic condoms differ from those made of latex rubber in that the nature of the plastic film allows unlimited shelf-life. Also, the plastic has a higher degree of lubricity than latex rubber; if there is a demand for extra lubrication in a particular market, this can be provided. Because the plastic is inert, these condoms need not be packaged in hermetically sealed containers. All these attributes make it possible to put these condoms on the distributors' shelves in developing countries competitively with rubber condoms. The shape of the plastic condom is based on that of the lamb caecum, which has long been used as luxury-type condom. The plastic condom is made from plastic film (ethylene ethyl acrilate) of 0.001 inch (0.0254 mm.) thickness. In addition, a rubber ring is provided and sealed into the base of the condom for retention during coitus. The advantage of the plastic condom design and the equipment on which it is made is that production can be carried out either in labour-intensive economy or with varying degrees of mechanization and automation. The uniform, finished condom if made using previously untrained workers. Training of workers can be done in a matter of hours on the two machines which are needed to produce and test the condoms. The plastic film is provided on a double wound roll, and condom blanks are prepared by means of a heat-sealing die on the stamping machine. The rubber rings are united to the condom blanks on an assembly machine, which consists of a mandrel and heat-sealing equipment to seal the rubber ring to the base of the condom. Built into the assembly machine is a simple air-testing apparatus that can detect the smallest pinhole flaw in a condom. The manufacturing process is completed by unravelling the condom from the assembly mandrel. The condom is then ready for packaging, either on automatic equipment or manually into small envelopes of highly polished paper. Although their present design is based on a heat-sealed blank, it may be possible shortly to manufacture plastic condoms on the same principle as rubber ones. A dipping process would be used, but with less sophisticated technology and with higher outputs per increment of capital investment. The present equipment used to make plastic condoms cost about 3,000 for one stamping machine and 22 assembly and testing machines. On a three shift per day, 300-day working year, it is possible, with experienced workers, to make 100,000 gross of plastic condoms for each manufacturing unit annually. As the technology is refined, the output should improve significantly. PMID:12155569

  18. Medical Students' Perceptions of Resident Teaching

    PubMed Central

    Brasher, Aimee Elizabeth; Chowdhry, Shahnaz; Hauge, Linnea S.; Prinz, Richard A.

    2005-01-01

    Objective: This study describes medical students’ perceptions about resident teaching on a surgery clerkship and examines student perceptions before and after the implementation of duty hours regulations (DHR). Summary Background Data: There has been much discussion about the impact of DHR on surgical education. One area that merits evaluation is the effect that DHR have had on student education. Learners perceive the clinical teacher role as comprised of 4 roles: teacher, person, physician, and supervisor. This model served as the basis for examining resident teaching before and after DHR. Methods: Students completed end-of-rotation evaluations about residents’ teaching effectiveness, amount of feedback, and quality of interactions. Student comments were compiled into individual resident reports, and reports were collected from pre- (2002–2003) and post- (2003–2004) DHR. A coding scheme was developed to describe resident performance in 4 roles: teacher, person, physician, and supervisor. Three coders independently reviewed 124 resident reports maintaining an interrater agreement of 80%. Analyses of variance were conducted to compare data from pre- and post-DHR. Results: After implementation of DHR, there were significantly more negative comments (P = 0.005), including comments about residents as supervisor (P = 0.001), teacher (P = 0.027), and teaching activities (P = 0.001). Positive comments about bedside teaching decreased (P = 0.007). Although total positive comments about resident as person increased (P = 0.01), total negative comments about resident as person also increased (P = 0.02). Conclusions: Findings of this study indicate that DHR have had a negative impact on medical students’ perceptions of resident teaching. Surgical educators must develop programs that address resident teaching skills in a different environment. PMID:16192815

  19. Strabismus Surgery

    MedlinePlus

    ... figures 2 and 3]. What is an adjustable suture? Strabismus surgery involves sewing the eye muscle to ... of the muscle. Standard strabismus surgery (no adjustable suture) utilizes a permanent knot. Adjustable suture technique utilizes ...

  20. Turbinate surgery

    MedlinePlus

    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery ... There are several types of turbinate surgery: Turbinectomy: All or part of the lower turbinate is taken out. This can be done in several different ways, but sometimes a ...

  1. After Surgery

    MedlinePlus

    ... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...

  2. Plastics Technician.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center on Education and Training for Employment.

    This document contains 16 units to consider for use in a tech prep competency profile for the occupation of plastics technician. All the units listed will not necessarily apply to every situation or tech prep consortium, nor will all the competencies within each unit be appropriate. Several units appear within each specific occupation and would…

  3. Rewarding the resident teacher.

    PubMed

    McBride, Jennifer M; Drake, Richard L

    2011-01-01

    Residents routinely make significant contributions to the education of medical students. However, little attention has been paid to rewarding these individuals for their involvement in these academic activities. This report describes a program that rewards resident teachers with an academic appointment as a Clinical Instructor. The residents participate in the laboratory portion of the anatomy program at the Cleveland Clinic Lerner College of Medicine. They prepare weekly cadaver dissections and present these dissections to the first year medical students. Guidelines developed by the anatomy faculty and approved by the appropriate committees at both the Cleveland Clinic and Case Western Reserve University establish requirements that a resident must meet to qualify for an academic appointment. Evaluation of this program indicates that it has been very successful based on medical student feedback, resident interest in gaining teaching experience, and residency directors appreciation of the opportunity for residents to gain valuable teaching experience in an academic setting. PMID:21480537

  4. Validation of an Objective Structured Assessment of Technical Skill for Surgical Residents.

    ERIC Educational Resources Information Center

    Faulkner, Heather; And Others

    1996-01-01

    Examined the concurrent validity of the Objective Structured Assessment of Technical Skill (OSATS), a new test of technical skills for general surgery residents. Correlations between OSATS scores and faculty rankings were generally high for six senior residents but low for six junior residents at the University of Toronto. (MDM)

  5. Photochromic plastics

    SciTech Connect

    Chu, N.Y.C.

    1990-12-31

    The benefits of photochromic glazing materials as well as other switchable devices for solar control and/or use have been analyzed. The analysis indicates that the saving in cooling costs may be significant for a commercial building. This saving can be further increased if other solar control technologies which operate in the solar spectra region outside the visible range are integrated with photochromic property. Photochromic plastics have the advantage of readiness to integrate with other solar control technologies as in the case of retrofit polyester film. The glazing applications of spirooxazines have only been considered recently. The few examples described in the preceding section are just exploratory. Improvements in photochromic performance and durability are definitely probable as more spirooxazine compounds and formulations are tested and stabilization methods are discovered. Recently, an all plastic model house was constructed by General Electric in which both photochromic and electrochromic switchable windows were employed. Thus, commercialization of photochromic plastics for glazing applications may not be as remote as it was not too long ago. 66 refs., 4 figs., 1 tab.

  6. Leaching of plastic additives to marine organisms.

    PubMed

    Koelmans, Albert A; Besseling, Ellen; Foekema, Edwin M

    2014-04-01

    It is often assumed that ingestion of microplastics by aquatic species leads to increased exposure to plastic additives. However, experimental data or model based evidence is lacking. Here we assess the potential of leaching of nonylphenol (NP) and bisphenol A (BPA) in the intestinal tracts of Arenicola marina (lugworm) and Gadus morhua (North Sea cod). We use a biodynamic model that allows calculations of the relative contribution of plastic ingestion to total exposure of aquatic species to chemicals residing in the ingested plastic. Uncertainty in the most crucial parameters is accounted for by probabilistic modeling. Our conservative analysis shows that plastic ingestion by the lugworm yields NP and BPA concentrations that stay below the lower ends of global NP and BPA concentration ranges, and therefore are not likely to constitute a relevant exposure pathway. For cod, plastic ingestion appears to be a negligible pathway for exposure to NP and BPA. PMID:24440692

  7. Cognitive outcome of surgery.

    PubMed

    Gallagher, Anne; Jambaqué, Isabelle; Lassonde, Maryse

    2013-01-01

    Epilepsy surgery is now widely accepted as an effective therapeutic option for carefully selected children with medically refractory epilepsy. The surgical procedure may cause cognitive deficits or exacerbate existing impairments, but it may also improve cognitive abilities by the restoration of functions located in adjacent or contralateral areas that had been secondarily affected by the epilepsy or the underlying pathology. Compared to adults, better cognitive outcome has been reported in children, a finding probably due to the developing state of the brain, which possesses considerable structural and functional plasticity. More extensive and effective surgery such as hemispherectomy is more commonly used in the pediatric population, and this must also influence surgical outcome. However, studies related to cognitive outcome of epilepsy surgery in children are limited, and controversial results are often reported. In this chapter, we provide a current overview of the literature on cognitive outcomes in children who undergo different types of epilepsy surgery, including focal resections as well as corpus callosotomy and hemispherectomy. Early surgical intervention appears to be a rational option for the treatment of childhood epilepsy since many cognitive deficits are linked to the epileptic process and may disappear when seizures are controlled. PMID:23622227

  8. Simulation in laparoscopic surgery.

    PubMed

    León Ferrufino, Felipe; Varas Cohen, Julián; Buckel Schaffner, Erwin; Crovari Eulufi, Fernando; Pimentel Müller, Fernando; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás; Boza Wilson, Camilo

    2015-01-01

    Nowadays surgical trainees are faced with a more reduced surgical practice, due to legal limitations and work hourly constraints. Also, currently surgeons are expected to dominate more complex techniques such as laparoscopy. Simulation emerges as a complementary learning tool in laparoscopic surgery, by training in a safe, controlled and standardized environment, without jeopardizing patient' safety. Simulation' objective is that the skills acquired should be transferred to the operating room, allowing reduction of learning curves. The use of simulation has increased worldwide, becoming an important tool in different surgical residency programs and laparoscopic training courses. For several countries, the approval of these training courses are a prerequisite for the acquisition of surgeon title certifications. This article reviews the most important aspects of simulation in laparoscopic surgery, including the most used simulators and training programs, as well as the learning methodologies and the different key ways to assess learning in simulation. PMID:25039039

  9. Rewarding the Resident Teacher

    ERIC Educational Resources Information Center

    McBride, Jennifer M.; Drake, Richard L.

    2011-01-01

    Residents routinely make significant contributions to the education of medical students. However, little attention has been paid to rewarding these individuals for their involvement in these academic activities. This report describes a program that rewards resident teachers with an academic appointment as a Clinical Instructor. The residents…

  10. Facility Focus: Residence Halls.

    ERIC Educational Resources Information Center

    College Planning & Management, 2002

    2002-01-01

    Describes residence halls seeking to meet needs beyond traditional mass housing for the 18- to 22-year-old students: Whittemore Hall at the Tuck School of Business at Dartmouth College (for older students); Small Group Housing at Washington University (grouping students with common interests); and the renovation of the residence hall at Boston's

  11. Residency training program paradigms for teaching robotic surgical skills to urology residents.

    PubMed

    Grover, Sonal; Tan, Gerald Y; Srivastava, Abhishek; Leung, Robert A; Tewari, Ashutosh K

    2010-03-01

    The advent of laparoscopic and robotic techniques for management of urologic malignancies marked the beginning of an ever-expanding array of minimally invasive options available to cancer patients. With the popularity of these treatment modalities, there is a growing need for trained surgical oncologists who not only have a deep understanding of the disease process and adept surgical skills, but also show technical mastery in operating the equipment used to perform these techniques. Establishing a robotic prostatectomy program is a tremendous undertaking for any institution, as it involves a huge cost, especially in the purchasing and maintenance of the robot. Residency programs often face many challenges when trying to establish a balance between costs associated with robotic surgery and training of the urology residents, while maintaining an acceptable operative time. Herein we describe residency training program paradigms for teaching robotic surgical skills to urology residents. Our proposed paradigm outlines the approach to compensate for the cost involved in robotic training establishment without compromising the quality of education provided. With the potential advantages for both patients and surgeons, we contemplate that robotic-assisted surgery may become an integral component of residency training programs in the future. PMID:20425095

  12. Tennis elbow surgery - discharge

    MedlinePlus

    ... surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... had surgery to repair a tendon in your elbow . The surgeon made a cut (incision) over the ...

  13. Maze Surgery

    MedlinePlus

    ... patients may also receive a pacemaker during the surgery. Recovery Time You can expect to stay in the hospital for 5 to 7 days or longer, including at least 1 to 2 days in the ... control any fluid buildup after surgery. You may also need to take aspirin for ...

  14. Plastic Hollow Tubes As Waveguides For IR Radiation

    NASA Astrophysics Data System (ADS)

    Croitoru, N.; Dror, J.; Mendlovic, D.

    1988-06-01

    A theoretical ray model was developed for energy distribution of IR radiation, transmitted through hollow straight and bent fibers. The theoretical results were compared with the experimental data obtained from measurements of our plastic hollow fibers. A satisfactory agreement between the experimental and theoretical data was achieved. Application of the plastic hollow fibers in surgery (on certain organic tissues) is described.

  15. Unnecessary surgery.

    PubMed Central

    Leape, L L

    1989-01-01

    The extent of unnecessary surgery has been the object of considerable speculation and occasional wild accusation in recent years. Most evidence of the existence of unnecessary surgery, such as information from studies of geographic variations and the results of second surgical opinion programs, is circumstantial. However, results from the few studies that have measured unnecessary surgery directly indicate that for some highly controversial operations the fraction that are unwarranted could be as high as 30 percent. Most unnecessary surgery results from physician uncertainty about the effectiveness of an operation. Elimination of this uncertainty requires more efficient production and dissemination of scientific information about clinical effectiveness. In the absence of adequate data from scientific studies, the use of a consensus of expert opinion, disseminated by means of comprehensive practice guidelines, offers the best opportunity to identify and eliminate unnecessary surgery. PMID:2668237

  16. Refractive Surgery

    PubMed Central

    Kellum, Keith

    2000-01-01

    The concept of surgically altering the eye to correct refractive errors has been considered for hundreds of years, but only in the past 60 years has interest grown considerably due to the development of modern refractive surgery techniques such as astigmatic keratotomies to correct astigmatism induced by cataract surgery and future technologies currently being investigated. Modern refractive surgery is more involved than setting the correct parameters on the laser. Patient selection and examination, proper technique, and postoperative follow-up for potential complications are essential for a successful refractive procedure. Critical evaluation of new techniques is vital to avoid the pitfall of overly exuberant enthusiasm for new and unproven methods of refractive surgery. Kellum K. Refractive surgery. The Ochsner Journal 2000; 2:164-167. PMID:21765686

  17. Which is the best method to learn ophthalmology? Resident doctors' perspective of ophthalmology training.

    PubMed

    Gogate, Parikshit; Deshpande, Madan; Dharmadhikari, Sheetal

    2008-01-01

    The study aimed to gauge ophthalmology resident doctors' perception of their teaching programs and various methods used in it and to formulate a well structured program for teaching ophthalmology. Closed ended and open-ended questionnaires were used for survey of ophthalmology residents in West Maharashtra, India. Sixty-seven out of 69 residents of seven residency programs completed the questionnaire. On a scale of 0 (most unsatisfactory) to 4 (best), lectures with power point presentation had a median score of 4, didactic lectures 2, seminar 3, case presentation 4, wet lab 3 and journal club 3. There was a discrepancy in the actual number of surgeries performed by the resident doctors and their perception of the number needed to master those surgeries. Phacoemulsification and non-cataract surgery training was neglected in most programs. The residents wanted to be evaluated regularly and taught basic ophthalmic examination, use of equipments and procedures in greater depth. PMID:18711271

  18. How quickly do albatrosses and petrels digest plastic particles?

    PubMed

    Ryan, Peter G

    2015-12-01

    Understanding how rapidly seabirds excrete or regurgitate ingested plastic items is important for their use as monitors of marine debris. van Franeker and Law (2015) inferred that fulmarine petrels excrete ∼75% of plastic particles within a month of ingestion based on decreases in the amounts of plastic in the stomachs of adult petrels moving to relatively clean environments to breed. However, similar decreases occur among resident species due to adults passing plastic loads to their chicks. The few direct measures of wear rates and retention times of persistent stomach contents suggest longer plastic residence times in most albatrosses and petrels. Residence time presumably varies with item size, type of plastic, the amount and composition of other persistent stomach contents, and the size at which items are excreted, which may vary among taxa. Accurate measures of ingested plastic retention times are needed to better understand temporal and spatial patterns in ingested plastic loads within marine organisms, especially if they are to be used as indicators of plastic pollution trends. PMID:26286902

  19. [Tagliacozzi: not just a plastic surgeon].

