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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. The Origins and Current State of Plastic Surgery Residency in the United States.

    PubMed

    Mackay, Donald Roy; Johnson, Shane

    2015-11-01

    The history of plastic surgery residency training in the United States dates back to the establishment of plastic surgery as a specialty. The pivotal role played by the American Board of Plastic Surgery is outlined. The history of the early regulatory bodies leading to the formation of the Accreditation Council for Graduate Medical Education and the Residency Review Committees and the establishment of the American Council of Academic Plastic Surgeons gives context to our current training models. PMID:26594962

  3. The Role of Overseas Missions in Plastic Surgery Resident Education.

    PubMed

    Lim, Rizal; Thaller, Seth

    2015-06-01

    Surgical mission work serves an important role in the education of plastic surgeons. Here, we examine the ways that participation in surgical mission work enhances resident education from the trainee's perspective. PMID:26080142

  4. Plastic Surgery

    MedlinePlus

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

  5. 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

  6. 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

  7. Generation Y and the Integrated Plastic Surgery Residency Match: A Cross-sectional Study of the 2011 Match Outcomes

    PubMed Central

    Narayan, Deepak

    2013-01-01

    Background: Plastic surgery is the most competitive specialty in medicine. We sought to identify factors associated with the successful match of generation Y applicants into integrated plastic surgery residency. Methods: We utilized the most recent data from the Charting Outcomes in the Match published by the National Resident Matching Program in 2011. We had data on US senior or independent applicant status, Alpha Omega Alpha (AOA) status, attendance of top 40 medical schools, advanced degree status, and number of contiguous ranks within plastic surgery. Our main outcome measure was match status. Results: A total of 81 out of 197 applicants (41.1%) successfully matched into integrated plastic surgery in the 2011 main match. US seniors matched at a significantly higher rate compared to independent applicants (44.0% vs 24.1%, P = 0.044). Matched US seniors were more likely to have AOA membership compared to unmatched US seniors (45.9% vs 27.7%, P = 0.014) and attend a top 40 medical school (52.7% vs 35.1%, P = 0.022). There were no differences in terms of advanced degrees between matched and unmatched US seniors. Unmatched US seniors were more likely to have 3 or fewer contiguous ranks of plastic surgery residency programs than matched US seniors (86.2% vs 68.9%, P = 0.007). Conclusions: US senior status, AOA membership, and attendance at a top 40 medical school are predictors of matching into integrated plastic surgery. Program directors need to be aware of the background of the millennial applicants to recruit and maintain top residents. PMID:25289227

  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. Ear Plastic Surgery

    MedlinePlus

    ... Meeting Calendar Find an ENT Doctor Near You Ear Plastic Surgery Ear Plastic Surgery Patient Health Information ... they may improve appearance and self-confidence. Can Ear Deformities Be Corrected? Formation of the ear during ...

  10. Plastic Surgery for Teenagers

    MedlinePlus

    ... or severe acne and scarring. Teens frequently gain self-esteem and confidence when their physical problems are corrected. ... art as a helpful index of anxiety and self-esteem with plastic surgery. Plastic and Reconstructive Surgery 2002. ...

  11. Periodontal Plastic Surgery

    MedlinePlus

    ... Dental Implants Dentures Direct Bonding Implants versus Bridges Orthodontics and Aligners Periodontal Plastic Surgery Porcelain Crowns Porcelain ... Dental Implants Dentures Direct Bonding Implants versus Bridges Orthodontics and Aligners Periodontal Plastic Surgery Porcelain Crowns Porcelain ...

  12. 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

  13. Plastic Surgery for Ethnic Patients

    MedlinePlus

    ... Briefing Papers > 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 ...

  14. Leadership in plastic surgery today.

    PubMed

    Prado, Arturo; Parada, Francisco

    2010-10-01

    This article was developed after the authors heard young plastic surgeons of their unit ask what attribute makes people want to follow a leader. What people most seek to find in a leader has been constant over time and shared in different countries, genders, and age groups. These qualities include honesty, a forward-looking perspective, inspiration, and competence (Kouzes and Posner, Clin Lab Manage Rev 8:340, 1994). However, the residents and fellows thought differently and told the authors how "they" wanted to be seen when they became leaders. They wanted to viewed as shifting engines pulling forward teams of plastic surgery as hard as possible, leaving space for followers to develop and grow. They also wanted to be seen as having impeccable behavior related to the assumption of obligations, and finally as having the "most" informal authority possible, an authority that is not negotiable because it is given by peers to the leader due to personal qualities and actions. Obtaining formal authority at a very young age is fine, but if a surgeon's associates have not given him or her informal authority, the surgeon is only the "boss" and not the leader of the group. Informal authority is constructed over a time line and given by others to the leader because of what he or she has in values and personal attitudes and because of what the leader has done and can go on doing with sustained credibility and competency. Therefore, it is the authors' opinion that the exercise of leadership in plastic surgery is supported by informal authority and that the leader of leaders will be the one who has the most of this attribute that never is given formally. PMID:20376661

  15. Plastic surgery on identical twins.

    PubMed

    Mühlbauer, W

    1991-01-01

    Four pairs of identical female twins have undergone a variety of plastic surgery procedures, including rhinoplasties, rhytidectomies, augmentation mammaplasties, and trochanteric liposuction. Performing plastic surgery on identical twins implies special considerations: the extent of preoperative phenotypic identity, the behavior of each twin (dominant or recessive), the twins' personal interdependence and individual expectations, the operative strategy (simultaneous versus sequential operations), the eventual complications, and the extent to which the operative results and postoperative appearance are identical. In general, counseling, operative technique, and responsibility for producing good results place greater demands on surgeons when performing plastic surgery on identical twins than on singletons. Still, the results have been gratifying. PMID:1994809

  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 ... Important facts about the safety and risks of plastic surgery Questions to ask my plastic surgeon Choose ...