    PubMed

    Soto-Miranda, Miguel Angel; Romero-y-Huesca, Andrés; Goné-Fernández, Alberto; Soto-González, Jaime

    2006-01-01

    Gaspare Tagliacozzi is known because of his great contributions to plastic surgery. He is considered a pioneer in the field, which has had more influence in his career than his other transcendental activity as a surgery and anatomy teacher in Bologna for almost 30 years. The aim of the present manuscript is to analyze his teaching activities which were equally important for us, and to recreate, with pictorial means, three unpublished historic moments in the life of this great man of science. Gaspare Tagliacozzi was born in Bologna in 1545 and is considered the father of plastic surgery. He obtained a degree in medicine and philosophy at the University. He was named surgery professor in 1576, and worked as such until his death in 1599. His De Curtorum Chirurgia per Insitionem treatise was published in 1589 and was considered the first exclusive treatise on plastic surgery. Bologna built a permanent operating theater (amphitheater) within the Archiginnasio in 1595. Because of his success, he increased his earnings; his first university teaching salary was 100 lire, but his earning increased to 1,140 lire later. Tagliacozzi's contributions, together with that of others such as Vesalius, Aldrovandi, Fallopian and Eustachian advanced the field and knowledge of anatomy. PMID:17128825

  20. Present Status of Autonomy in Surgical Residency--a Program Director's Perspective.

    PubMed

    Patel, Mitesh; Bhullar, Jasneet S; Subhas, Gokulakkrishna; Mittal, Vijay

    2015-08-01

    As surgery residents graduate and begin their careers as junior attending surgeons, the question of whether a surgeon can complete a case alone still lingers. Allowing autonomy during residency answers this question. The purpose of this study was to gather input from general surgery residency program directors on how they achieve autonomy for residents in their programs. An online survey of 18 questions was sent to all general surgery residency program directors in the United States between April and June of 2013 via e-mail. Questions were asked regarding classification of autonomy, percentage of case completed by the resident independently, and in what area a resident worked with minimal supervision. Of the 202 delivered, 85 program directors were responded (42%). Seventy-eight per cent of programs classified a resident as surgeon junior whether the resident completed more than 50 per cent of the case. Most classified autonomy as either the resident completing >75 per cent of a case (41%) or completing the critical steps of a surgery (41%). Eighty-eight per cent stated that chief residents completed the majority of cases under supervision, whereas only 12 per cent stated the chief had autonomy in the operating room and also acted as teaching assistant. While, 60 per cent stated their chief residents did not work in any area of the hospital independently. Despite differences in how autonomy is defined among programs, most program directors feel that their chief residents do not achieve complete autonomy. Programs should allow their residents to work in a progressive responsibility as they progress into their fourth and fifth years of residency to achieve autonomy. PMID:26215240

  1. Residence Halls/Lounges.

    ERIC Educational Resources Information Center

    American School & University, 2002

    2002-01-01

    Describes the design of notable school residence halls and lounges, including the educational context and design goals. Includes information on architects, suppliers, and cost, as well as photographs. (EV)

  2. Technology in Residence.

    ERIC Educational Resources Information Center

    Fox, Jordan

    1999-01-01

    Discusses the necessity for incorporating current technology in today's college residence halls to meet the more diverse and continued activities of its students. Technology addressed covers data networking and telecommunications, heating and cooling systems, and fire-safety systems. (GR)

  3. [The civil responsibility of the plastic surgeon in esthetic procedures].

    PubMed

    Ferreira, M C; Ferreira, E H

    1992-01-01

    The authors discuss the professional liability of plastic surgeon for the results of esthetic procedures. In their opinion, plastic surgery was artificially divided in reconstructive and esthetic one. Legal decisions have also separated them and the success of results in esthetic procedures have been considered to be obligatory by the courts. The authors believe that in all cases of plastic surgery including esthetic operations the surgeon should use the adequate ways to achieve the best possible results that represent the average for the cultural and ethnic group in question. PMID:1340624

  4. Brain surgery

    MedlinePlus

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  5. Elimination of 24-hour continuous medical resident duty in Quebec

    PubMed Central

    Hamadani, Fadi; Deckelbaum, Dan; Shaheen, Mohammed; Sauvé, Alexandre; Dumitra, Sinziana; Ahmed, Najma; Latulippe, Jean-François; Balaa, Fady; Walsh, Mark; Fata, Paola

    2016-01-01

    Summary In 2012 Quebec limited continuous in-hospital duty to 16 consecutive hours for all residents regardless of postgraduate (PGY) level. The new restrictions in Quebec appeared to have a profound, negative effect on the quality of life of surgical residents at McGill University and a perceived detrimental effect on the delivery of surgical education and patient care. Here we discuss the results of a nationwide survey that we created and distributed to general surgery residents across Canada to capture and compare their perceptions of the changes to duty hour restrictions. PMID:26574704

  6. [Aesthetic surgery, medical discourse and health].

    PubMed

    Ferreira, Francisco Romão

    2011-05-01

    The increase in plastic surgery interventions in Brazil and the growth of the beauty industry, as well as care of the body and corporal enhancement, are part of a broader process of medical and aesthetic preoccupation with health. According to the Brazilian Plastic Surgery Association there has been a substantial increase in the number of plastic surgery procedures in Brazil. Every year, approximately 350,000 aesthetic surgical interventions are performed in the country. Our work investigated the construction of meaning and value, the use of aesthetic parameters in this construction and how those meanings are appropriated and treated by those representatives of the medical profession who work in the body transformation process, namely plastic surgeons. In this respect, an analysis of the pronouncements and discourse posted on the Brazilian Plastic Surgery Association website was conducted, as it is the regulatory body of the field and is responsible for training professionals and supervising the sector. Analysis of the official content of the website page posted on September 26, 2005 was the basis for this research. PMID:21655710

  7. Bariatric surgery

    PubMed Central

    Karmali, Shahzeer; Stoklossa, Carlene Johnson; Sharma, Arya; Stadnyk, Janet; Christiansen, Sandra; Cottreau, Danielle; Birch, Daniel W.

    2010-01-01

    Abstract OBJECTIVE To review the management of bariatric surgical patients. QUALITY OF EVIDENCE MEDLINE, EMBASE, and Cochrane Library databases were searched, as well as PubMed US National Library, from January 1950 to December 2009. Evidence was levels I, II, and III. MAIN MESSAGE Bariatric surgery should be considered for obese patients at high risk of morbidity and mortality who have not achieved adequate weight loss with lifestyle and medical management and who are suffering from the complications of obesity. Bariatric surgery can result in substantial weight loss, resolution of comorbid conditions, and improved quality of life. The patient’s weight-loss history; his or her personal accountability, responsibility, and comprehension; and the acceptable level of risk must be taken into account. Complications include technical failure, bleeding, abdominal pain, nausea or vomiting, excess loose skin, bowel obstruction, ulcers, and anastomotic stricture. Lifelong monitoring by a multidisciplinary team is essential. CONCLUSION Limited long-term success of behavioural and pharmacologic therapies in severe obesity has led to renewed interest in bariatric surgery. Success with bariatric surgery is more likely when multidisciplinary care providers, in conjunction with primary care providers, assess, treat, monitor, and evaluate patients before and after surgery. Family physicians will play a critical role in counseling patients about bariatric surgery and will need to develop skills in managing these patients in the long-term. PMID:20841586

  8. Robotic assisted andrological surgery

    PubMed Central

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

    The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE). PMID:23241637

  9. Robotic assisted andrological surgery.

    PubMed

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

    The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE). PMID:23241637

  10. Tennis elbow surgery

    MedlinePlus

    Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is usually an outpatient surgery. This means you will not stay in the hospital overnight. You will be given medicine ( ...

  11. Residency Programs and Psychotherapy Competencies: A Survey of Chief Residents

    ERIC Educational Resources Information Center

    Khurshid, Khurshid A.; Bennett, Jeffrey I.; Vicari, Sandy; Lee, Karen L.; Broquet, Karen E.

    2005-01-01

    Objective: To survey chief residents' opinion about various aspects of psychotherapy competency determination. Methods: Chief residents of various psychiatry residency programs were surveyed. Results: One hundred two chief residents were surveyed. Seventy two (70.58%) completed the survey. Eighty four percent of the respondents reported that they…

  12. Developing the academic thoracic surgeon: teaching surgery.

    PubMed

    Baumgartner, W A; Greene, P S

    2000-04-01

    Teaching surgery can be a very gratifying experience for those of us involved in academic thoracic surgery. Fundamentals of a good residency program require that patients should always be placed in the highest priority. However, the residency program should also be committed to teaching as a priority. Creating the proper operating room environment is essential for optimal conduct of the operation. This environment is similar to that of the airline industry, which is known as crew or cockpit resource management. The design of a teaching program needs to have evaluation as one of its key elements. In addition to resident evaluation, it is also important to have faculty evaluation by the residents. The goal of any residency program should be to foster the development of the future leaders in our specialty. The information contained within this article represents the art and science of teaching thoracic surgery as applied by the faculty in the Division of Cardiac Surgery at The Johns Hopkins Hospital. PMID:10727957

  13. Teaching professionalism to residents.

    PubMed

    Klein, Eileen J; Jackson, J Craig; Kratz, Lyn; Marcuse, Edgar K; McPhillips, Heather A; Shugerman, Richard P; Watkins, Sandra; Stapleton, F Bruder

    2003-01-01

    The need to teach professionalism during residency has been affirmed by the Accreditation Council for Graduate Medical Education, which will require documentation of education and evaluation of professionalism by 2007. Recently the American Academy of Pediatrics has proposed the following components of professionalism be taught and measured: honesty/integrity, reliability/responsibility, respect for others, compassion/empathy, self-improvement, self-awareness/knowledge of limits, communication/collaboration, and altruism/advocacy. The authors describe a curriculum for introducing the above principles of professionalism into a pediatrics residency that could serve as a model for other programs. The curriculum is taught at an annual five-day retreat for interns, with 11 mandatory sessions devoted to addressing key professionalism issues. The authors also explain how the retreat is evaluated and how the retreat's topics are revisited during the residency, and discuss general issues of teaching and evaluating professionalism. PMID:12525406

  14. Preparedness of Entering Pediatric Dentistry Residents: Advanced Pediatric Program Directors' and First-Year Residents' Perspectives.

    PubMed

    Rutkauskas, John; Seale, N Sue; Casamassimo, Paul; Rutkauskas, John S

    2015-11-01

    For children to receive needed oral health care, adequate training at both the predoctoral and postdoctoral levels of dental education is required, but previous studies have found inadequacies in predoctoral education that lead to general dentists' unwillingness to treat certain young populations. As another way of assessing predoctoral preparation, the aim of this study was to determine the perspectives of first-year residents and pediatric program directors about residents' preparedness to enter advanced education programs in pediatric dentistry. Surveys were sent to all 74 U.S. program directors and 360 first-year residents. The survey focused on procedures related to prevention, behavior management, restorative procedures, pulp therapy, sedation, and surgery, as well as treating patients funded by Medicaid and with special health care needs. Among the first-year residents, 173 surveys were returned for a 48% response rate; 61 directors returned surveys for an 82% response rate. Only half of the residents (55%) reported feeling adequately prepared for their first year in residency; less than half cited adequate preparation to place stainless steel crowns (SSCs) (42%) and perform pulpotomies (45%). Far fewer felt adequately prepared to provide treatment for children six months to three years of age, including examinations (29%), infant oral exams (27%), and children with severe caries (37%). The program directors were even less positive about the adequacy of residents' preparation. Only 17% deemed them adequately prepared to place SSCs and 13% to perform pulpotomies. Approximately half reported their first-year residents were inadequately prepared to treat very young children and children with severe caries (55% each). This study found that the perceived inadequacy of predoctoral education in pediatric dentistry was consistent at both the learner and educator levels, supporting previous studies identifying inadequacies in this area. PMID:26522630

  15. Financing Residency Training Redesign

    PubMed Central

    Carney, Patricia A.; Waller, Elaine; Green, Larry A.; Crane, Steven; Garvin, Roger D.; Pugno, Perry A.; Kozakowski, Stanley M.; Douglass, Alan B.; Jones, Samuel; Eiff, M. Patrice

    2014-01-01

    Background Redesign in the health care delivery system creates a need to reorganize resident education. How residency programs fund these redesign efforts is not known. Methods Family medicine residency program directors participating in the Preparing Personal Physicians for Practice (P4) project were surveyed between 2006 and 2011 on revenues and expenses associated with training redesign. Results A total of 6 university-based programs in the study collectively received $5,240,516 over the entire study period, compared with $4,718,943 received by 8 community-based programs. Most of the funding for both settings came from grants, which accounted for 57.8% and 86.9% of funding for each setting, respectively. Department revenue represented 3.4% of university-based support and 13.1% of community-based support. The total average revenue (all years combined) per program for university-based programs was just under $875,000, and the average was nearly $590,000 for community programs. The vast majority of funds were dedicated to salary support (64.8% in university settings versus 79.3% in community-based settings). Based on the estimated ratio of new funding relative to the annual costs of training using national data for a 3-year program with 7 residents per year, training redesign added 3% to budgets for university-based programs and about 2% to budgets for community-based programs. Conclusions Residencies undergoing training redesign used a variety of approaches to fund these changes. The costs of innovations marginally increased the estimated costs of training. Federal and local funding sources were most common, and costs were primarily salary related. More research is needed on the costs of transforming residency training. PMID:26140119

  16. Nail surgery.

    PubMed

    Haneke, Eckart

    2013-01-01

    Nail surgery is a special branch of hand and dermatologic surgery. It is not widely performed, and many physicians do not feel at ease to perform it. The objective of this contribution is to give a short overview of the most important surgical procedures in clinical practice. References from the literature and the author's own experiences are condensed to describe what a dermatologic practitioner with knowledge of the nail and some surgical skills can perform. Nail surgery is a precise technique that requires careful administration and attention to details. Proper patient preparation starts with a patient history to identify potential contraindications and to prevent unnecessary complications. The author recommends isopropyl alcohol scrub and chlorhexidine for disinfection and ropivacaine 1% for anesthesia. The technique used for anesthesia depends on the type of surgery. Surgical procedures are described for diagnostic biopsies, nail avulsion in general, onychogryposis, paronychia treatment, hematomas and bone fracture due to trauma, removal of subungual foreign bodies, ingrowing nails, pincer nails, warts, ungual fibrokeratomas, digital myxoid pseudocyst, subungual exostoses, and various tumors. If performed correctly with adequate skills, nail surgery will lead to functionally and aesthetically satisfying results in the majority of instances. PMID:24079580

  17. Aktau Plastics Plant Explosives Material Report

    SciTech Connect

    CASE JR.,ROGER S.