  18. [Humanitarian plastic surgery in question].

    PubMed

    Montandon, D; Quinodoz, P; Pittet, B

    2004-06-01

    Humanitarian plastic surgery has become very fashionable and more and more surgeons are attracted by this type of commitment. The authors remind here of the necessary conditions and limitations of these actions. The communicative action according to J. Habermas, which means a true partnership with the local health care specialists should be the only valid engagement. PMID:15276263

  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. Anxiety disorders in plastic surgery.

    PubMed

    Rankin, M; Borah, G L

    1997-08-01

    Surgery is a stressful event, with the potential for profound disturbance to the patient's psychological and physiologic homeostasis. Cosmetic surgery is a particularly intense psychological experience because, in addition to the usual concerns about surgical side effects, cosmetic patients bring their hopes and expectations for improved self-image, putting them at risk for the added anxiety of disappointment. High levels of anxiety coupled with the perception of vulnerability or threat to self can cause significant psychological reactions complicating care for the plastic surgical patient. This paper outlines the diagnostic features of the common types of anxiety disorders seen in plastic surgical patients, and it offers treatment strategies for the practitioner, delineating when referral to a mental health expert is advised. Specific clinical case studies of panic attack, posttraumatic stress disorder, and acute stress disorder are presented to illustrate the variety of abnormal anxiety responses that may be encountered in the perioperative setting. Interventions for the anxious patient are part science and part art. Careful questioning and psychosocial assessment can identify those patients who are at greater risk for psychological problems after surgery. However, some patients may mask or keep secret their concerns, which can be manifested with resulting anger and hostility. Plastic surgeons must use appropriate indicators of psychological anxiety and measure a specific patient's reactions to surgery to make the diagnosis of abnormal anxiety. Close follow-up by the plastic surgical team is an essential part of the anxiety disorder patient's psychological treatment, but it is imperative that these problematic patients be referred promptly to a qualified mental health professional to limit their adverse experience and promote their well-being. Patients who are less anxious during the perioperative period report less emotional distress and fewer defensive

  1. 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

  2. Anaesthetic complications in plastic surgery.

    PubMed

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

    2013-05-01

    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

  3. 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

  4. The Future of Plastic Surgery: Surgeon's Perspective.

    PubMed

    Ozturk, Sinan; Karagoz, Huseyin; Zor, Fatih

    2015-11-01

    Since the days of Sushruta, innovation has shaped the history of plastic surgery. Plastic surgeons have always been known as innovators or close followers of innovations. With this descriptive international survey study, the authors aimed to evaluate the future of plastic surgeons by analyzing how plastic surgery and plastic surgeons will be affected by new trends in medicine. Aesthetic surgery is the main subclass of plastic surgery thought to be the one that will change the most in the future. Stem cell therapy is considered by plastic surgeons to be the most likely "game changer." Along with changes in surgery, plastic surgeons also expect changes in plastic surgery education. The most approved assumption for the future of plastic surgery is, "The number of cosmetic nonsurgical procedures will increase in the future." If surgeons want to have better outcomes in their practice, they must at least be open minded for innovations if they do not become innovators themselves. Besides the individual effort of each surgeon, international and local plastic surgery associations should develop new strategies to adopt these innovations in surgical practice and education. PMID:26594981

  5. Antibiotic Use in Facial Plastic Surgery.

    PubMed

    González-Castro, Javier; Lighthall, Jessyka G

    2016-08-01

    Prophylactic antibiotic use in facial plastic surgery is a highly controversial topic primarily due to the lack of evidence in support of or against antibiotic use. In this section the authors present the available literature on the most commonly performed procedures within facial plastic surgery in an attempt to see if the data support or contradict the need for antibiotic prophylaxis in facial plastic surgery. PMID:27400848

  6. 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

  7. Breast education in general surgery residency.

    PubMed

    Wilson, Jason P; Miller, Austin; Edge, Stephen B

    2012-01-01

    Breast cancer treatment has changed substantially with increased specialization. Overall, the number of cases performed by residents upon completion of residency has decreased and the introduction of sentinel lymph node biopsy has reduced the number of axillary lymph node dissections being performed. Our objective was to evaluate the breast surgery education being provided by general surgery residency programs. A survey was administered to applicants to the Roswell Park Cancer Institute surgical oncology fellowship program in the fall of 2009. This survey examined the type of training program, the breast surgery exposure, and applicant comfort with the medical and surgical aspects of breast cancer. The survey was completed by 29 of 35 applicants. Of the respondents, 83 per cent were chief residents. Overall, participants had comfort levels above 8 (of 10) with breast related cases. For modified radical mastectomies and axillary lymph node dissections the comfort level dropped below 8. Participants were least comfortable discussing the medical management of breast cancer. General surgery residents completing training were less comfortable operating in the axilla compared with the breast. The study suggests careful attention should be paid to assuring adequate breast education in surgical residency. PMID:22273306

  8. 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

  9. Surgical Adhesives in Facial Plastic Surgery.

    PubMed

    Toriumi, Dean M; Chung, Victor K; Cappelle, Quintin M

    2016-06-01

    In facial plastic surgery, attaining hemostasis may require adjuncts to traditional surgical techniques. Fibrin tissue adhesives have broad applications in surgery and are particularly useful when addressing the soft tissue encountered in facial plastic surgery. Beyond hemostasis, tissue adhesion and enhanced wound healing are reported benefits associated with a decrease in operating time, necessity for drains and pressure dressings, and incidence of wound healing complications. These products are clinically accessible to most physicians who perform facial plastic surgery, including skin grafts, flaps, rhytidectomy, and endoscopic forehead lift. PMID:27267012

  10. Plastic Surgery and Suicide: A Clinical Guide for Plastic Surgeons.

    PubMed

    Reddy, Vikram; Coffey, M Justin

    2016-08-01

    Several studies have identified an increased risk of suicide among patient populations which a plastic surgeon may have a high risk of encountering: women undergoing breast augmentation, cosmetic surgery patients, and breast cancer patients. No formal guidelines exist to assist a plastic surgeon when faced with such a patient, and not every plastic surgery team has mental health clinicians that are readily accessible for consultation or referral. The goal of this clinical guide is to offer plastic surgeons a set of practical approaches to manage potentially suicidal patients. In addition, the authors review a screening tool, which can assist surgeons when encountering high-risk patients. PMID:27622096

  11. Plastic Surgery and Suicide: A Clinical Guide for Plastic Surgeons

    PubMed Central

    Coffey, M. Justin

    2016-01-01

    Summary: Several studies have identified an increased risk of suicide among patient populations which a plastic surgeon may have a high risk of encountering: women undergoing breast augmentation, cosmetic surgery patients, and breast cancer patients. No formal guidelines exist to assist a plastic surgeon when faced with such a patient, and not every plastic surgery team has mental health clinicians that are readily accessible for consultation or referral. The goal of this clinical guide is to offer plastic surgeons a set of practical approaches to manage potentially suicidal patients. In addition, the authors review a screening tool, which can assist surgeons when encountering high-risk patients. PMID:27622096

  12. 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

  13. 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

  14. Basic science curriculum in vascular surgery residency.

    PubMed

    Sidawy, A N; Sumpio, B; Clowes, A W; Rhodes, R S

    2001-04-01

    Recognizing the importance of basic science teaching in surgical education, the leadership of the Association of Program Directors in Vascular Surgery (APDVS) appointed a panel to gather information and to present its findings at the 1999 annual fall meeting of the Apdvs. A questionnaire was distributed to the program directors present. In addition, information was gathered from the American Board of Surgery regarding the basic science content in the vascular surgery item pool on the vascular surgery qualifying examination (VQE). The vascular surgery unit of the surgical resident curriculum was also analyzed. Fifty-three program directors (64%) completed the questionnaire. Although only two program directors felt that their residents were better prepared to answer basic science questions, the results of the Vqe showed that the examinees do not, as a group, perform differently on basic science items than on clinical management questions. In addition, only a minority of program directors (15%) use a specific method to monitor the learning process of their residents. The majority of the program directors responding (75%) felt that they were capable of teaching basic science to residents. Interestingly, almost half the 53 respondents (47%) said that a basic science curriculum should be comprehensive, not exclusively relevant to the clinical setting. Vqe content outline and the vascular surgery unit of the surgical resident curriculum revealed great emphasis on clinically relevant basic science information. The Apdvs panel recommends that a basic science curriculum should be comprehensive, yet clinically pertinent, and completely integrated with the clinical curriculum. In terms of how to teach basic science in vascular residencies, the panel supports teaching conferences that are problem-based with a faculty member acting as the "resource person" and with specific goals set for the conferences. The panel also suggested establishing a Web site that provides a series of

  15. Plastic Surgery Training Worldwide: Part 1. The United States and Europe

    PubMed Central

    Kamali, Parisa; van Paridon, Maaike W.; Ibrahim, Ahmed M. S.; Paul, Marek A.; Winters, Henri A.; Martinot-Duquennoy, Veronique; Noah, Ernst Magnus; Pallua, Norbert

    2016-01-01

    Background: Major differences exist in residency training, and the structure and quality of residency programs differ between different countries and teaching centers. It is of vital importance that a better understanding of the similarities and differences in plastic surgery training be ascertained as a means of initiating constructive discussion and commentary among training programs worldwide. In this study, the authors provide an overview of plastic surgery training in the United States and Europe. Methods: A survey was sent to select surgeons in 10 European countries that were deemed to be regular contributors to the plastic surgery literature. The questions focused on pathway to plastic surgery residency, length of training, required pretraining experience, training scheme, research opportunities, and examinations during and after plastic surgery residency. Results: Plastic surgery residency training programs in the United States differ from the various (selected) countries in Europe and are described in detail. Conclusions: Plastic surgery education is vastly different between the United States and Europe, and even within Europe, training programs remain heterogeneous. Standardization of curricula across the different countries would improve the interaction of different centers and facilitate the exchange of vital information for quality control and future improvements. The unique characteristics of the various training programs potentially provide a basis from which to learn and to gain from one another. PMID:27257571

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. Telemedicine in plastic surgery: E-consult the attending surgeon.

    PubMed

    Pap, Stephen A; Lach, Elliot; Upton, Joseph

    2002-08-01

    Telemedicine has evolved into a valuable but underused resource for the delivery of health care to patients at a distance, particularly where patient transport is impractical, expensive, complicated, and/or urgent. Today, over 250,000 telemedicine consults are generated annually, involving various specialties in both military and civilian health delivery systems. The ability to evaluate and triage plastic surgery patients through the use of telemedicine has not been widely explored. We have designed, developed, and tested a "store-and-forward" solution at UMass Memorial Hospital and Beth Israel Deaconess Hospital whereby the plastic surgery residents who responded to a consult request transmitted digital photographs by means of the Internet to the attending physician on call. The customary telephone call between resident and attending physician benefited from the additional photographic data, and patient management resulted in a clear, concise, and unambiguous treatment plan. The initial management suggested by the resident was modified on some occasions, particularly with complex problems. The use of digital images was especially helpful for evaluation of radiographs and complex wounds of the hand and face. The solution proved to be very valuable for both attending physicians and residents in plastic surgery. The photographs provide rich detail and resolution comparable to high-quality prints. The mechanics of obtaining images and the process of sending them electronically was readily mastered. Images reached their destination in only a few minutes over standard telephone lines. No problems were encountered while sending or viewing images on Macintosh or Windows platforms. Determining course of action with a complete clinical history now includes a level of visual detail previously not available. As this application expands into wider use, data integrity and safety will have to be more formally secured and monitored. Our model of telemedicine has broad