    1999-12-01

    The U.S. Department of Energy (DOE) has been cooperating with the Republic of Kazakhstanin Combined Threat Reduction (CTR) activities at the BN350 reactor located at the Mangyshlak Atomic Energy Complex (MAEC) in the city of Aktau, Kazakhstan since 1994. DOE contract personnel have been stationed at this facility for the last two years and DOE representatives regularly visit this location to oversee the continuing cooperative activities. Continued future cooperation is planned. A Russian news report in September 1999 indicated that 75 metric tons of organic peroxides stored at the Plastics Plant near Aktau were in danger of exploding and killing or injuring nearby residents. To ensure the health and safety of the personnel at the BN350 site, the DOE conducted a study to investigate the potential danger to the BN350 site posed by these materials at the Plastics Plant. The study conclusion was that while the organic peroxides do have hazards associated with them, the BN350 site is a safe distance from the Plastics Plant. Further, because the Plastics Plant and MAEC have cooperative fire-fighting agreements,and the Plastics Plant had exhausted its reserve of fire-fighting foam, there was the possibility of the Plastics Plant depleting the store of fire-fighting foam at the BN350 site. Subsequently, the DOE decided to purchase fire-fighting foam for the Plastics Plant to ensure the availability of free-fighting foam at the BN350 site.

  18. An Assigned Teaching Resident Rotation

    ERIC Educational Resources Information Center

    Daniels-Brady, Catherine; Rieder, Ronald

    2010-01-01

    Objective: The authors' adult psychiatry residency training program identified several educational needs for residents at their institution. Junior residents needed enhanced learning of clinical interviewing skills and learning connected to the inpatient psychiatry ward rotations, and senior residents needed opportunities to prepare for the…

  19. [Metabolic surgery].

    PubMed

    Jurowich, C; Germer, C T; Seyfried, F; Thalheimer, A

    2012-06-01

    The prevalence of obesity and diabetes mellitus type 2 is constantly rising worldwide and is one of the most threatening global health and health economic problems. Whereas bariatric surgery is well established in the treatment of morbid obesity, the surgical treatment options for type 2 diabetes mellitus alone are still under discussion (metabolic surgery). Bariatric procedures differ considering weight loss and influencing associated comorbidities. Detailed knowledge of available surgical treatment options for morbid obesity, the risks and requirements of laparoscopic skills, effectiveness and, as far as already known, mechanisms of action are crucial for appropriate implementation. PMID:22695815

  20. The Residence Life Cinema.

    ERIC Educational Resources Information Center

    Dungan, Jane Fidler; Elion, Audrey; Gusmano, Phil

    1997-01-01

    Explores the implementation, results, and the limitations of the Residence Life Cinema program at the University of Memphis. Claims that such programs offer an innovative method for fostering student development by utilizing movies to stimulate affective and cognitive processes in students--processes that may not occur without a catalyst. (RJM)

  1. Facility Focus: Residence Halls.

    ERIC Educational Resources Information Center

    College Planning & Management, 1999

    1999-01-01

    Presents three college residence-hall projects that reveal the diversity in planning and design ideas available for successfully meeting student needs. Discusses use of unique interior designs and locations, multi-service features, and the use of prefabricated materials to cut building costs are discussed. (GR)

  2. Selection of Anesthesiology Residents.

    ERIC Educational Resources Information Center

    Baker, J. David, III; And Others

    1993-01-01

    Selection data for all Medical University of South Carolina anesthesiology residency applicants (about 200 per year) and the 8 selected per year were compared for 4 years. Results showed standardized test scores, grades, and class ranks of those selected were not higher than of others, but interview and recommendation scores were higher.…

  3. Peer Review for Residents

    ERIC Educational Resources Information Center

    Patel, Malini; Hardy, Daniel W.; Chand, Ravi

    2005-01-01

    Objective: Accreditation Council of Graduate Medical Education (ACGME) currently requires experiences in administration for psychiatry residents. In response to this challenge, the authors created a peer review workshop. Methods: The authors report on the design, implementation, and outcome of the peer review workshop for PGY-3 and PGY-4…

  4. Aesthetic Surgery of the Female Genitalia

    PubMed Central

    Dobbeleir, Julie M.L.C.L.; Landuyt, Koenraad Van; Monstrey, Stan J.

    2011-01-01

    Aesthetic genital surgery seems to have become a fashionable issue nowadays. Many procedures and techniques have been described these last years, but very few long-term results or follow up studies are available. The novelty of this aspect of plastic surgery and the lack of evidence-based interventions, have led to a comparison with female genital mutilation. In this article, the authors provide an overview of the possible surgical procedures as well as the general principles of aesthetic surgery of the female genitalia. PMID:22547970

  5. Increasing Competitiveness for an Otolaryngology Residency: Where We Are and Concerns about the Future.

    PubMed

    Kaplan, Alyson B; Riedy, Katherine N; Grundfast, Kenneth M

    2015-11-01

    For graduating medical students, securing a residency in otolaryngology-head and neck surgery has become exceedingly difficult. This commentary explores the ways that applicants and residency programs are reacting to the increasing competitiveness in applying to, interviewing for, and matching to an otolaryngology residency. The commonly held perceptions of applicants are compared to perspectives held by residency program directors and resident selection committees. Unintended consequences of the growing trend for medical students to add a research year to their curriculum are presented. Some cautions and suggestions about how to improve the application and selection process are offered. PMID:26187905

  6. Violence against surgical residents.

    PubMed Central

    Barlow, C B; Rizzo, A G

    1997-01-01

    Violence against hospital personnel is underreported (less than one in five assaults), and accurate statistics as to the rate of violence against hospital personnel are thus difficult to establish. In the psychiatric discipline, an abundance of information has been published regarding violence in the health care setting, but few studies have examined violence outside psychiatric hospitals or by patients not diagnosed with psychiatric ailments. Using a survey that elicits information about workplace violence, we sought to gauge the prevalence of violent acts affecting general hospital workers who treat victims of violence on a daily basis. The survey was completed by a cohort of surgical staff nationwide (475 responses from 57 residency programs). Two hundred and eighty residents reported having witnessed one or more physical attacks, and 179 reported having been attacked. Violent acts were more likely to be committed in a public hospital than a private institution (P = 0.05). As shown in previous research, most attacks occurred in the emergency room (P = 0.01); the wards and parking lot were next in frequency. Women residents were more likely than men to call hospital security to intervene in a potentially violent situation (P = 0.04), and junior residents (postgraduate years 1-4) were more likely to be attacked than senior residents (> or = 5 years) (P = 0.04). The attacker was most likely to be a young black male between ages 19 and 30 (P = 0.01). We found no statistical relationship between the attacker and the victim regarding sex or race. Of the 475 respondents, 470 reported that they carry a gun themselves or know someone in the hospital environment who carries a gun. Images Figure 1. PMID:9291743

  7. Carotid artery surgery

    MedlinePlus

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  8. Perceptions and misconceptions of the plastic and reconstructive surgeon.

    PubMed

    Kim, D C; Kim, S; Mitra, A

    1997-04-01

    Little is known about professional perceptions of plastic and reconstructive surgery. In an era of managed health care and social reform, public perception, or misconception, may ultimately have a significant impact on this specialty. A survey was conducted to provide some initial evidence for the scope and scale of the misconceptions. Three populations were surveyed for this study: consecutive patients visiting a primary-care facility, medical students, and primary-care physicians. The survey addressed various aspects of plastic surgery-reconstruction, hand, craniofacial, and aesthetic surgery. One thousand one hundred twenty-one individuals of various ages, education levels, and ethnic backgrounds participated in this study. Our data demonstrate that public perception of the plastic and reconstructive surgeon is limited and grossly underestimates this specialty. Although the plastic surgeon is associated with reconstructive surgery, they are not necessarily identified as primary surgeons for procedures fundamental to this specialty. Furthermore, a significant number of respondents would prefer a cosmetic surgeon for aesthetic procedures. We believe that it is crucial that the public, physicians, and medical establishments (e.g., insurance companies, hospital administrations) be educated on the essence of plastic and reconstructive surgery. PMID:9111906

  9. Preprosthetic Surgery.

    PubMed

    Ephros, Hillel; Klein, Robert; Sallustio, Anthony

    2015-08-01

    Preprosthetic oral and maxillofacial surgery has changed dramatically over the last 3 decades. Surgical preparation for dentures has been displaced by site development for implants. Nonetheless, there is still a role to play for several preprosthetic procedures. In this article, historical context is provided, enduring concepts are reviewed, and procedures that remain relevant are described and discussed. PMID:26231818

  10. Cosmetic surgery.

    PubMed Central

    Harris, D. L.

    1989-01-01

    The psychotherapeutic nature of cosmetic surgery is emphasised by outlining the range of symptoms from which patients suffer and by explaining the sequence of psychological reactions which cause them. The principles which govern the selection of patients are defined. A brief account of each of the main cosmetic operations is given together with notes on their limitations and risks. PMID:2589786

  11. Arthroscopic Surgery.

    ERIC Educational Resources Information Center

    Connors, G. Patrick

    Arthroscopic surgery (or microsurgery) is a significant breakthrough in treating knee injuries. Its applications range from basic diagnosis to arthroscopic menisectomy, although its use in some procedures is still highly controversial. Many surgeons perform the diagnostic procedure, but follow this with the conventional surgical approach.…

  12. Cardiac Surgery

    PubMed Central

    Weisse, Allen B.

    2011-01-01

    Well into the first decades of the 20th century, medical opinion held that any surgical attempts to treat heart disease were not only misguided, but unethical. Despite such reservations, innovative surgeons showed that heart wounds could be successfully repaired. Then, extracardiac procedures were performed to correct patent ductus arteriosus, coarctation of the aorta, and tetralogy of Fallot. Direct surgery on the heart was accomplished with closed commissurotomy for mitral stenosis. The introduction of the heart-lung machine and cardiopulmonary bypass enabled the surgical treatment of other congenital and acquired heart diseases. Advances in aortic surgery paralleled these successes. The development of coronary artery bypass grafting greatly aided the treatment of coronary heart disease. Cardiac transplantation, attempts to use the total artificial heart, and the application of ventricular assist devices have brought us to the present day. Although progress in the field of cardiovascular surgery appears to have slowed when compared with the halcyon times of the past, substantial challenges still face cardiac surgeons. It can only be hoped that sufficient resources and incentive can carry the triumphs of the 20th century into the 21st. This review covers past developments and future opportunities in cardiac surgery. PMID:22163121

  13. Fetal Surgery

    PubMed Central

    Laberge, Jean-Martin

    1986-01-01

    Fetal surgery has come of age. For decades experimental fetal surgery proved essential in studying normal fetal physiology and development, and pathophysiology of congenital defects. Clinical fetal surgery started in the 1960s with intrauterine transfusions. In the 1970s, the advent of ultrasonography revolutionized fetal diagnosis and created a therapeutic vacuum. Fetal treatment, medical and surgical, is slowly trying to fill the gap. Most defects detected are best treated after birth, some requiring a modification in the time, mode and place of delivery for optimal obstetrical and neonatal care. Surgical intervention in utero should be considered for malformations that cause progressive damage to the fetus, leading to death or severe morbidity; that can be corrected or palliated in utero with a reasonable expectation of normal postnatal development; that cannot wait to be corrected after birth, even considering pre-term delivery; that are not accompanied by chromosomal or other major anomalies. At present, congenital hydronephrosis is the most common indication for fetal surgery, followed by obstructive hydrocephalus. Congenital diaphragmatic hernia also fulfills the criteria, but its correction poses more problems, and no clinical attempts have been reported so far. In the future many other malformations or diseases may become best treated in utero. The ethical and moral issues are complex and need to be discussed as clinical and experimental progress is made. PMID:21267309

  14. The Effect of Pass-Fail on the Selection and Performance of Residents.

    ERIC Educational Resources Information Center

    Tardiff, Kenneth

    1980-01-01

    The results of a large survey, investigating preference given to students from graded schools when selecting residents, are analyzed. The respondents are directors of residency training programs. Preference and higher ratings of performance were given to graded students if their programs were in medicine, surgery, or obstetrics/gynecology.…

  15. Microsurgery flap in endodontic surgery: case report

    PubMed Central

    CECCHETTI, F.; RICCI, S.; DI GIORGIO, G.; PISACANE, C.; OTTRIA, L.

    2009-01-01

    SUMMARY In periodontal plastic surgery it is increasingly more evident the relavance of the protection of the gingival marginal anatomy through the realization of a conservative flap. Minimizing the recession of the treated tissue. A correct healing always needs to take into account the diameter and type of the suture and the time of removal from the wound. PMID:23285354

  16. Leadership and business education in orthopaedic residency training programs.

    PubMed

    Kiesau, Carter D; Heim, Kathryn A; Parekh, Selene G

    2011-01-01

    Leadership and business challenges have become increasingly present in the practice of medicine. Orthopaedic residency programs are at the forefront of educating and preparing orthopaedic surgeons. This study attempts to quantify the number of orthopaedic residency programs in the United States that include leadership or business topics in resident education program and to determine which topics are being taught and rate the importance of various leadership characteristics and business topics. A survey was sent to all orthopaedic department chairpersons and residency program directors in the United States via e-mail. The survey responses were collected using a survey collection website. The respondents rated the importance of leadership training for residents as somewhat important. The quality of character, integrity, and honesty received the highest average rating among 19 different qualities of good leaders in orthopaedics. The inclusion of business training in resident education was also rated as somewhat important. The topic of billing and coding received the highest average rating among 14 different orthopaedically relevant business topics. A variety of topics beyond the scope of clinical practice must be included in orthopaedic residency educational curricula. The decreased participation of newly trained orthopaedic surgeons in leadership positions and national and state orthopaedic organizations is concerning for the future of orthopaedic surgery. Increased inclusion of leadership and business training in resident education is important to better prepare trainees for the future. PMID:21838073

  17. Elective surgery cancelation on day of surgery: An endless dilemma

    PubMed Central

    Fayed, A; Elkouny, A; Zoughaibi, N; Wahabi, HA

    2016-01-01

    Background: Cancelation of surgery is a constant agonizing dilemma for nearly all healthcare services that has been intensively investigated to find out its roots, consequences, and possible solutions. The rates of cancelation of surgery vary between centers and more so among surgical specialties with numerous reasons standing behind this phenomenon. Patients and Methods: In the current study, analysis of monthly cancelation rates from January 2009 to December 2012, and assessment of establishing new operating rooms (ORs) using statistical process control charts was conducted. A detailed review of a total of 1813 cases canceled on the day of surgery from January to December 2012, to examine the various reasons of cancelation among surgical specialties. Results: The average cancelation rate was 11.1%, which dropped to 9.0% after launching of new theaters. Four reasons explained about 80% of cancelations; Patients “no show” was the leading cause of cancelation (27%). One-fourth of cancelations (24.3%) were due to the need for further optimization, and the third most prominent cause of cancelation was a lack of OR time (19.5%). Unavailability of staff/equipment/implants accounted for only 0.7% of cancelations. The no show was the most common cause of cancelation among all surgical specialties ranging from 21% for plastic surgery to 32% in ophthalmic surgeries. Conclusion: It was confirmed that there is a unique profile of cancelation of surgery problem for every institute, an extension of infrastructure may not be the only solution. Control charts helped to enhance the general picture and are functional in monitoring and evaluating changes in the cancelation of surgery. PMID:26955314

  18. Resident-to-resident violence triggers in nursing homes.

    PubMed

    Snellgrove, Susan; Beck, Cornelia; Green, Angela; McSweeney, Jean C

    2013-11-01

    Certified nurses' assistants (CNAs) employed by a rural nursing home in Northeast Arkansas described their perceptions of resident-to-resident violence in order to provide insight on factors, including unmet needs, that may trigger the phenomenon. Semistructured interviews were conducted with 11 CNAs. Data were analyzed using content analysis and constant comparison. Two categories of triggers emerged from the data-active and passive. Active triggers involved the actions of other residents that were intrusive in nature, such as wandering into a residents' personal space, taking a resident's belongings, and so forth. Passive triggers did not involve the actions of residents but related to the internal and external environment of the residents. Examples were factors such as boredom, competition for attention and communication difficulties. Results indicate that there are factors, including unmet needs within the nursing home environment that may be identified and altered to prevent violence between residents. PMID:23447361

  19. [Impact of digital technology on clinical practices: perspectives from surgery].