  2. 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

  3. Outcome analysis of factors impacting the plastic surgery match.

    PubMed

    Wood, Jeyhan S; David, Lisa R

    2010-06-01

    Matching into an integrated plastic surgery program has become highly competitive. As a result it has become more difficult for both the applicants and the residency programs to determine which attributes are most important to match in plastic surgery and, more importantly, to make a surgeon who will contribute to the future of our specialty. This study was conducted to analyze potential associations between a successful match into plastic surgery and the number of interviews offered and attended, Alpha Omega Alpha (AOA) membership, and participation in away rotations. Increased competitiveness of the specialty also has required that the applicant spend significant time and money on the match process to improve his chances. Therefore, we looked at the financial impact of the interview process as well as at compliance with the new communication mandate by the Plastic Surgery Residency Review Committee designed to decrease some of the time and monetary costs associated with the match process. An anonymous 30-item survey was e-mailed to all the applicants to our institution last year. The survey consisted of questions addressing applicant profile with specific questions regarding the interview process. Descriptive statistics, including frequencies and proportions for each of the questions, were calculated. To assess the relationship between categorical outcomes, a Fisher exact test was used. Results with a P value less than 0.05 were considered to be statistically significant. Considering matching as the primary outcome measure, a statistically significant relationship was found with the number of plastic surgery interview invitations received and attended (P < 0.0001 for both), as well as with AOA membership (P = 0.018), with 89% (32/36) of the responders in AOA matching into plastic surgery. Although doing an away rotation did not have a significant association with match rate, one-third of responders matched where they did an away rotation. Gender was not found to

  4. American Society of Ophthalmic Plastic and Reconstructive Surgery

    MedlinePlus

    ... plastic and reconstructive surgery specializing in the face, orbits, eyelids, and lacrimal system. We sponsor several scientific ... plastic and reconstructive surgery specializing in the face, orbits, eyelids, and lacrimal system. The Society has over ...

  5. CDC Warns of Dangers of Plastic Surgery in Dominican Republic

    MedlinePlus

    ... fullstory_159884.html CDC Warns of Dangers of Plastic Surgery in Dominican Republic Report details cases of ... Coast became infected with a disfiguring bacteria following plastic surgery procedures they had in the Dominican Republic. ...

  6. American Academy of Facial Plastic and Reconstructive Surgery

    MedlinePlus

    ... Contact Us Shopping Cart American Academy of Facial Plastic and Reconstructive Surgery Home Meetings & Courses Find a ... About Our Academy The American Academy of Facial Plastic and Reconstructive Surgery is the world's largest specialty ...

  7. 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

  8. 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

  9. 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

  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. 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

  12. [Informed consent in aesthetic plastic surgery].

    PubMed

    Fenger, H

    2006-02-01

    The informed consent plays a very decisive part in aesthetic plastic surgery. As there is often no medical indication in plastic surgery, the patient has to be informed about all the facts of an operation, especially about the possible risks. The legal requests for therapeutic and economic clarification gain in importance. The jurisdiction in Germany demands a merciless clarification for the patient. The patient needs to be clarified about all facts early enough so that he has a sufficient amount of time to weigh-up the pros und cons of the operation and if necessary to take advice from someone else. The sufficient documentation is very important at the sight of the extensive burden of proof at the expense of the physician. PMID:16538575

  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. [Training of residents in abdominal wall surgery in Spain].

    PubMed

    Miguelena Bobadilla, J M; Morales García, D; Serra Aracil, X; Sanz Sánchez, M; Iturburu, I; Docobo Durántez, F; Jover Navalón, J M; López De Cenarruzabeitia, I; Lobo Martínez, E

    2013-02-01

    The training of residents in abdominal wall surgery is a fundamental aspect of surgical training, representing globally 20% of its activity. In this paper, we analyze the current state of resident training in this kind of surgery in Spain, taking into account the broad spectrum it covers: general services, specific functional units, ambulatory surgery programs. To do this, based on the specifications of the specialty program, specific data were used from several different sources of direct information and a review of the results obtained by residents in hernia surgery. In general, our residents agree with their training and the recorded results are in line with objectives outlined in the program. However, it would be important to structure their teaching schedules, a rotation period in any specific unit and their involvement in outpatient surgery programs. PMID:22074730

  16. [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

  17. 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…

  18. The Economic Burden of Orthopedic Surgery Residency Interviews on Applicants

    PubMed Central

    Fogel, Harold A.; Finkler, Elissa S.; Wu, Karen; Schiff, Adam P.; Nystrom, Lukas M.

    2016-01-01

    Background The intense competition for orthopedic surgery residency positions influences the interview process. The financial impact on residency applicants is less well understood. The purpose of the present study was to define the economic burden of the orthopedic surgery residency interview process while additionally describing how applicants finance the expense. Methods We distributed surveys to 48 nonrotating applicants at our institution’s residency interview days for the 2015 match year. The survey consisted of eleven questions specific to the costs of interviewing for orthopedic surgery residency positions. Results The survey response rate was 90% (43/48). Applicants applied to a median of 65 orthopedic surgery residency programs (range 21-88) and targeted a median of 15 interviews (range 12-25). The mean cost estimate for a single interview was $450 (range $200-800) and the cost estimate for all interviews was $7,119 (range $2,500-15,000). Applicants spent a mean of $344 (range $0-750) traveling to our interview. Seventy-two percent borrowed money to finance their interview costs and 28% canceled interviews for financial reasons. Conclusions The financial cost of interviewing for orthopedic surgery is substantial and a majority of applicants add to their educational debt by taking out loans to finance interviews. Future considerations should be made to minimize these costs for an already financially burdened population. PMID:27528831

  19. Evaluation of training and professional expectations of surgery residents.

    PubMed

    Herbella, Fernando Augusto Mardiros; Fuziy, Rogerio A; Takassi, Guilherme F; Dubecz, Atilla; Del Grande, Jose C

    2011-01-01

    Residency programs, especially in surgery, have been undergoing constant changes, not only in our country, but also internationally. Due to the depreciation of medical specialties and their lowering compensation, expectations and profile of residents in surgical fields are changing. The assessment of attitudes, experience in training and professional expectations among residents is an important topic. Recent international studies published in the area demonstrate this fact. It is worth noting the absence of similar studies in our country, as well as others. This study aims to assess the residents of the area of surgery, through a questionnaire, their attitudes, experiences during training and professional expectations. We applied and analyzed questionnaires adapted and translated into Portuguese to 50 professionals of both sexes and different years of residence. The results of this study showed high satisfaction with the specialty, but large financial concern and conflicting opinions about the future of the specialty. PMID:21971863

  20. 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

  1. 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

  2. Prevention of perioperative hypothermia in plastic surgery.

    PubMed

    Young, V Leroy; Watson, Marla E

    2006-01-01

    While inadvertent perioperative hypothermia has received serious attention in many surgical specialties, few discussions of hypothermia have been published in the plastic surgery literature. This article reviews the physiology of thermoregulation, describes how both general and regional anesthesia alter the normal thermoregulatory mechanisms, indicates risk factors particularly associated with hypothermia, and discusses the most effective current methods for maintaining normothermia. Hypothermia is typically defined as a core body temperature of /=36.5 degrees C is maintained. Unless preventive measures are instituted, inadvertent hypothermia occurs in 50% to 90% of surgical patients, even those undergoing relatively short procedures lasting one to one-and-a-half hours. During either general or regional anesthesia, a patient's natural behavioral and autonomic responses to cold are unavailable or impaired, and the combination of general and neuraxial anesthesia produces the highest risk for inadvertent perioperative hypothermia. Unless hypothermia is prevented, the restoration of normothermia can take more than 4 hours once anesthesia is stopped. Consequences of hypothermia are serious and affect surgical outcomes in plastic surgery patients. Potential complications include morbid cardiac events, coagulation disorders and blood loss, increased incidence of surgical wound infection, postoperative shivering, longer hospital stays, and increased costs associated with surgery. Measures for preventing hypothermia are emphasized in this article, especially those proven most effective in prospective and controlled clinical studies. Perhaps the most important step in maintaining normothermia is to prewarm patients in the preoperative area with forced-air heating systems. Intraoperative warming with forced-air and fluid warming are also essential. Other strategies

  3. [Guidelines and quality assurance in national and international practice in the area of plastic surgery].

    PubMed

    Eisenmann-Klein, M

    1997-01-01

    Multiple quality assurance activities in the German plastic surgery association are outlined, such as the collection of structural data, inspections of units by expert commissions, tracer diagnosis, continuous evaluation of health outcome by patient questionnaire, training programs for residents and a credit point system for congress activities. Interdisciplinary groups are formed for internal quality management within hospitals. EBOPRAS is responsible for accreditation of training centers and the European (Union) Board certification. EQUAM activities aim for quality improvement of biomaterials. Quality management activities within the International Confederation of Plastic, Reconstructive and Aesthetic Surgery concentrate on the definition of minimal requirements for training units and the establishment of a quality management philosophy. PMID:9574120

  4. 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

  5. Colorectal surgeons teaching general surgery residents: current challenges and opportunities.

    PubMed

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

    2012-09-01

    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

  6. 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

  7. New microsurgical applications: implications for the infrastructures of plastic surgery.

    PubMed

    Lineaweaver, William C

    2002-01-01

    As a technical innovation, microsurgery has changed concepts and strategies throughout plastic surgery. The infrastructures of plastic surgery currently are evolving in ways that make the identity and future of the specialty uncertain. Microsurgery also may be a basis for fresh thoughts in these areas of infrastructure. This article touched on some areas where microsurgery could be an important element in organizational development, namely patient population identification, economic strategies, academic organization, and medical education. More thorough exploration of these ideas and identification of others may result in a new foundation for plastic surgery with microsurgery as a key element. PMID:11827370

  8. [Skin tumors in facial plastic surgery].

    PubMed

    Heppt, W

    2009-04-01

    As the incidence of facial skin tumors is rising, otorhinolaryngologists are becoming more and more involved in the field of facial plastic surgery. The most common tumor locations on the head are the sun-exposed areas such as the nose, forehead, cheek, and auricle. The most common histologic findings are actinic keratosis and basal cell carcinoma. In planning tumor resection and defect repair, many factors, including histology, size, and localization of the tumor as well as conditions of the adjacent skin, must be considered. The key to defect repair after tumor resection is to choose the most appropriate technique from a range of possibilities. Because of skin laxity, most small and midsize facial defects can be closed directly or with high-tension sutures under skin expansion. More extensive defects and those located in critical areas require pedicled flaps or free grafts transferring skin from adjacent or distant areas. In patients with recurrent or deeply infiltrative tumors, reconstructive procedures of the facial nerve, parotid duct, and lacrimal duct might be needed. This is also true for reconstruction of the anatomic framework of the eyelids, the nose, and the pinna. PMID:19347378

  9. [Science and research in academic plastic surgery in Germany].