    PubMed

    Zhang, Y; Liu, X J

    2016-04-01

    Digital medical technologies or computer aided medical procedures, refer to imaging, 3D reconstruction, virtual design, 3D printing, navigation guided surgery and robotic assisted surgery techniques. These techniques are integrated into conventional surgical procedures to create new clinical protocols that are known as "digital surgical techniques". Conventional health care is characterized by subjective experiences, while digital medical technologies bring quantifiable information, transferable data, repeatable methods and predictable outcomes into clinical practices. Being integrated into clinical practice, digital techniques facilitate surgical care by improving outcomes and reducing risks. Digital techniques are becoming increasingly popular in trauma surgery, orthopedics, neurosurgery, plastic and reconstructive surgery, imaging and anatomic sciences. Robotic assisted surgery is also evolving and being applied in general surgery, cardiovascular surgery and orthopedic surgery. Rapid development of digital medical technologies is changing healthcare and clinical practices. It is therefore important for all clinicians to purposefully adapt to these technologies and improve their clinical outcomes. PMID:27117211

  20. Lung Carcinoid Tumor: Surgery

    MedlinePlus

    ... for lung carcinoid tumor symptoms Surgery to treat lung carcinoid tumors Surgery is the main treatment for ... often be cured by surgery alone. Types of lung surgery Different operations can be used to treat ( ...

  1. Surgery for Breast Cancer

    MedlinePlus

    ... Next Topic Breast-conserving surgery (lumpectomy) Surgery for breast cancer Most women with breast cancer have some type ... Relieve symptoms of advanced cancer Surgery to remove breast cancer There are two main types of surgery to ...

  2. Scoliosis surgery - child

    MedlinePlus

    Spinal curvature surgery - child; Kyphoscoliosis surgery - child; Video-assisted thoracoscopic surgery - child; VATS - child ... Before surgery, your child will receive general anesthesia. This will make ... and unable to feel pain during the operation. During ...

  3. Preparing for Surgery

    MedlinePlus

    ... Events Advocacy For Patients About ACOG Preparing for Surgery Home For Patients Search FAQs Preparing for Surgery ... Surgery FAQ080, August 2011 PDF Format Preparing for Surgery Gynecologic Problems What is the difference between outpatient ...

  4. Surgery for Breast Cancer

    MedlinePlus

    ... treated? Next Topic Radiation therapy for breast cancer Surgery for breast cancer Most women with breast cancer ... common types of breast cancer surgery. Breast-conserving surgery (BCS) This type of surgery removes only a ...

  5. Bloodless surgery in geriatric surgery.

    PubMed

    Guarino, Salvatore; Di Matteo, Filippo; Sorrenti, Salvatore; Greco, Roberto; Nardi, Matteo; Favoriti, Pasqualino; De Antoni, Enrico; Filippini, Angelo; Catania, Antonio

    2014-01-01

    In bloodless surgery a series of measures has to be implemented to reduce the perioperative need for transfusion of whole blood or its components. Jehovah's Witness are the most representative group of patients opting for bloodless surgery as their faith follows strict believes that prohibits receiving blood. Geriatric patients requiring bloodless surgery are even more delicate and represent a challenge for surgeons. The physiological response of the over 65 year population to decreased hemoglobin level is slower and less effective than in young and adult patients. Herby we describe the perioperative protocol implemented in our surgical Department offered to geriatric Jehovah's Witness patients. Preoperative optimization of the patients is the key step in the preparation period. Intraoperative anesthetic and surgical measures are also required along with a strict postoperative follow-up. From our experience, bloodless surgery is feasible in the geriatric population as long as it is performed in specialized centers where a multidisciplinary team is prepared to specifically manage this scenario. Rigorous patients selection and preparation are mandatory. PMID:25183638

  6. Spine surgery - discharge

    MedlinePlus

    ... discharge; Microdecompression - discharge; Laminotomy - discharge; Disk removal - discharge; Spine surgery - diskectomy - discharge; Intervertebral foramina - discharge; Spine surgery - foraminotomy - ...

  7. Mentoring in Psychiatric Residency Programs: A Survey of Chief Residents

    ERIC Educational Resources Information Center

    Lis, Lea DeFrancisci; Wood, William C.; Petkova, Eva; Shatkin, Jess

    2009-01-01

    Objective: Mentorship is an important component of graduate education. This study assessed the perceptions of general psychiatry chief residents regarding the adequacy of mentorship provided during training. Methods: The authors surveyed 229 chief residents participating in the APA National Chief Residents Leadership Program in 2004 and 2005. The…

  8. Plastic bag clip discovered in partial colectomy accompanying proposal for phylogenic plastic bag clip classification

    PubMed Central

    Lehmer, Larisa M; Ragsdale, Bruce D; Daniel, John; Hayashi, Edwin; Kvalstad, Robert

    2011-01-01

    A plastic bag clip was incidentally found anchored in the mucosa of a partial colectomy specimen 2.6 cm proximal to a ruptured diverticulum for which the patient, a mentally retarded, diabetic, 58-year-old man, underwent surgery. Over 20 cases of accidental ingestion of plastic bag clips have been published. Known complications include small bowel perforation, obstruction, dysphagia, gastrointestinal bleeding and colonic impaction. Preoperative diagnosis of plastic clips lodged in the gastrointestinal tract is frustrated due to radiographic translucency. This occult threat could likely be prevented by the design of gastrointestinally safe, plastic-bag-sealing devices. Presented here is a morphologically based classification of bag clips as a possible guide for determining the most hazardous varieties and to aid further discussions of their impact on health. PMID:22679182

  9. Expansion of the coordinator role in orthopaedic residency program management.

    PubMed

    Grant, Richard E; Murphy, Laurie A; Murphy, James E

    2008-03-01

    The Accreditation Council of Graduate Medical Education's (ACGME) Data Accreditation System indicates 124 of 152 orthopaedic surgery residency program directors have 5 or fewer years of tenure. The qualifications and responsibilities of the position based on the requirements of orthopaedic surgery residency programs, the institutions that support them, and the ACGME Outcome Project have evolved the role of the program coordinator from clerical to managerial. To fill the void of information on the coordinators' expanding roles and responsibilities, the 2006 Association of Residency Coordinators in Orthopaedic Surgery (ARCOS) Career survey was designed and distributed to 152 program coordinators in the United States. We had a 39.5% response rate for the survey, which indicated a high level of day-to-day managerial oversight of all aspects of the residency program; additional responsibilities for other department or division functions for fellows, rotating medical students, continuing medical education of the faculty; and miscellaneous business functions. Although there has been expansion of the role of the program coordinator, challenges exist in job congruence and position reclassification. We believe use of professional groups such as ARCOS and certification of program coordinators should be supported and encouraged. PMID:18196362

  10. Residency curriculum in forensic psychiatry.

    PubMed

    Bloom, J D; Kinzie, J D; Shore, J H

    1980-06-01

    The authors describe the development of a curriculum in forensic psychiatry in a general psychiatric residency training program. Educational objectives for both knowledge and skills are presented. The authors detail training experiences at each level of psychiatric residency, including electives available for fourth-year residents. They encourage other training programs to share similar reports with a view toward the development of standards in the training of residents in forensic psychiatry. PMID:7377398

  11. Analysis of Resident Case Logs in an Anesthesiology Residency Program.

    PubMed

    Yamamoto, Satoshi; Tanaka, Pedro; Madsen, Matias Vested; Macario, Alex

    2016-04-15

    Our goal in this study was to examine Accreditation Council for Graduate Medical Education case logs for Stanford anesthesia residents graduating in 2013 (25 residents) and 2014 (26 residents). The resident with the fewest recorded patients in 2013 had 43% the number of patients compared with the resident with the most patients, and in 2014, this equaled 48%. There were residents who had 75% more than the class average number of cases for several of the 12 case types and 3 procedure types required by the Accreditation Council for Graduate Medical Education. Also, there were residents with fewer than half as many for some of the required cases or procedure types. Some of the variability may have been because of the hazards of self-reporting. PMID:26517235

  12. Plastics in Building.

    ERIC Educational Resources Information Center

    Skeist, Irving, Ed.

    The evaluation and use of plastics in the construction industry are explained. The contributors offer extensive, timely, and thoroughly researched data on the chemistry, properties, functions, engineering behavior, and specific applications of plastics to building requirements. The major subjects discussed in depth are--(1) the role of plastics in

  13. Tomorrow's Plastic World

    ERIC Educational Resources Information Center

    Macdonald, Averil

    2005-01-01

    Far from being just cheap packaging materials, plastics may be the materials of tomorrow. Plastic can conduct electricity, and this opens up a host of high-tech possibilities in the home and in energy generation. These possibilities are discussed here along with how plastic can be recycled and perhaps even grown.

  14. Processing of plastics

    PubMed Central

    Spaak, Albert

    1975-01-01

    An overview is given of the processing of plastic materials from the handling of polymers in the pellet and powder form to manufacturing of a plastic fabricated product. Various types of equipment used and melt processing ranges of various polymer formulations to make the myriad of plastic products that are commercially available are discussed. PMID:1175556

  15. Plastics in Building.

    ERIC Educational Resources Information Center

    Skeist, Irving, Ed.

    The evaluation and use of plastics in the construction industry are explained. The contributors offer extensive, timely, and thoroughly researched data on the chemistry, properties, functions, engineering behavior, and specific applications of plastics to building requirements. The major subjects discussed in depth are--(1) the role of plastics in…

  16. Emerging alternative model for cardiothoracic surgery training in India

    PubMed Central

    Vaithianathan, Rajan; Panneerselvam, Senthil

    2013-01-01

    Background In India, cardiothoracic (CT) surgery training follows a 3+3-year model, where 3 years of general surgery residency with certification (MS/DNB) is required for entering 3 years of thoracic surgery residency (MCh/DNB). There are two certifying boards at the national level. One being the Medical Council of India (MCI), which oversees the major accreditation process involving the undergraduate and postgraduate medical education in India, and the other being the National Board of Examinations (NBE), which was formed for the purpose of establishing a uniform standard of postgraduate medical education. Recently, the latter body has come up with an alternative model for thoracic surgery residency in India. This model includes an integrated 6-year residency, with lesser emphasis on general surgical skills and greater exposure to CT surgery. Conclusions Changes to the current model of training for CT surgery is the need of the hour and should be initiated very soon by the MCI to meet the future demand for CT surgeons in India. An integrated training program is essential to create a new generation of cardiovascular specialists. Future directions to achieve this goal must include modifications to the undergraduate programs so as to infuse interest for CT surgery in the young minds of medical students. PMID:23651927

  17. Biodegradability of plastics.

    PubMed

    Tokiwa, Yutaka; Calabia, Buenaventurada P; Ugwu, Charles U; Aiba, Seiichi

    2009-09-01

    Plastic is a broad name given to different polymers with high molecular weight, which can be degraded by various processes. However, considering their abundance in the environment and their specificity in attacking plastics, biodegradation of plastics by microorganisms and enzymes seems to be the most effective process. When plastics are used as substrates for microorganisms, evaluation of their biodegradability should not only be based on their chemical structure, but also on their physical properties (melting point, glass transition temperature, crystallinity, storage modulus etc.). In this review, microbial and enzymatic biodegradation of plastics and some factors that affect their biodegradability are discussed. PMID:19865515

  18. Biodegradability of Plastics

    PubMed Central

    Tokiwa, Yutaka; Calabia, Buenaventurada P.; Ugwu, Charles U.; Aiba, Seiichi

    2009-01-01

    Plastic is a broad name given to different polymers with high molecular weight, which can be degraded by various processes. However, considering their abundance in the environment and their specificity in attacking plastics, biodegradation of plastics by microorganisms and enzymes seems to be the most effective process. When plastics are used as substrates for microorganisms, evaluation of their biodegradability should not only be based on their chemical structure, but also on their physical properties (melting point, glass transition temperature, crystallinity, storage modulus etc.). In this review, microbial and enzymatic biodegradation of plastics and some factors that affect their biodegradability are discussed. PMID:19865515

  19. Considerations in Asian cosmetic surgery.

    PubMed

    McCurdy, John A

    2007-08-01

    From the point of view of the facial plastic surgeon, certain facial features necessitate formulation of unique surgical approaches for aesthetic modification and justify specialized study of surgical techniques that are consistent and reliable in producing good aesthetic results in the Asian face. Cosmetic surgery of the Asian face is a challenging and fascinating endeavor. In large part, the challenge relates to understanding cultural and psychologic differences that often translate into behavior that may be unfamiliar to the surgeon. Continuing efforts to understand the Asian psyche are mandatory if communication is to be effective. PMID:17658435