    PubMed

    Giunta, R E; Machens, H-G

    2009-12-01

    Plastic surgery has passed through a very positive evolution in the last decades on the solid fundament of constantly developing academic plastic surgery. Aim of this paper is an objective evaluation of the current status of academic plastic surgery regarding research topics, currently available ressources and scientific outcome based on a questionnaire. The return rate of the questionnaire in academic departments was 92%. Main topics in research besides wound healing were topics from regenerative medicine such as tissue engineering, biomaterials, genetherapy and angiogenesis with the main focus on skin and fat tissues. In the past five years a total of 25 million Euros of third party research grants were raised. Research relied mainly on interdisciplinary research facilities. Regarding the scientific outcome more than 200 scientific papers were published in basic science research journals having an impactfactor higher than two. These results clearly demonstrate that plastic surgery is scientifically highly productive in academic surroundings where independent departments are established. Considering that independent units of plastic surgery exist in a relatively small number of all 36 university hospitals in germany, it has to be claimed for further independent departments so to provide adequate research facilities for further evolution of academic plastic surgery. PMID:20029742

  10. 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

  11. 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

  12. 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

  13. Awareness and Perception of Plastic Surgery among Healthcare Professionals in Pune, India: Do They Really Know What We Do?

    PubMed Central

    Panse, Nikhil; Panse, Smita; Kulkarni, Priya; Dhongde, Rajendra; Sahasrabudhe, Parag

    2012-01-01

    Purpose. The aim of this study is to understand the level of awareness and knowledge of plastic surgery in healthcare professionals in a tertiary health care facility in Pune, India. This study also aims to highlight the perception of the medical professionals about plastic surgery and what they think a plastic surgeon does. Materials and Methods. A questionnaire-based survey was done at B.J Medical College and Sassoon Hospital, Pune in 2011. Feedback evaluation forms from hundred resident doctors and faculty were evaluated and analyzed. Results. There is not much awareness about plastic surgery as a specialty amongst health care providers. Plastic surgery is mostly perceived as cosmetic surgery, and the other spectrum of the patients we cater to goes largely unnoticed. Of all the clinical conditions given to the participants, there was not a single clinical condition where the respondents favored unanimously for plastic surgeons. Conclusion. Plastic surgery as a specialty is poorly understood by our medical colleagues, and the onus of creating and improving the awareness and perception of our specialty lies on us. Herculean unified efforts at individual as well as global level will help us achieve this goal. PMID:22685647

  14. [The new residency program in neurological surgery in Spain].

    PubMed

    Lobato, R D; Fernandez Alen, J; Alday, R; Gómez, P A; Lagares, A

    2003-09-01

    A new Residency Program in Neurological Surgery has been recently elaborated by the "Comisión Nacional de Neurocirugía" following the requirement of the National Council of Specialities. This new Program, which will replace the one proposed in 1992, has been designed in a similar way as those applied in countries providing the best neurosurgical training. Changes included deal with the definition of the speciality, and the introduction of new rotations,a resident Log Book, a Tutor with a well defined profil and commitments, a structured planning of academic and clinical objectives, a rotation or training in research, and a planning for continuous evaluation of the progress of the resident. It is likely that an appropriate application of the new Program in Spanish neurosurgical units with accreditation for training will result in formation of highly competent neurosurgeons. However, there are new challenges for improving neurosurgical training and the development of our speciality in Spain, as those related with new legislation regulating resident working hours, or some political decisions changing the mechanisms for controlling the number of resident positions per year. PMID:14506551

  15. 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

  16. Ethnic trends in facial plastic surgery.

    PubMed

    Sturm-O'Brien, Angela K; Brissett, Annette E A; Brissett, Anthony E

    2010-05-01

    The appearance of patients seeking cosmetic surgery is changing to reflect our multicultural society. Integral to addressing the desires of a cross-cultural patient population is an understanding of one's perception of race, ethnicity, and culture. Race is an objective description, whereas ethnicity is a subjective description of a person's social group. Culture, on the other hand, defines the behaviors, beliefs, and values of a group. How a person perceives their place within these groups affects his or her self-image and approach to cosmetic surgery. These cultural perceptions are important, as patients of Asian, Hispanic, and African descent make up the fastest growing groups that desire cosmetic surgery. Factors contributing to this trend include population growth, especially within multicultural communities, improvements in social status, and increasing disposable income, combined with a positive perception of cosmetic surgery. Surgical philosophies have also changed, shifting from the perspective of racial transformation, defined as the use of a common set of surgical goals for all ethnicities, toward a view of racial preservation, with the goal of preserving one's racial and ethnic features. PMID:20446200

  17. Autonomic dysreflexia: a plastic surgery primer.

    PubMed

    Curtin, Catherine M; Gater, David R; Chung, Kevin C

    2003-09-01

    Plastic surgeons are integral to the management team for patients with spinal cord injuries, with responsibilities including pressure sore management and upper extremity reconstruction. Injury to the spinal cord profoundly disrupts the body's ability to maintain homeostasis. In particular, the autonomic system can become unregulated, resulting in a massive sympathetic discharge called autonomic dysreflexia. Autonomic dysreflexia occurs in the majority of patients with injuries above the sixth thoracic vertebra and causes sudden, severe hypertension. If left untreated, autonomic dysreflexia can result in stroke or death. Because this syndrome causes morbidity and mortality, it is crucial for plastic surgeons to be able to recognize and treat autonomic dysreflexia. This article reviews the etiology, symptoms, and treatment of this syndrome. PMID:12966249

  18. Intraoperative Flap Complications in LASIK Surgery Performed by Ophthalmology Residents

    PubMed Central

    Romero-Diaz-de-Leon, Lorena; Serna-Ojeda, Juan Carlos; Navas, Alejandro; Graue-Hernández, Enrique O.; Ramirez-Miranda, Arturo

    2016-01-01

    Purpose: To report the rate of flap-related complications in LASIK surgery performed by in-training ophthalmology residents and to analyze the risk factors for these complications. Methods: We analyzed 273 flap dissections in 145 patients from March 2013 to February 2014. We included all LASIK surgeries performed by 32 ophthalmology residents using a Moria M2 microkeratome. All the flap-related complications were noted. Comparison between both groups with and without complications was performed with an independent Student's t-test and relative risks were calculated. Results: There were 19 flap-related complications out of the 273 flap dissections (6.95%). The most common complication was incomplete flap dissection (n = 10; 3.66%), followed by free-cap (n = 5; 1.83%), and flap-buttonhole (n = 2; 0.73%). There was no significant difference between the complicated and uncomplicated cases in terms of the right versus the left eye, pachymetry results, white-to-white diameter, and spherical equivalent. But this difference was significant for mean keratometry (P = 0.008), K-min (P = 0.01), and K-max (P = 0.03) between these groups. Final visual acuity after rescheduling laser treatment was similar in both groups. Relative risks for flap-related complications were 2.03 for the first LASIK surgery (CI 95% 0.64 to 6.48; P = 0.22) and 1.26 (CI 95% 0.43 to 3.69; P = 0.66) for the surgeon's flap-related complications. Female gender presented an odds ratio of 2.48 (CI 95% 0.68 to 9.00; P = 0.16) for complications. Conclusion: Flap-related complications are common intraoperative event during LASIK surgery performed by in-training ophthalmologists. Keratometries and surgeon's first procedure represent a higher probability for flap related complications than some other biometric parameters of patient's eye.

  19. 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

  20. 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

  1. Neuropsychologic predictors of operative skill among general surgery residents.

    PubMed

    Schueneman, A L; Pickleman, J; Hesslein, R; Freeark, R J

    1984-08-01

    The present study develops a rating scale method for evaluating operative skills, assesses the predictive utility of neuropsychologic tests of nonverbal cognitive and psychomotor abilities in accounting for individual differences in surgical skills, and compares the efficiency of these measures with those of traditional residency selection criteria. According to a multifactorial design, 120 general surgery residents were tested with a neuropsychologic test battery and then rated by attending surgeons on surgical skills exhibited during the course of 1445 surgical procedures. Analysis of the neuropsychologic battery resulted in three factors (complex visuo-spatial organization, stress tolerance, psychomotor abilities) that were statistically unrelated to traditional measures such as Medical College Admission Test and National Board scores. Multiple regression analyses indicated that academic predictors, taken alone, either do not correlate (National Board scores) or correlate negatively (Medical College Admission Test scores) with the surgery ratings. Conversely, neuropsychologic test scores show significant positive correlation (r = 0.68) with the ratings. When both sets of predictor variables are combined, a multiple regression coefficient of 0.80 is found with the ratings, with more than two thirds of the predictive power attributable to the neuropsychologic test scores. These tests may provide a useful addition to traditional methods of predicting operative skills. PMID:6463862

  2. Brain plasticity and hand surgery: an overview.

    PubMed

    Lundborg, G

    2000-06-01

    The hand is an extension of the brain, and the hand is projected and represented in large areas of the motor and sensory cortex. The brain is a complicated neural network which continuously remodels itself as a result of changes in sensory input. Such synaptic reorganizational changes may be activity-dependent, based on alterations in hand activity and tactile experience, or a result of deafferentiation such as nerve injury or amputation. Inferior recovery of functional sensibility following nerve repair, as well as phantom experiences in virtual, amputated limbs are phenomena reflecting profound cortical reorganizational changes. Surgical procedures on the hand are always accompanied by synaptic reorganizational changes in the brain cortex, and the outcome from many hand surgical procedures is to a large extent dependent on brain plasticity. PMID:10961548

  3. 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

  4. The John D. Constable International Traveling Fellowship: A Reciprocal Education in Plastic Surgery.

    PubMed

    Eberlin, Kyle R; Del Frari, Barbara; Dai, Xinyi; Austen, William G

    2015-06-01

    The John D. Constable International Traveling Fellowship has been an integral part of the American Association of Plastic Surgeons since 2006 and has provided an opportunity for international plastic surgeons to work with leaders in American plastic surgery. PMID:26080120

  5. 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

  6. 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

  7. Endoscopic techniques in aesthetic plastic surgery.

    PubMed

    McCain, L A; Jones, G

    1995-01-01

    There has been an explosive interest in endoscopic techniques by plastic surgeons over the past two years. Procedures such as facial rejuvenation, breast augmentation and abdominoplasty are being performed with endoscopic assistance. Endoscopic operations require a complex setup with components such as video camera, light sources, cables and hard instruments. The Hopkins Rod Lens system consists of optical fibers for illumination, an objective lens, an image retrieval system, a series of rods and lenses, and an eyepiece for image collection. Good illumination of the body cavity is essential for endoscopic procedures. Placement of the video camera on the eyepiece of the endoscope gives a clear, brightly illuminated large image on the monitor. The video monitor provides the surgical team with the endoscopic image. It is important to become familiar with the equipment before actually doing cases. Several options exist for staff education. In the operating room the endoscopic cart needs to be positioned to allow a clear unrestricted view of the video monitor by the surgeon and the operating team. Fogging of the endoscope may be prevented during induction by using FREDD (a fog reduction/elimination device) or a warm bath. The camera needs to be white balanced. During the procedure, the nurse monitors the level of dissection and assesses for clogging of the suction. PMID:7568452

  8. 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

  9. 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

  10. [PLASTIC SURGERY OF THE VULVA AND THEIR CIRCUMSTANCES].