  20. Bariatric Surgery

    PubMed Central

    2005-01-01

    Executive Summary Objective To conduct an evidence-based analysis of the effectiveness and cost-effectiveness of bariatric surgery. Background Obesity is defined as a body mass index (BMI) of at last 30 kg/m2.1 Morbid obesity is defined as a BMI of at least 40 kg/m2 or at least 35 kg/m2 with comorbid conditions. Comorbid conditions associated with obesity include diabetes, hypertension, dyslipidemias, obstructive sleep apnea, weight-related arthropathies, and stress urinary incontinence. It is also associated with depression, and cancers of the breast, uterus, prostate, and colon, and is an independent risk factor for cardiovascular disease. Obesity is also associated with higher all-cause mortality at any age, even after adjusting for potential confounding factors like smoking. A person with a BMI of 30 kg/m2 has about a 50% higher risk of dying than does someone with a healthy BMI. The risk more than doubles at a BMI of 35 kg/m2. An expert estimated that about 160,000 people are morbidly obese in Ontario. In the United States, the prevalence of morbid obesity is 4.7% (1999–2000). In Ontario, the 2004 Chief Medical Officer of Health Report said that in 2003, almost one-half of Ontario adults were overweight (BMI 25–29.9 kg/m2) or obese (BMI ≥ 30 kg/m2). About 57% of Ontario men and 42% of Ontario women were overweight or obese. The proportion of the population that was overweight or obese increased gradually from 44% in 1990 to 49% in 2000, and it appears to have stabilized at 49% in 2003. The report also noted that the tendency to be overweight and obese increases with age up to 64 years. BMI should be used cautiously for people aged 65 years and older, because the “normal” range may begin at slightly above 18.5 kg/m2 and extend into the “overweight” range. The Chief Medical Officer of Health cautioned that these data may underestimate the true extent of the problem, because they were based on self reports, and people tend to over-report their height and under-report their weight. The actual number of Ontario adults who are overweight or obese may be higher. Diet, exercise, and behavioural therapy are used to help people lose weight. The goals of behavioural therapy are to identify, monitor, and alter behaviour that does not help weight loss. Techniques include self-monitoring of eating habits and physical activity, stress management, stimulus control, problem solving, cognitive restructuring, contingency management, and identifying and using social support. Relapse, when people resume old, unhealthy behaviour and then regain the weight, can be problematic. Drugs (including gastrointestinal lipase inhibitors, serotonin norepinephrine reuptake inhibitors, and appetite suppressants) may be used if behavioural interventions fail. However, estimates of efficacy may be confounded by high rates of noncompliance, in part owing to the side effects of the drugs. In addition, the drugs have not been approved for indefinite use, despite the chronic nature of obesity. The Technology Morbidly obese people may be eligible for bariatric surgery. Bariatric surgery for morbid obesity is considered an intervention of last resort for patients who have attempted first-line forms of medical management, such as diet, increased physical activity, behavioural modification, and drugs. There are various bariatric surgical procedures and several different variations for each of these procedures. The surgical interventions can be divided into 2 general types: malabsorptive (bypassing parts of the gastrointestinal tract to limit the absorption of food), and restrictive (decreasing the size of the stomach so that the patient is satiated with less food). All of these may be performed as either open surgery or laparoscopically. An example of a malabsorptive technique is Roux-en-Y gastric bypass (RYGB). Examples of restrictive techniques are vertical banded gastroplasty (VBG) and adjustable gastric banding (AGB). The Ontario Health Insurance Plan (OHIP) Schedule of Benefits for Physician Services includes fee code “S120 gastric bypass or partition, for morbid obesity” as an insured service. The term gastric bypass is a general term that encompasses a variety of surgical methods, all of which involve reconfiguring the digestive system. The term gastric bypass does not include AGB. The number of gastric bypass procedures funded and done in Ontario, and funded as actual out-of-country approvals,2 is shown below. Number of Gastric Bypass Procedures by Fiscal Year: Ontario and Actual Out-of-Country (OOC) Approvals Data from Provider Services, MOHLTC Courtesy of Provider Services, Ministry of Health and Long Term Care Review Strategy The Medical Advisory Secretariat reviewed the literature to assess the effectiveness, safety, and cost-effectiveness of bariatric surgery to treat morbid obesity. It used its standard search strategy to retrieve international health technology assessments and English-language journal articles from selected databases. The interventions of interest were bariatric surgery and, for the controls, either optimal conventional management or another type of bariatric procedure. The outcomes of interest were improvement in comorbid conditions (e.g., diabetes, hypertension); short- and long-term weight loss; quality of life; adverse effects; and economic analysis data. The databases yielded 15 international health technology assessments or systematic reviews on bariatric surgery. Subsequently, the Medical Advisory Secretariat searched MEDLINE and EMBASE from April 2004 to December 2004, after the search cut-off date of April, 2004, for the most recent systematic reviews on bariatric surgery. Ten studies met the inclusion criteria. One of those 10 was the Swedish Obese Subjects study, which started as a registry and intervention study, and then published findings on people who had been enrolled for at least 2 years or at least 10 years. In addition to the literature review of economic analysis data, the Medical Advisory Secretariat also did an Ontario-based economic analysis. Summary of Findings Bariatric surgery generally is effective for sustained weight loss of about 16% for people with BMIs of at least 40 kg/m2 or at least 35 kg/m2 with comorbid conditions (including diabetes, high lipid levels, and hypertension). It also is effective at resolving the associated comorbid conditions. This conclusion is largely based on level 3a evidence from the prospectively designed Swedish Obese Subjects study, which recently published 10-year outcomes for patients who had bariatric surgery compared with patients who received nonsurgical treatment. (1) Regarding specific procedures, there is evidence that malabsorptive techniques are better than other banding techniques for weight loss and resolution of comorbid illnesses. However, there are no published prospective, long-term, direct comparisons of these techniques available. Surgery for morbid obesity is considered an intervention of last resort for patients who have attempted first-line forms of medical management, such as diet, increased physical activity, behavioural modification, and drugs. In the absence of direct comparisons of active nonsurgical intervention via caloric restriction with bariatric techniques, the following observations are made: A recent systematic review examining the efficacy of major commercial and organized self-help weight loss programs in the United States concluded that the evidence to support the use of such programs was suboptimal, except for one trial on Weight Watchers. Furthermore, the programs were associated with high costs, attrition rates, and probability of regaining at least 50% of the lost weight in 1 to 2 years. (2) A recent randomized controlled trial reported 1-year outcomes comparing weight loss and metabolic changes in severely obese patients assigned to either a low-carbohydrate diet or a conventional weight loss diet. At 1 year, weight loss was similar for patients in each group (mean, 2–5 kg). There was a favourable effect on triglyceride levels and glycemic control in the low-carbohydrate diet group. (3) A decision-analysis model showed bariatric surgery results in increased life expectancy in morbidly obese patients when compared to diet and exercise. (4) A cost-effectiveness model showed bariatric surgery is cost-effective relative to nonsurgical management. (5) Extrapolating from 2003 data from the United States, Ontario would likely need to do 3,500 bariatric surgeries per year. It currently does 508 per year, including out-of-country surgeries. PMID:23074460

  1. Kidney stones are common after bariatric surgery

    PubMed Central

    Lieske, John C.; Mehta, Ramila A.; Milliner, Dawn S.; Rule, Andrew D; Bergstralh, Eric J.; Sarr, Michael G.

    2014-01-01

    Obesity, a risk factor for kidney stones and chronic kidney disease (CKD), is effectively treated with bariatric surgery. However, it is unclear if surgery alters stone or CKD risk. To determine this we studied 762 Olmsted County, Minnesota residents who underwent bariatric surgery and matched them with equally obese control individuals who did not undergo surgery. The majority of bariatric patients underwent standard Roux-en-Y gastric bypass (RYGB) (78%), with the remainder having more malabsorptive procedures (very long limb RYGB or biliopancreatic diversion/duodenal switch; 14%), or restrictive procedures (laparoscopic banding or sleeve gastrectomy; 7%). Mean age was 45 years with 80% female. The mean preoperative BMI was 46.7 kg/m2 for both cohorts. Rates of kidney stones were similar between surgery patients and controls at baseline, but new stone formation significantly increased in surgery patients (11.0%) compared to controls (4.3%) during 6.0 years of follow up. After malabsorptive and standard surgery, the comorbidity-adjusted hazard ratio of incident stones was significantly increased to 4.15 and 2.13, respectively but not significantly changed for restrictive surgery. The risk of CKD significantly increased after the malabsorptive procedures (adjusted hazard ratio of 1.96). Thus, while RYGB and malabsorptive procedures are more effective for weight loss, both are associated with increased risk of stones, while malabsorptive procedures also increase CKD risk. PMID:25354237

  2. #SocialMedia for the Academic Plastic Surgeon—Elevating the Brand

    PubMed Central

    Humphries, Laura S.; Curl, Brandon

    2016-01-01

    Summary: The link between social media and surgery has been under increasingly popular discussion. This article discusses the potential role of social media in creating and maintaining the brand of an academic plastic surgeon. PMID:27104098

  3. New plastic joints for plastic orthoses.

    PubMed

    Watanabe, H; Kutsuna, T; Morinaga, H; Okabe, T

    1982-04-01

    Plastic joints for orthoses have more advantages than metal joints. They are lightweight, noiseless comfortable to use, rust proof, corrosion free, and radiolucent. Two types of plastic joints were developed by the authors, one for the ankle joint and the other for the knee joint, elbow joint or hip joint. Polypropylene was chosen as the joint material because of its appropriate flexibility and toughness. PMID:7079105

  4. Nursing students' perceptions of clients undergoing elective cosmetic surgery.

    PubMed

    Cooper, Leah Beth

    2007-01-01

    Aesthetic obsession is commonplace in current society. Supermarket a isles dedicated to beauty products, makeup, and anti-aging creams seem to expand daily. Television and publications flood the public with messages of what constitutes beauty and how to achieve the ideal. Surgical alteration of the body is swiftly becoming a form of self-care technique along with other heath-promoting behavior. Since 2003, the general acceptance of plastic surgery among all Americans surpassed 50% (American Society for Aesthetic Plastic Surgery, 2003). Elective cosmetic surgical procedures have increased by an astounding 444% since 1997 (American Society of Plastic Surgeons, 2006). This quest for body satisfaction based on modern cultural norms increases the public's need for accurate information and understanding from those in the healthcare profession. Despite a transformation in the general population's conception of cosmetic surgery and its clients, stigma still lies in many individuals, including those in the healthcare profession. As this progressively growing patient population emerges, many in healthcare question their attitudes toward plastic surgery and the patients receiving aesthetic operations. With clients undergoing plastic surgery becoming increasingly visible within the healthcare system, some unique aspects of patient care must be addressed. PMID:17901826

  5. Tissue-resident macrophages

    PubMed Central

    Davies, Luke C.; Jenkins, Stephen J.; Allen, Judith E.; Taylor, Philip R.

    2014-01-01

    Tissue-resident macrophages are a heterogeneous population of immune cells that fulfill tissue-specific and niche-specific functions. These range from dedicated homeostatic functions, such as clearance of cellular debris and iron processing, to central roles in tissue immune-surveillance, response to infection and the resolution of inflammation. Recent studies highlight marked heterogeneity in the origins of tissue macrophages that arise from hematopoietic versus self-renewing embryo-derived populations. We discuss the tissue–niche-specific factors that dictate cell phenotype, the definition of which will allow novel strategies to promote the restoration of tissue homeostasis. Understanding the mechanisms that dictate tissue macrophage heterogeneity should explain why simplified paradigms of macrophage activation do not explain the extent of heterogeneity seen in vivo. PMID:24048120

  6. How Plastics Work

    NASA Astrophysics Data System (ADS)

    Bloomfield, Louis

    2013-03-01

    We encounter plastics every day, but despite their widespread use, amazing range of properties, and basic scientific underpinnings, most physicists--like most people--know relatively little about plastics. In contrast to hard crystalline and amorphous solids (e.g., metals, salts, ceramics, and glasses), we take plastics for granted, select them carelessly, and examine them more closely only on a need-to-know basis. By ignoring plastics until we need them, however, we risk not knowing what we don't know and using the wrong ones. To repurpose a familiar advertisement, ``there's a plastic for that.'' This talk will review some of the basic physics and science of plastics. It will examine the roles of temperature, order, intermolecular forces, entanglements, and linkages in plastics, and how those issues affect the properties of a given plastic. We'll stop along the way to recognize a few of the more familiar plastics, natural and synthetic, and explain some of their mechanical, chemical, and optical properties. The talk will conclude by explaining the remarkable properties of a plastic that has been largely misunderstood since its discovery 70 years ago: Silly Putty.

  7. Current status of surgery in dermatology.

    PubMed

    Hanke, C William; Moy, Ronald L; Roenigk, Randall K; Roenigk, Henry H; Spencer, James M; Tierney, Emily P; Bartus, Cynthia L; Bernstein, Robert M; Brown, Marc D; Busso, Mariano; Carruthers, Alastair; Carruthers, Jean; Ibrahimi, Omar A; Kauvar, Arielle N B; Kent, Kathryn M; Krueger, Nils; Landau, Marina; Leonard, Aimee L; Mandy, Stephen H; Rohrer, Thomas E; Sadick, Neil S; Wiest, Luitgard G

    2013-12-01

    An article titled "Current issues in dermatologic office-based surgery" was published in the JAAD in October 1999 (volume 41, issue 4, pp. 624-634). The article was developed by the Joint American Academy of Dermatology/American Society for Dermatologic Surgery Liaison Committee. A number of subjects were addressed in the article including surgical training program requirements for dermatology residents and selected advances in dermatologic surgery that had been pioneered by dermatologists. The article concluded with sections on credentialing, privileging, and accreditation of office-based surgical facilities. Much has changed since 1999, including more stringent requirements for surgical training during dermatology residency, and the establishment of 57 accredited Procedural Dermatology Fellowship Training Programs. All of these changes have been overseen and approved by the Residency Review Committee for Dermatology and the Accreditation Committee for Graduate Medical Education. The fertile academic environment of academic training programs with interaction between established dermatologic surgeons and fellows, as well as the inquisitive nature of many of our colleagues, has led to the numerous major advances in dermatologic surgery, which are described herein. PMID:24099730

  8. Robotic Surgery

    NASA Technical Reports Server (NTRS)

    2000-01-01

    The Automated Endoscopic System for Optimal Positioning, or AESOP, was developed by Computer Motion, Inc. under a SBIR contract from the Jet Propulsion Lab. AESOP is a robotic endoscopic positioning system used to control the motion of a camera during endoscopic surgery. The camera, which is mounted at the end of a robotic arm, previously had to be held in place by the surgical staff. With AESOP the robotic arm can make more precise and consistent movements. AESOP is also voice controlled by the surgeon. It is hoped that this technology can be used in space repair missions which require precision beyond human dexterity. A new generation of the same technology entitled the ZEUS Robotic Surgical System can make endoscopic procedures even more successful. ZEUS allows the surgeon control various instruments in its robotic arms, allowing for the precision the procedure requires.

  9. Burn surgery.

    PubMed

    Tenenhaus, Mayer; Rennekampff, Hans Oliver

    2007-10-01

    The challenges posed by thermal injury often are daunting emotionally and physically for the survivor, family, and staff. Morbidity and mortality have improved with advances in emergent and multidisciplinary care; the establishment of dedicated burn centers; and increased education, prevention, and experience. The role of surgery in the treatment of these complex injury patterns continues to evolve, incorporating refined concepts of tissue preservation, wound bed preparation, and early attention to functional and esthetic parameters. Societal reintegration, psychosocial support, and new pain control strategies have dramatically improved the quality of life for our patients during and after the acute course of care. With improved survivability and a changing demographic, fundamental reconstructive surgical principles have found increased applicability and are instituted at the time of admission whenever possible. PMID:17967624

  10. Spatial abilities of medical graduates and choice of residency programs.

    PubMed

    Langlois, Jean; Wells, George A; Lecourtois, Marc; Bergeron, Germain; Yetisir, Elizabeth; Martin, Marcel

    2015-01-01

    Spatial abilities have been related in previous studies to three-dimensional (3D) anatomy knowledge and the performance in technical skills. The objective of this study was to relate spatial abilities to residency programs with different levels of content of 3D anatomy knowledge and technical skills. The hypothesis was that the choice of residency program is related to spatial abilities. A cohort of 210 medical graduates was enrolled in a prospective study in a 5-year experiment. Spatial abilities were measured with a redrawn Vandenberg and Kuse Mental Rotations Test (MRT) in two (MRTA) and three (MRTC) dimensions. Medical graduates were enrolled in Family Medicine (n = 76, 36.2%), Internal Medicine (64, 30.5%), Surgery (52, 24.8%), and Anesthesia (18, 8.6%). The assumption was that the level of 3D anatomy knowledge and technical skills content was higher in Surgery and Anesthesia compared to Family Medicine and Internal Medicine. Mean MRTA score of 12.4 (±SD 4.6), 12.0 (±4.3), 14.1 (±4.3), and 14.6 (±4.0) was obtained in Family Medicine, Internal Medicine, Surgery, and Anesthesia, respectively (P = 0.0176). Similarly, mean MRTC score of 8.0 (±4.4), 7.5 (±3.6), 8.5 (±3.9), and 7.9 (±4.1) was obtained (P = 0.5647). Although there was a tendency for lower MRTA score in Family Medicine and Internal Medicine compared to Surgery and Anesthesia, no statistically significant main effect of residency, year, sex, or the interactions were observed for the MRTA and MRTC. Studied sample of medical graduates was not found to choose their residency programs based on their innate spatial abilities. PMID:24953052

  11. Applying for a Fellowship in Colon and Rectal Surgery

    PubMed Central

    Einarsdottir, Hulda

    2011-01-01

    Colon and Rectal Surgery is a challenging and fulfilling field with interesting and widely variable tasks, making it the preferred career for an increasing number of residents who are in the final path of their general surgery training. Due to the steadily rising interest in the field, it has become increasingly difficult to match into a fellowship in Colon and Rectal Surgery. For those who have decided to pursue a career in Colon and Rectal Surgery, this overview may be of some use during the quite cumbersome and costly process of applying for a fellowship. PMID:22654566

  12. [Minimally invasive surgery and robotic surgery: surgery 4.0?].

    PubMed

    Feußner, H; Wilhelm, D

    2016-03-01

    Surgery can only maintain its role in a highly competitive environment if results are continuously improved, accompanied by further reduction of the interventional trauma for patients and with justifiable costs. Significant impulse to achieve this goal was expected from minimally invasive surgery and, in particular, robotic surgery; however, a real breakthrough has not yet been achieved. Accordingly, the new strategic approach of cognitive surgery is required to optimize the provision of surgical treatment. A full scale integration of all modules utilized in the operating room (OR) into a comprehensive network and the development of systems with technical cognition are needed to upgrade the current technical environment passively controlled by the surgeon into an active collaborative support system (surgery 4.0). Only then can the true potential of minimally invasive surgery and robotic surgery be exploited. PMID:26801753

  13. Our plastic age.

    PubMed

    Thompson, Richard C; Swan, Shanna H; Moore, Charles J; vom Saal, Frederick S

    2009-07-27

    Within the last few decades, plastics have revolutionized our daily lives. Globally we use in excess of 260 million tonnes of plastic per annum, accounting for approximately 8 per cent of world oil production. In this Theme Issue of Philosophical Transactions of the Royal Society, we describe current and future trends in usage, together with the many benefits that plastics bring to society. At the same time, we examine the environmental consequences resulting from the accumulation of waste plastic, the effects of plastic debris on wildlife and concerns for human health that arise from the production, usage and disposal of plastics. Finally, we consider some possible solutions to these problems together with the research and policy priorities necessary for their implementation. PMID:19528049

  14. Our plastic age

    PubMed Central

    Thompson, Richard C.; Swan, Shanna H.; Moore, Charles J.; vom Saal, Frederick S.

    2009-01-01

    Within the last few decades, plastics have revolutionized our daily lives. Globally we use in excess of 260 million tonnes of plastic per annum, accounting for approximately 8 per cent of world oil production. In this Theme Issue of Philosophical Transactions of the Royal Society, we describe current and future trends in usage, together with the many benefits that plastics bring to society. At the same time, we examine the environmental consequences resulting from the accumulation of waste plastic, the effects of plastic debris on wildlife and concerns for human health that arise from the production, usage and disposal of plastics. Finally, we consider some possible solutions to these problems together with the research and policy priorities necessary for their implementation. PMID:19528049

  15. Gallbladder Cancer: Surgery

    MedlinePlus

    ... or organs to which cancer has spread Possible risks and side effects The risks and side effects of surgery depend on how ... health before the surgery. All surgery carries some risk, including the possibility of bleeding, blood clots, infections, ...

  16. Joint Replacement Surgery

    MedlinePlus

    ... Trial Journal Articles Arthritis July 2014 Joint Replacement Surgery: Health Information Basics for You and Your Family What Is Joint Replacement Surgery? Joint replacement surgery is removing a damaged joint ...

  17. Coronary Artery Bypass Surgery

    MedlinePlus

    ... t help, you may need coronary artery bypass surgery. The surgery creates a new path for blood to flow ... more than one bypass. The results of the surgery usually are excellent. Many people remain symptom-free ...

  18. Laser surgery - skin

    MedlinePlus

    Surgery using a laser ... used is directly related to the type of surgery being performed and the color of the tissue ... Laser surgery can be used to: Close small blood vessels to reduce blood loss Remove warts , moles , sunspots, and ...

  19. Types of Heart Surgery

    MedlinePlus

    ... heart surgery that is becoming more common is robotic-assisted surgery. For this surgery, a surgeon uses a computer to control surgical tools on thin robotic arms. The tools are inserted through small incisions ...

  20. Surgery For Stomach Cancer

    MedlinePlus

    ... then be put directly into the tube. Possible complications and side effects of surgery Surgery for stomach cancer is difficult and can have complications. These can include bleeding from the surgery, blood ...

  1. Plasticized phenolphthalein polycarbonate

    NASA Technical Reports Server (NTRS)

    Harrison, E. S.

    1976-01-01

    Phenolphthalein polycarbonate was successfully plasticized with polychlorinated biphenyls (e.g., Aroclor 1231) or tricresyl phosphate and cast from tetrahydrofuran to give clear films without loss of fire resistance. At loadings of 20 to 30 percent plasticizer the Tg was lowered to approximately 100 C which would render phenolphthalein polycarbonate easily moldable. Although these materials had some mechanical integrity as shown by their film forming ability, the room temperature toughness of the plasticized polymer was not significantly improved over unmodified polymer.

  2. 5. Port complex, with USCS residence at center, INS residence ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. Port complex, with USCS residence at center, INS residence at right background and main port building at left background. View to southeast. - U.S. Customs Service Port of Roosville, U.S. Highway 93, immediately south of U.S.-Canadian border, Eureka, Lincoln County, MT

  3. Additives in plastics.

    PubMed Central

    Deanin, R D

    1975-01-01

    The polymers used in plastics are generally harmless. However, they are rarely used in pure form. In almost all commercial plastics, they are "compounded" with monomeric ingredients to improve their processing and end-use performance. In order of total volume used, these monomeric additives may be classified as follows: reinforcing fibers, fillers, and coupling agents; plasticizers; colorants; stabilizers (halogen stabilizers, antioxidants, ultraviolet absorbers, and biological preservatives); processing aids (lubricants, others, and flow controls); flame retardants, peroxides; and antistats. Some information is already available, and much more is needed, on potential toxicity and safe handling of these additives during processing and manufacture of plastics products. PMID:1175566

  4. Astrocytes: Orchestrating synaptic plasticity?

    PubMed

    De Pittà, M; Brunel, N; Volterra, A

    2016-05-26

    Synaptic plasticity is the capacity of a preexisting connection between two neurons to change in strength as a function of neural activity. Because synaptic plasticity is the major candidate mechanism for learning and memory, the elucidation of its constituting mechanisms is of crucial importance in many aspects of normal and pathological brain function. In particular, a prominent aspect that remains debated is how the plasticity mechanisms, that encompass a broad spectrum of temporal and spatial scales, come to play together in a concerted fashion. Here we review and discuss evidence that pinpoints to a possible non-neuronal, glial candidate for such orchestration: the regulation of synaptic plasticity by astrocytes. PMID:25862587

  5. Plasticity in the Human Visual Cortex: An Ophthalmology-Based Perspective

    PubMed Central

    Rosa, Andreia Martins; Silva, Maria Ftima; Murta, Joaquim

    2013-01-01

    Neuroplasticity refers to the ability of the brain to reorganize the function and structure of its connections in response to changes in the environment. Adult human visual cortex shows several manifestations of plasticity, such as perceptual learning and adaptation, working under the top-down influence of attention. Plasticity results from the interplay of several mechanisms, including the GABAergic system, epigenetic factors, mitochondrial activity, and structural remodeling of synaptic connectivity. There is also a downside of plasticity, that is, maladaptive plasticity, in which there are behavioral losses resulting from plasticity changes in the human brain. Understanding plasticity mechanisms could have major implications in the diagnosis and treatment of ocular diseases, such as retinal disorders, cataract and refractive surgery, amblyopia, and in the evaluation of surgical materials and techniques. Furthermore, eliciting plasticity could open new perspectives in the development of strategies that trigger plasticity for better medical and surgical outcomes. PMID:24205505

  6. Incorporating resident research into the dermatology residency program

    PubMed Central

    Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C

    2013-01-01

    Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education. PMID:23901305

  7. Management of Surfing Injuries: A Plastic Surgeon's Viewpoint. Case Reports.

    ERIC Educational Resources Information Center

    Rudolph, Ross

    1989-01-01

    Describes plastic surgery techniques used to irrigate, debride, and close lacerations caused by surfboards. Head lacerations and nose fractures are the most common injuries. According to a survey, lacerations may be deeper than expected from their surface appearance and wounds may contain surfboard fragments. Injury prevention is discussed. (SM)

  8. Celebrating the Fiftieth Baker Gordon Symposium on Cosmetic Surgery: The Legacy of Thomas J. Baker, M.D.

    PubMed

    Stuzin, James M

    2016-02-01

    The Baker Gordon Symposium on Cosmetic Surgery celebrates its fiftieth year. A review of its history mirrors the evolution of aesthetic surgery in terms of advancements in techniques, and the acceptance of cosmetic surgery as a credible subspecialty of plastic surgery. Beginning in 1967, the Baker Gordon Symposium was the first live surgery symposium that focused on aesthetic surgery, and set a precedent for aesthetic surgery education over the ensuing decades. Historically, the pioneers in aesthetic techniques first presented their innovations at the Baker Gordon Symposium, helping to educate and train their peers to perform cosmetic procedures. The legacy of Thomas Baker is intertwined with the history of the Baker Gordon Symposium, both in terms of his contributions to plastic surgery education, and to the acceptance of the subspecialty of aesthetic surgery. PMID:26818283

  9. Sexual Education for Psychiatric Residents

    ERIC Educational Resources Information Center

    Levine, Stephen B.; Scott, David L.

    2010-01-01

    Objective: The authors seek to promote sexuality curriculum development in departments of psychiatry. Methods: The authors first focus on educational philosophy about what residents can be taught about sexual topics and then provide numerical and narrative resident evaluation data following a 6-month, half day per week rotation in a sexuality…

  10. Medicolegal program for resident physicians.

    PubMed

    Kollas, C D

    1997-09-01

    Few residents are taught to cope with medical liability and the legal aspects of business and administrative issues in medicine. The need for this practical, postgraduate curriculum led to be a collaborative effort between Dr. Kollas and the State Society to create an educational guidebook and seminar series which offers practical postgraduate medicolegal curriculum to resident physicians across Pennsylvania. PMID:9509868

  11. Medical Residency Goes to School

    ERIC Educational Resources Information Center

    Boatright, Beth; Gallucci, Chrysan; Swanson, Judy; Van Lare, Michelle; Yoon, Irene

    2009-01-01

    The Highline School District, located roughly 10 miles south of Seattle, Washington, has begun to implement a residency model for professional learning. Like the medical model, current teachers often traveled from other schools to be "in residency" at a previously selected classroom for six half-day sessions during the 2005-06 school year. Some…

  12. Residence Hall Seating That Works.

    ERIC Educational Resources Information Center

    Wiens, Janet

    2003-01-01

    Describes the seating chosen for residence halls at the Massachusetts Institute of Technology and the University of New England. The seating required depends on ergonomics, aesthetics, durability, cost, and code requirements. In addition, residence halls must have a range of seating types to accommodate various uses. (SLD)

  13. Substance Abuse by Anesthesiology Residents.

    ERIC Educational Resources Information Center

    Lutsky, Irving; And Others

    1991-01-01

    The analysis of 183 responses to a survey of former anesthesiology residents of the Medical College of Wisconsin found that 29 had been self-administered problematic substance abusers during their residencies, 23 had been alcohol dependent, and 6 had been drug dependent. More than 85 percent of respondents considered the drug policy information…

  14. Variation in Rheumatoid Hand and Wrist Surgery in the Medicare beneficiaries: A Population-Based Cohort Study

    PubMed Central

    Zhong, Lin; Chung, Kevin C.; Baser, Onur; Fox, David A.; Yuce, Huseyin; Waljee, Jennifer F.

    2016-01-01

    Objective To examine the rate and variation in RA-related hand and wrist surgery among Medicare beneficiaries in the United States and identify the patient and provider factors that influence surgical rates. Methods Using 2006–2010 100% Medicare claims data of beneficiaries with RA diagnosis, we examined rates of rheumatoid hand and wrist arthroplasty, arthrodesis and hand tendon reconstruction in U.S. We used multivariate logistic regression models to examine variation in receipt of surgery by patient characteristics, provider factors (regional density of rheumatologists, orthopaedic surgeons and plastic surgeons) and rate of biologics use. Results Between 2006 and 2010, the annual rate of RA-related hand and wrist arthroplasty or arthrodesis was 23.1 per 10,000 patients, and the annual rate of hand tendon reconstruction was 4.2 per 10,000 patients. The rates of surgery varied 9-fold across hospital referral regions in U.S. Younger patient age, female gender, white race, higher socioeconomic status (SES) and rural residence were associated with higher likelihood of undergoing arthroplasty and arthrodesis. We observed no significant difference in rate of arthroplasty and arthrodesis by density of orthopaedic and plastic surgeons or biologics use, but a significant decrease in the rate with increasing density of rheumatologists. However, the receipt of hand tendon reconstruction was not influenced by provider factors, but only correlated with age, race, SES and rural status of the patients. Conclusions Surgical reconstruction of rheumatoid hand deformities varies widely across the United States, driven by both regional availability of subspecialty care in rheumatology and individual patient factors. PMID:25593243

  15. Detecting plastics in seedcotton

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The US cotton industry wants to increase market share and value by supplying pure cotton. Removing contamination requires developing a means to detect plastics in seedcotton. This study was conducted to determine if Ion Mobility Spectrometry (IMS) could be used to find small amounts of plastic in ...

  16. Detecting plastics in seedcotton

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To increase global market share and value the US cotton industry needs to supply cotton lint that is free of contamination. Removing plastic contamination first requires developing a means to detect plastics in seedcotton. This study was conducted to validate a custom Ion Mobility Spectrometer (IM...

  17. Cosmetic Surgery Makeover Programs and Intentions to Undergo Cosmetic Enhancements: A Consideration of Three Models of Media Effects

    ERIC Educational Resources Information Center

    Nabi, Robin L.

    2009-01-01

    The recent proliferation of reality-based television programs highlighting cosmetic surgery has raised concerns that such programming promotes unrealistic expectations of plastic surgery and increases the desire of viewers to undergo such procedures. In Study 1, a survey of 170 young adults indicated little relationship between cosmetic surgery

  18. Track recording plastic compositions

    NASA Technical Reports Server (NTRS)

    Tarle, Gregory (Inventor)

    1983-01-01

    Improved nuclear track recording plastic compositions are provided which exhibit greatly decreased surface roughness when etched to produce visible tracks of energetic nuclear particles which have passed into and/or through said plastic. The improved compositions incorporate a small quantity of a phthalic acid ester into the major plastic component which is derived from the polymerization of monomeric di-ethylene glycol bis allyl carbonate. Di-substituted phthalic acid esters are preferred as the added component, with the further perference that the ester substituent has a chain length of 2 or more carbon atoms. The inclusion of the phthalic acid ester to an extent of from about 1-2% by weight of the plastic compositions is sufficient to drastically reduce the surface roughness ordinarily produced when the track recording plastic is contacted by etchants.

  19. Clinical Applications of Barbed Suture in Aesthetic Breast Surgery.

    PubMed

    Mitchell, Ryan T M; Bengtson, Bradley P

    2015-10-01

    The breadth of literature regarding barbed suture applications in plastic surgical procedures and of importance to this article, barbed suture applications in breast surgery, is growing dramatically as surgical practitioners are becoming more familiar with the advantages of this new suture technology. Barbed suture devices were first implemented by plastic surgeons for the use in various minimally invasive techniques for facial rejuvenation, but have now surpassed these applications and are now much more commonly used in Breast and Body closures. PMID:26408446

  20. Discount cosmetic surgery: industry trends and strategies for success.

    PubMed

    Krieger, Lloyd M

    2002-08-01

    Discount cosmetic surgery is a topic of interest to plastic surgeons. To understand this trend and its effects on plastic surgeons, it is necessary to review the economics of cosmetic surgery, plastic surgery's practice environment, and the broader business principles of service industries. Recent work looked at the economics of the plastic surgery market. This analysis demonstrated that increased local density of plastic surgeons was associated with lower adjusted fees for cosmetic procedures. A survey of plastic surgeons about their practice environment revealed that 93 percent categorized the majority of their patients as very or moderately price-sensitive. Fully 98 percent described their business climate as very or moderately competitive and most plastic surgeons thought they lost a sizable number of cosmetic patients within the last year for reasons of price.A standard industry analysis, when applied to cosmetic surgery, reveals the following: an increased number of surgeons leads to lower fees (reducing their bargaining power as suppliers), patients are price-sensitive (increasing their bargaining power as buyers), and there are few barriers to entry among providers (allowing potential new entrants into the market). Such a situation is conducive to discounting taking hold-and even becoming the industry norm. In this environment, business strategy dictates there are three protocols for success: discounting, differentiation, and focus. Discounting joins the trend toward cutting fees. Success comes from increasing volume and efficiency and thus preserving profits. Differentiation creates an industrywide perception of uniqueness; this requires broadly positioning plastic surgeons as holders of a distinct brand identity separate from other "cosmetic surgeons." The final strategy is to focus on a particular buyer group to develop a market niche, such as establishing a "Park Avenue" practice catering to patients who demand a prestigious surgeon, although this is likely a small segment of the overall patient population. Plastic surgeons that buck the trend toward discount cosmetic surgery must take concrete and potentially costly steps to implement a plausible strategy for distinguishing their practices within the crowded cosmetic surgery market. PMID:12142686

  1. Effects of Resident Involvement on Complication Rates after Laparoscopic Gastric Bypass

    PubMed Central

    Krell, Robert W; Birkmeyer, Nancy JO; Reames, Bradley N; Carlin, Arthur M; Birkmeyer, John D; Finks, Jonathan F

    2014-01-01

    BACKGROUND Although resident involvement has been shown to be safe for most procedures, the impact of residents on outcomes after complex laparoscopic procedures is not well understood. We sought to examine the impact of resident involvement on outcomes after bariatric surgery using a population-based clinical registry. STUDY DESIGN We analyzed 17,057 patients who underwent a primary laparoscopic gastric bypass in the 35-hospital Michigan Bariatric Surgery Collaborative from July 2006 to August 2012. Resident involvement was characterized at the surgeon level. Using hierarchical logistic regression, we examined the influence of resident involvement on 30-day complications, accounting for patient characteristics as well as hospital and surgeon case volume. To evaluate potential mediating factors for specific complications, we also adjusted for operative duration. RESULTS Risk-adjusted 30-day complication rates with and without residents were 13.0% and 8.5%, respectively (p < 0.01). Resident involvement was independently associated with wound infection (odds ratio [OR] = 2.06; 95% CI, 1.24–3.43) and venous thromboembolism (OR = 2.01; 95% CI, 1.19–3.40), but not with any other medical or surgical complications. Operative duration was longer with resident involvement (median duration with residents 129 minutes vs 88 minutes without; p < 0.01). After adjusting for operative duration, resident involvement was still independently associated with wound infection (OR = 1.67; 95% CI, 1.01–2.76), but not venous thromboembolism (OR = 1.73; 95% CI, 0.99–3.04). CONCLUSIONS Resident involvement in laparoscopic gastric bypass is independently associated with wound infections and venous thromboembolism. The effect appears to be mediated in part by longer operative times. These findings highlight the importance of strategies to assess and improve resident technical proficiency outside the operating room. PMID:24315885

  2. Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training

    PubMed Central

    Shweiki, Ehyal; Martin, Niels D; Beekley, Alec C; Jenoff, Jay S; Koenig, George J; Kaulback, Kris R; Lindenbaum, Gary A; Patel, Pankaj H; Rosen, Matthew M; Weinstein, Michael S; Zubair, Muhammad H; Cohen, Murray J

    2015-01-01

    Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care. Achievement and work-motivation theories attempt to explain people’s choice, performance, and persistence in tasks. Expectancy Theory as one such theory was reviewed in detail, appearing particularly applicable to surgical residency training. Correlations between Expectancy Theory as a work-motivation theory and residency education were explored. Understanding achievement and work-motivation theories affords an opportunity to gain insight into resident motivation in training. The application of Expectancy Theory in particular provides an innovative perspective into residency education. Afforded are opportunities to promote the development of programmatic methods facilitating surgical resident motivation in education. PMID:25995656

  3. [Guided maxillofacial surgery: Simulation and surgery aided by stereolithographic guides and custom-made miniplates.

    PubMed

    Philippe, B

    2013-08-01

    We present a new model of guided surgery, exclusively using computer assistance, from the preoperative planning of osteotomies to the actual surgery with the aid of stereolithographic cutting guides and osteosynthetic miniplates designed and made preoperatively, using custom-made titanium miniplates thanks to direct metal laser sintering. We describe the principles that guide the designing and industrial manufacturing of this new type of osteosynthesis miniplates. The surgical procedure is described step-by-step using several representative cases of dento-maxillofacial dysmorphosis. The encouraging short-term results demonstrate the wide range of application of this new technology for cranio-maxillofacial surgery, whatever the type of osteotomy performed, and for plastic reconstructive surgery. PMID:23928253

  4. Learning styles of orthodontic residents.

    PubMed

    Hughes, Janeen M; Fallis, Drew W; Peel, Jennifer L; Murchison, David F

    2009-03-01

    Significant challenges face many orthodontic residency programs, particularly a shortage of full-time experienced faculty members. Due to this shortage, it is critical that program directors design comprehensive curricula that incorporate the most effective and efficient teaching methods. It is theorized that teaching effectiveness and efficiency are optimized when the course design and content closely match students' learning preferences. This survey study was designed to distinguish the learning preferences of orthodontic residents utilizing Felder and Soloman's Index of Learning Styles, which assesses student learning preferences in four dimensions using dichotomous scales, thereby providing insight into how teaching strategies can best be structured. As a secondary focus, additional questions on the survey were asked to gain information about residents' access to the Internet and comfort level with online learning so as to address acceptance of web-based courses in response to the shortage of full-time faculty members. Orthodontic residents, contacted via email, were requested to complete an online survey; 261 responses were collected. The results indicate that orthodontic residents are highly visual learners and show a preference for sensing and sequential learning strategies. In terms of information technology, the residents are comfortable with and have adequate access to current technological assets; therefore, they may be well suited for inclusion of computer-based teaching modules and other multimedia devices in their residency curriculum. PMID:19289721

  5. Recommendations for the Use of Leeches in Reconstructive Plastic Surgery

    PubMed Central

    2014-01-01

    A written informed consent should be obtained from the patient before hirudotherapy is initiated. The patients should be treated each day of leech therapy with anti-Aeromonas antibiotics. Leeches should be applied on the darker spots of the reattached body parts or flaps. Usually 1–10 leeches are used for each treatment, while at the beginning, the patient might need two or more treatments per day. Leech therapy is used until venous capillary return is established across the wound border by angiogenesis. Usually the treatment with leeches lasts for 2–6 days. Hematologic evaluations should be performed every 4 hrs and the patient has to receive blood transfusions when the hemoglobin level is lower than 8 g/dL. Signs of regional lymphadenitis, slight swelling, and pain of regional lymph nodes on the side of leech application and subfebrile temperature can occur. Contraindications related to hirudotherapy include arterial insufficiency, hemophilia, hemorrhagic diathesis, hematological malignancies, anemia, hypotension, and sepsis. Leech therapy is not recommended in pregnancy and lactation and in patients with an unstable medical status, history of allergy to leeches or severe allergic diathesis, and disposition to keloid scar formation, as well as in those using anticoagulants and immunosuppressants. PMID:24653746

  6. Munchausen’s Syndrome in Plastic Surgery: An Interdisciplinary Challenge

    PubMed Central

    Pavan, Chiara; Bassetto, Franco; Azzi, Mariafrancesca; Vindigni, Vincenzo

    2015-01-01

    Summary: Munchausen’s syndrome is a rare psychiatric disease. We report a case in which we have collaborated with the psychiatrist for the diagnosis and also propose a diagnostic flowchart. PMID:26180729

  7. The possibility for use of venous flaps in plastic surgery

    NASA Astrophysics Data System (ADS)

    Baytinger, V. F.; Kurochkina, O. S.; Selianinov, K. V.; Baytinger, A. V.; Dzyuman, A. N.

    2015-11-01

    The use of venous flaps is controversial. The mechanism of perfusion of venous flaps is still not fully understood. The research was conducted on 56 white rats. In our experimental work we studied two different models of venous flaps: pedicled venous flap (PVF) and pedicled arterialized venous flap (PAVF). Our results showed that postoperative congestion was present in all flaps. However 66.7% of all pedicled venous flaps and 100% of all pedicled arterialized venous flaps eventually survived. Histological examination revealed that postoperatively the blood flow in the skin of the pedicled arterialized venous flap became «re-reversed» again; there were no differences between mechanism of survival of venous flaps and other flaps. On the 7-14th day in the skin of all flaps were processes of neoangiogenesis and proliferation. Hence the best scenario for the clinical use of venous flaps unfolds when both revascularization and skin coverage are required.

  8. [Pathomorphology and indications in plastic surgery of the breast].

    PubMed

    Bässler, R

    1979-07-01

    The pathohistological features of two breasts with implants coated with polyurethane are described.--The first case with an implant of 4 months shows a capsule with cellular collagen tissue and triangular and rectangular polyurethane particles with foreign body reactions. The second case, an autopsy of a female artist, revealed a mammary augmentation in both breasts in situ. The prothesis were surrounded by a regular capsule tissue without inflammation.--The different reactions in the connective tissue of the breasts surrounding the implants are described: Silicone implants by Cronin and polyurethane coated implants by Ashley. Complications of breast prothesis are discussed. The constrictive fibrosis is initiated by local chronic inflammation and foreign body reactions. The subcutaneous mastectomy with implantation of prothesis is performed today in cases of fibrocystic diseases with atypical epithelial proliferations, in cases with recurrend fibrocystic disease, with non-invasive ductal carcinoma and lobular carcinoma in situ. The subcutaneous mastectomy is therefore a prophylactic and a therapeutic method. PMID:384701

  9. US dermatology residency program rankings.

    PubMed

    Aquino, Lisa L; Wen, Ge; Wu, Jashin J

    2014-10-01

    Unlike many other adult specialties, US News & World Report does not rank dermatology residency programs annually. We conducted a study to rank individual US dermatology residency programs based on set criteria. For each residency program, data from 2008 related to a number of factors were collected, including annual amount of National Institutes of Health (NIH) and Dermatology Foundation (DF) funding received; number of publications from full-time faculty members; number of faculty lectures given at 5 annual society meetings; and number of full-time faculty members who were on the editorial boards of 6 dermatology journals with the highest impact factors. Most of the data were obtained through extensive Internet searches, and missing data were obtained by contacting individual residency programs. The programs were ranked based on the prior factors according to a weighted ranking algorithm. A list of overall rankings also was created. PMID:25372254

  10. The Optometric Residency: Its Bloom.

    ERIC Educational Resources Information Center

    Bleything, Willard B.

    1979-01-01

    Guidelines for proposed residencies in optometry are presented for pediatric, rehabilitative, and hospital optometry. Their significance in terms of costs, patient population, faculty expertise, and critical mass are discussed. (JMF)

  11. Resident evaluation of orthodontic programs in the United States.

    PubMed

    Noble, James; Hechter, Frank J; Karaiskos, Nicholas E; Wiltshire, William A

    2009-11-01

    The objective of this study was to investigate the satisfaction of orthodontic residents in the United States with their programs and determine the scope of their training. Program chairs/directors of all sixty-five U.S. orthodontic graduate programs were contacted for permission to email their residents. A total of 335 residents from thirty-seven programs were invited to complete an anonymous, online, fifty-seven-item survey in May 2007. Data were categorized, and basic statistics were performed. A total of 136 (40.60 percent) residents completed the survey. Overall, 75.74 percent were satisfied with their program. Residents said they feel they receive appropriate didactic teaching sessions and dedicated academic time (60.29 percent). Most residents (92.70 percent) indicated their program offers training in numerous philosophies, while 80.29 percent said they have sufficient clinically based training and 59.85 percent said they have sufficient research-based training. A total of 57.66 percent said they will not complete more than thirty cases from start to finish and on average treat two orthognathic surgery, thirteen extraction, twenty-four nonextraction, and nine adult patients. Most (92.70 percent) said their program contains care for disabled or underserved patients; most (92.70 percent) said they feel they will be adequately prepared to provide unsupervised orthodontic care after graduation; and 54.41 percent said they think other specialties have a positive view of orthodontics. Only 58.09 percent indicated they have a formal interdisciplinary program for treating patients. We conclude that U.S. orthodontic residents are satisfied with their programs. They receive training in a variety of approaches; however, inadequacies in exposure to interdisciplinary teaching and a limitation of the number of cases started and completed were identified. These observations may be a result of program length due to the preponderance of twenty-four- to thirty-month programs. PMID:19910478

  12. Aesthetic/Cosmetic surgery and ethical challenges.

    PubMed

    Atiyeh, Bishara S; Rubeiz, Michel T; Hayek, Shady N

    2008-11-01

    Is aesthetic surgery a business guided by market structures aimed primarily at material gain and profit or a surgical intervention intended to benefit patients and an integral part of the health-care system? Is it a frivolous subspecialty or does it provide a real and much needed service to a wide range of patients? At present, cosmetic surgery is passing through an identity crisis as well as an acute ethical dilemma. A closer look from an ethical viewpoint makes clear that the doctor who offers aesthetic interventions faces many serious ethical problems which have to do with the identity of the surgeon as a healer. Aesthetic surgery that works only according to market categories runs the risk of losing the view for the real need of patients and will be nothing else than a part of a beauty industry which has the only aim to sell something, not to help people. Such an aesthetic surgery is losing sight of real values and makes profit from the ideology of a society that serves only vanity, youthfulness, and personal success. Unfortunately, some colleagues brag that they chose the plastic surgery specialty just to become rich aesthetic surgeons, using marketing tactics to promote their practice. This is, at present, the image we project. As rightly proposed, going back a little to Hippocrates, to the basics of being a physician, is urgently warranted! Being a physician is all that a "cosmetic" surgeon should be. In the long run, how one skillfully and ethically practices the art of plastic surgery will always speak louder than any words. PMID:18820963

  13. Role of Evidence-Based Reviews in Surgery in teaching critical appraisal skills and in journal clubs

    PubMed Central

    Ahmadi, Negar; Dubois, Luc; McKenzie, Marg; Brown, Carl J.; MacLean, Anthony R.; McLeod, Robin S.

    2013-01-01

    Background Evidence-Based Reviews in Surgery (EBRS) is a program developed to teach critical appraisal skills to general surgeons and residents. The purpose of this study was to assess the use of EBRS by general surgery residents across Canada and to assess residents’ opinions regarding EBRS and journal clubs. Methods We surveyed postgraduate year 2–5 residents from 15 general surgery programs. Data are presented as percentages and means. Results A total of 231 residents (58%, mean 56% per program, range 0%–100%) responded: 172 (75%) residents indicated that they know about EBRS and that it is used in their programs. More than 75% of residents who use EBRS agreed or strongly agreed that the EBRS clinical and methodological articles and reviews are relevant. Only 55 residents (24%) indicated that they used EBRS online. Most residents (198 [86%]) attend journal clubs. The most common format is a mandatory meeting held at a special time every month with faculty members with epidemiological and clinical expertise. Residents stated that EBRS articles were used exclusively (13%) or in conjunction with other articles (57%) in their journal clubs. Most respondents (176 of 193 [91%]) stated that journal clubs are very or somewhat valuable to their education. Conclusion The EBRS program is widely used among general surgery residents across Canada. Although most residents who use EBRS rate it highly, a large proportion are unaware of EBRS online features. Thus, future efforts to increase awareness of EBRS online features and increase its accessibility are required. PMID:23883511

  14. Abortion training in residency programs.

    PubMed

    Westhoff, C

    1994-01-01

    Following the expanded legalization of abortion in 1973, obstetrics/gynecology residency programs began to include training in these techniques. Due to a lack of specific requirements, however, many programs have never offered this training. Because most abortions are provided in freestanding clinics rather than in hospitals, many residents have not had an opportunity to learn abortion techniques. Since the 1970s, the number of residency programs that offer or require abortion training has decreased; currently, only about 12% of US obstetrics/gynecology residency programs require it. The development of collaborative programs where gynecology residents can go to learn abortion outside the hospital is one way to improve the proportion of residents who are trained. Training physicians from other specialties and midlevel clinicians is also being used to increase the number of abortion providers. New requirements specifying that obstetrics/gynecology training programs must include training in abortion techniques are under consideration. If adopted, these requirements may improve access to safe abortion for US women. PMID:7806758

  15. Shape-Shifting Plastic

    SciTech Connect

    2015-05-20

    A new plastic developed by ORNL and Washington State University transforms from its original shape through a series of temporary shapes and returns to its initial form. The shape-shifting process is controlled through changes in temperature

  16. A Plastic Menagerie

    ERIC Educational Resources Information Center

    Hadley, Mary Jane

    2010-01-01

    Bobble heads had become quite popular, depicting all sorts of sports figures, animals, and even presidents. In this article, the author describes how her fourth graders made bobble head sculptures out of empty plastic drink bottles. (Contains 1 online resource.)

  17. Recycle plastics into feedstocks

    SciTech Connect

    Kastner, H.; Kaminsky, W.

    1995-05-01

    Thermal cracking of mixed-plastics wastes with a fluidized-bed reactor can be a viable and cost-effective means to meet mandatory recycling laws. Strict worldwide environmental statutes require the hydrocarbon processing industry (HPI) to develop and implement product applications and technologies that reuse post-consumer mixed-plastics waste. Recycling or reuse of plastics waste has a broad definition. Recycling entails more than mechanical regranulation and remelting of polymers for film and molding applications. A European consortium of academia and refiners have investigated if it is possible and profitable to thermally crack plastics into feedstocks for refining and petrochemical applications. Development and demonstration of pyrolysis methods show promising possibilities of converting landfill garbage into valuable feedstocks such as ethylene, propylene, BTX, etc. Fluidized-bed reactor technologies offer HPI operators a possible avenue to meet recycling laws, conserve raw materials and yield a profit. The paper describes thermal cracking for feedstocks and pyrolysis of polyolefins.

  18. Plasticity of amorphous carbon

    NASA Astrophysics Data System (ADS)

    von Lautz, Julian; Moseler, Michael; Pastewka, Lars

    2014-03-01

    We use molecular dynamics simulations to probe the plastic response of representative bulk volumes of amorphous carbon at densities from 2.0 g cm-3 to 3.3 g cm-3 in simple and triaxial shear. After an initial elastic response the samples yield with only little strain hardening or softening. Individual plastic events in this network forming glass are strikingly similar to those observed for bulk metallic glasses: We find that plasticity is carried by fundamental rearrangements of regions of around 100 atoms, the shear transformation zone. In the simple shear geometry, those events coalesce to form a shear-band on longer time scales. During plastic deformation, the material changes its hybridization by transforming sp3 carbon atoms to sp2. We provide evidence that this transformation of the structural state occurs before the material yields, hence weakening the material. This work was supported by the European Commission (Marie-Curie IOF 272619).

  19. Laser cutting plastic materials

    SciTech Connect

    Van Cleave, R.A.

    1980-08-01

    A 1000-watt CO/sub 2/ laser has been demonstrated as a reliable production machine tool for cutting of plastics, high strength reinforced composites, and other nonmetals. More than 40 different plastics have been laser cut, and the results are tabulated. Applications for laser cutting described include fiberglass-reinforced laminates, Kevlar/epoxy composites, fiberglass-reinforced phenolics, nylon/epoxy laminates, ceramics, and disposable tooling made from acrylic.

  20. [The therapeutic function of the aesthetic surgery].

    PubMed

    Flageul, G; Godefroy, M; Lacoeuilhe, G

    2003-10-01

    By its definition and its etymology, aesthetic surgery is as much a surgery for the soul as for the body. Aesthetic surgery is a true "armed" therapy that essentially targets the psychology of the patient. This therapeutic "arsenal" preserves and/or restores the health of the patient according to its different aspects as defined by the World Health Organization. The plastic surgeon is always concerned about his patient as a whole, and as a human being, of whom he takes charge. Indeed there lies his specificity: He is as well a surgeon and a physician. We identify and analyze, in this chapter, the particular quality of patient-surgeon relationship on a surgical, psychological and juridical level. It is interesting to note that this collaboration results from a spontaneous convergence. The surgeon, the main interested figure, asserts himself mainly as a physician that is totally involved in a dialogue with his patient. He multiplies the interviews and he sharpens his clinical approach, and his own reactions, with regard to the demand for plastic surgery. The psychiatrist establishes the theoretical and practical aspects of the patient demand. The jurist, far from the barren dissertation of the law, reconsiders the environment of the demand and legitimates the generating wish: he insists on the necessary information but also on assuming responsibility. The therapeutic function of the plastic surgery appears essentially related to the success of a psychic repair solicited by the patient but that is scarcely specified by him as such, and of which he is, most probably, rarely fully aware. The process is to listen and to gather the information that guarantees mutual understanding. Plastic surgery is considered irreplaceable by many of our patients, and indisputable by us. It brings incomparable social and human fertility. It is, however, an ambitious and difficult project that is highly demanding. It is far from the impression of facility reflected by the media. Every actor of this scene, where the patient takes the center stage, must be aware of it. PMID:14599898

  1. The Need for Plastics Education.

    ERIC Educational Resources Information Center

    Society of Plastics Engineers, Inc., Stamford, CT.

    In view of a lack of trained personnel in the industry, the Plastics Education Foundation proposes that educators (1) add more plastics programs, (2) establish plastics engineering degrees at appropriate 4-year institutions, (3) add plastics processing technology to current engineering curricula, and (4) interest younger students in courses and/or…

  2. The Need for Plastics Education.

    ERIC Educational Resources Information Center

    Society of Plastics Engineers, Inc., Stamford, CT.

    In view of a lack of trained personnel in the industry, the Plastics Education Foundation proposes that educators (1) add more plastics programs, (2) establish plastics engineering degrees at appropriate 4-year institutions, (3) add plastics processing technology to current engineering curricula, and (4) interest younger students in courses and/or

  3. [French innovations in aesthetic surgery of the face].

    PubMed

    Labbé, D; Kaluzinski, E

    2010-10-01

    This article on French innovations in aesthetic surgery is a report mainly centered on the cervicofacial renovation surgery, with historic review and interviews of people who played a dominating role regarding anatomical works, invention and innovation of techniques, and their development. The main theme is the facial face-lift, which genesis dates back to the First World War, and to the surgery of the « gueules cassées » with Morestin, father of the French plastic surgery. During the interwar years, plastic surgery techniques were developed by great French names such as Passot, Noël and Bourguet. The invention of the craniofacial surgery in the 1960s and historic anatomical works on the SMAS by Tessier and his team in the 1970s, allowed to clarify for everyone the various principles and indications of the face-lift, recently improved by Le Louarn and Besins. It is besides, in nasal aesthetic surgery, and still thanks to anatomical works, that Robin described in 1973 the technique of rhinoplasty by extramucous way, then developed by Jost, co-inventor with his master Redon of the aspirating drain tile. PMID:20869800

  4. Key principles in running a successful business in facial plastics.

    PubMed

    Sufyan, Ahmed S; Williams, Edwin F

    2014-04-01

    The ultimate goal for most facial plastic surgeons is to develop a successful practice. For those currently owning a practice and those planning on developing a practice, the skills and training necessary to establish and manage a facial plastic practice are not taught in medical school, residency, or most fellowships. The goal of this article is to underline the key principles of running a successful business. This article does not replace an MBA, but it allows you to be aware of potential challenges that all businesses encounter. PMID:24810128

  5. Experimental study and verification of the residence time distribution using fluorescence spectroscopy and color measurement

    NASA Astrophysics Data System (ADS)

    Aigner, Michael; Lepschi, Alexander; Aigner, Jakob; Garmendia, Izaro; Miethlinger, Jürgen

    2015-05-01

    We report on the inline measurement of residence time (RT) and residence time distribution (RTD) by means of fluorescence spectroscopy [1] and optical color measurements [2]. Measurements of thermoplastics in a variety of single-screw extruders were conducted. To assess the influence of screw configurations, screw speeds and mass throughput on the RT and RTD, tracer particles were introduced into the feeding section and the RT was measured inline in the plasticization unit. Using special measurement probes that can be inserted into 1/2″ - 20 UNF (unified fine thread) bore holes, the mixing ability of either the whole plasticization unit or selected screw regions, e.g., mixing parts, can be validated during the extrusion process. The measurement setups complement each other well, and their combined use can provide further insights into the mixing behavior of single-screw plasticization units.

  6. Podiatric Resident Performance on a Basic Competency Examination in Musculoskeletal Medicine.

    PubMed

    Creech, Corine L; Pettineo, Steven J; Meyr, Andrew J

    2016-01-01

    A basic competency examination in musculoskeletal medicine has previously been administered to residents across a variety of medical specialties and has demonstrated that medical school preparation in musculoskeletal medicine might be inadequate. The objectives of the present study were to assess podiatric surgical resident performance on this examination and to assess podiatric surgical residency director opinions of the level of importance of the test subject areas. A total of 117 podiatric surgical residents from 15 residency programs completed the 25-question examination. The residents scored a meanstandard deviation of 60.32%12.60% (range 22.00% to 92.00%). On the 7 questions rated by podiatric residency directors as ?8 on a 10-point scale of relative importance, this score improved to 84.92%11.93% (range 39.29% to 100.0%). Senior level residents did not outperform junior level residents (60.76% versus 60.44%; p=.898), and those who had completed a general orthopedics rotation at some point in their education did not outperform those who had not (61.12% versus 58.64%; p=.370). The podiatric residency directors assigned a meanstandard deviation importance score of 6.972.07 out of 10 for the 25 questions and suggested a meanstandard deviation passing score of 69.14%9.03% for the examination. The results of the present investigation provide original data on podiatric surgical resident performance on a basic competency examination in musculoskeletal medicine. Although the residents scored well for some specific test areas, the overall performance was similar to that of previous iterations of the examination given to general surgery and internal medicine residents. The lower scores compared with those from the orthopedic and physical therapy specialties might indicate a need for improved general musculoskeletal medicine education within the podiatric curriculum. PMID:26215554

  7. Overwork Among Residents in India: A Medical Resident's Perspective.

    PubMed

    Azhar, Gulrez S; Azhar, Abdullah Z; Azhar, Ahmad S

    2012-07-01

    This paper argues that medical residents who do most of the hard work in big hospitals and medical colleges are overworked. A hierarchical organizational structure, staffing patterns, and fear of failure in examinations leads to overwork among residents going unreported. This can lead to poor academic performance and research work. Gaps in communication have serious implications on patient health. Undesirable practices like LAMA (leave against medical advice) also result from overwork. Issues of pay and contracts including mandatory service need to be looked into carefully. National and international recommendations on work hours have consistently been ignored. The solutions suggested are simple and easy to implement. PMID:24479024

  8. Overwork Among Residents in India: A Medical Resident's Perspective

    PubMed Central

    Azhar, Gulrez S.; Azhar, Abdullah Z.; Azhar, Ahmad S.

    2012-01-01

    This paper argues that medical residents who do most of the hard work in big hospitals and medical colleges are overworked. A hierarchical organizational structure, staffing patterns, and fear of failure in examinations leads to overwork among residents going unreported. This can lead to poor academic performance and research work. Gaps in communication have serious implications on patient health. Undesirable practices like LAMA (leave against medical advice) also result from overwork. Issues of pay and contracts including mandatory service need to be looked into carefully. National and international recommendations on work hours have consistently been ignored. The solutions suggested are simple and easy to implement. PMID:24479024

  9. Depression in nursing home residents.

    PubMed

    Abrams, R C; Teresi, J A; Butin, D N

    1992-05-01

    Although their extent remains unclear, major and minor depressions are widespread in the nursing home population. This statement appears intuitively to be correct when consideration is given to the inactivity, decline in functional competence, loss of personal autonomy, and unavoidable confrontation with the process of death and dying that are associated with nursing home placement. In addition, some nursing home residents have had previous episodes of depression or are admitted to the facility already dysthymic or with other chronic forms of the illness. Such circumstances provide a favorable culture for the development and persistence of depressive illness. When the high frequency of other psychiatric disorders among nursing home residents is factored in, it is not surprising that long-term health care facilities have come to be regarded as de facto psychiatric hospitals. Nursing homes largely lack the treatment resources of psychiatric hospitals, however. Nursing home physicians are often unprepared to make psychiatric diagnoses, and a perfunctory annual psychiatric evaluation is insufficient to manage the complex depression syndromes of nursing home residents. Because nursing home psychiatrists typically work on a consultation basis, recommendations are not necessarily acted upon by the primary physicians. The consequences of undiagnosed and untreated depression are substantial. From the psychiatric perspective, the possibility that depression increases the risk for eventual development of permanent dementia highlights the importance of early identification for cases of reversible dementia. From the rehabilitation point of view, persistent depression among individuals with physical dependency following a catastrophic illness is associated with failure to improve in physical functioning. Depression can probably be linked to increased medical morbidity in nursing home residents, a relationship that also has been suggested for elderly medical inpatients. If so, the use of nursing time and other health-care facility services would be greater for depressed than nondepressed residents, and financial costs would be higher as well. Finally, recent data point to increased mortality in nursing home residents with major depressive disorder. It is apparent that depression in long-term care facilities is a condition with doubtful prognosis and negative medical, social, and financial consequences. The highest costs of all may be paid by nursing home residents who experience the unrelieved suffering of depressive illness. Only epidemiologic research using standard diagnostic criteria and direct resident assessment will adequately establish the magnitude of the need for intervention among depressed residents in long-term care.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1600481

  10. American Board of Surgery

    MedlinePlus

    ... American Board of Surgery is an independent, nonprofit organization founded in 1937 to provide board certification to individuals who have met a defined standard of education, training and knowledge in the field of surgery. 1617 John F. ...

  11. Endoscopic Sinus Surgery

    MedlinePlus

    ... followed by a long recovery period. With recent advances in technology, including the nasal endoscope, sinus surgery ... nose, tear duct blockage, and others. Additionally, recent advances in endoscopic sinus surgery allow your sinus surgeon ...

  12. Ear surgery - series (image)

    MedlinePlus

    ... in an outpatient surgical facility, or in a hospital. The surgery is performed while the patient is awake but ... covered with a bulky, moderate pressure dressing following surgery. ... the hospital on the same day, or shortly thereafter. Within ...

  13. Complications of Sinus Surgery

    MedlinePlus

    ... further intracranial surgeries. Impaired sense of taste or smell : The sense of smell usually improves after the procedure because airflow is ... in their voice after sinus surgery. Impairment of smell or taste: (see above) Infection: The most common ...

  14. Refractive corneal surgery - discharge

    MedlinePlus

    ... You will be less dependent on glasses or contact lenses after the surgery. Sometimes, you will no longer ... tears. Check with your doctor. Do NOT wear contact lenses on the eye that had surgery, even if ...

  15. Heart bypass surgery

    MedlinePlus

    ... having coronary bypass surgery include: Infection, including chest wound infection, which is more likely to happen if you are obese, have diabetes, or have already had this surgery Heart attack ...

  16. Weight Loss Surgery

    MedlinePlus

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you cannot lose weight ... obesity. There are different types of weight loss surgery. They often limit the amount of food you ...

  17. Cosmetic ear surgery

    MedlinePlus

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... Cosmetic ear surgery may be done in the surgeon's office, an outpatient clinic, or a hospital. It can be performed under ...

  18. Hip fracture surgery

    MedlinePlus

    ... neck fracture repair; Trochanteric fracture repair; Hip pinning surgery; Osteoarthritis-hip ... You may receive general anesthesia before this surgery. This means ... spinal anesthesia. With this kind of anesthesia, medicine is ...

  19. Corrective Jaw Surgery

    MedlinePlus Videos and Cool Tools

    ... best performed by a trained surgeon with specialized education and training. Click here to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  20. Concerns about cosmetic surgery.

    PubMed

    De Sousa, Avinash

    2007-01-01

    This article looks at some ethical challenges in cosmetic surgery. Enhancement versus therapy, risks, patient autonomy, beneficence and informed consent are issues that need to be considered when considering cosmetic surgery in today's world. PMID:18630237