    PubMed

    Rabinerson, David; Salman, Lina; Gabbay-Benziv, Rinnat

    2016-03-01

    Plastic surgery of the vulva for aesthetic reasons is recently gaining popularity in the Western world, as well as in Israel. There are different methods of executing these operations with no meaningful difference in the surgical results and the satisfaction of the patients. There are also more complicated plastic operations, in which the vulva is involved. These are performed in cases of pseudohermaphroditism, various states of intersex, sex change operations and developmental defects of the genitor-urinary systems. These are considered successful procedures. Furthermore, the issue of the illegal mutilation surgery of the external female genitalia, on religious or cultural background, is mentioned. All the above-mentioned types of operations involving the vulva are discussed. PMID:27305753

  11. Financial conflicts of interest in plastic surgery: background, potential for bias, disclosure, and transparency.

    PubMed

    Luce, Edward A

    2015-04-01

    Relationships between physicians and industry, whether it be pharmaceutical companies, medical device manufacturers, or purveyors of medical technology, contain both an element of potential for good and a potential for harm. Certainly, the potential for good is realized when the collaboration results in improved plastic surgery patient care due to product and technology development. If the collaboration contains a financial component, the potential for harm exists in the form of a financial conflict of interest on the part of the physician. Recently, considerable discussion has been directed toward the pervasiveness of financial conflict of interest in all three arenas of the profession of medicine: education, research, and clinical practice, although an overlap exists among all three with respect to the issue of conflict of interest. This article will focus on conflict of interest in plastic surgery education, both continuing medical education for practitioners and graduate medical education for plastic surgery residents, as well as conflict of interest in research, such as conflicts related to publications in our literature. PMID:25285680

  12. Ten years of replantation surgery at the Department of Plastic Surgery, Charles University Hospital, Prague.

    PubMed

    Kletenský, J; Nejedlý, A; Pros, Z; Svoboda, S; Tvrdek, M

    1994-01-01

    The authors present results of the ten years replantation surgery centre at the department of plastic surgery in Prague. The presented series of patients includes 393 persons operated on because of amputation or ischaemic injury to the region of the upper extremity. The number of replantations and revascularisations in the individual years is analysed, as well as the age of the patients, type of injury, mechanism of injury and operation results. PMID:7618394

  13. 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.

  14. 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

  15. Analysis and implications of changing hepatopancreatobiliary (HPB) case loads in general surgery residency training for HPB surgery accreditation

    PubMed Central

    Daee, Sally Sayeh; Flynn, Jeffrey C; Jacobs, Michael J; Mittal, Vijay K

    2013-01-01

    Objective This study was conducted to determine whether residents are receiving enough hepatopancreatobiliary (HPB) training during general surgery residencies to exclude the necessity of pursuing formal fellowships in HPB surgery. Methods Trends in HPB surgery training were examined using Accreditation Council for Graduate Medical Education (ACGME) operative log data for the academic years 1999/2000 to 2009/2010. Results Of 800 000 HPB operations performed annually in the USA, the proportion of HPB procedures performed by general surgery residents increased from 15% (122 007) to 18% (143 000) between the periods under study. Numbers of pancreatic, liver and biliary procedures performed by graduating general surgery residents increased by 47% (from 8185 to 12 006), 31% (from 7468 to 9765), and 14% (from 106 354 to 121 239), respectively. The mean number of operations undertaken by a graduating resident increased from 8.3 to 11.5 (38% increase) for pancreatic surgeries, from 7.6 to 9.4 (24% increase) for liver surgeries, and from 107.5 to 116.6 (8% increase) for biliary surgeries. Total numbers of complex pancreatic, liver and biliary procedures increased by 91% (from 4768 to 9129) and 24% (from 6649 to 8233), and decreased by 29% (from 6581 to 4648), respectively. Conclusions The overall trend shows an increase in the number of HPB procedures undertaken by graduating general surgery residents. The mean number of procedures exceeds ACGME requirements, but falls short of association guidelines. However, certain residents exceed International Hepato-Pancreato-Biliary Association (IHPBA) fellowship requirements for total and complex procedures during residency. Consideration should be given to those residents to allow them to bypass fellowship training provided that they meet other IHPBA standards. PMID:23521184

  16. 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

  17. 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

  18. Objective Assessment in Residency Based Training for Transoral Robotic Surgery

    PubMed Central

    Curry, Martin; Malpani, Anand; Li, Ryan; Tantillo, Thomas; Jog, Amod; Blanco, Ray; Ha, Patrick K; Califano, Joseph; Kumar, Rajesh; Richmon, Jeremy

    2015-01-01

    Objective To develop a robotic surgery training regimen integrating objective skill assessment for otolaryngology and head and neck surgery trainees consisting of training modules of increasing complexity and leading up to procedure specific training. In particular, we investigate applications of such a training approach for surgical extirpation of oropharyngeal tumors via a transoral approach using the da Vinci Robotic system. Study Design Prospective blinded data collection and objective evaluation (OSATS) of three distinct phases using the da Vinci Robotic surgical system. Setting Academic University Medical Engineering/Computer Science laboratory Methods Between September 2010 and July 2011, 8 Otolaryngology Head and Neck Surgery residents and 4 staff “experts” from an academic hospital participated in three distinct phases of robotic surgery training involving 1) robotic platform operational skills, 2) set-up of the patient side system, and 3) a complete ex-vivo surgical extirpation of an oropharyngeal “tumor” located in the base of tongue. Trainees performed multiple (4) approximately equally spaced training sessions in each stage of the training. In addition to trainees, baseline performance data was obtained for the experts. Each surgical stage was documented with motion and event data captured from the application programming interfaces (API) of the da Vinci system, as well as separate video cameras as appropriate. All data was assessed using automated skill measures of task efficiency, and correlated with structured assessment (OSATS, and similar Likert scale) from three experts to assess expert and trainee differences, and compute automated and expert assessed learning curves. Results Our data shows that such training results in an improved didactic robotic knowledge base and improved clinical efficiency with respect to the set-up and console manipulation. Experts (e.g. average OSATS 25, Stdev. 3.1, module 1 – suturing) and trainees (average

  19. 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

  20. 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…

  1. 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

  2. Twenty years of experience with particulate silicone in plastic surgery.

    PubMed

    Planas, J; del Cacho, C

    1992-01-01

    The use of particulate silicone in plastic surgery involves the introduction of solid silicone into the body. The silicone is in small pieces in order for it to adapt to the shape of the defect. This way large quantities can be introduced through small incisions. It is also possible to distribute the silicone particles from outside the skin to make the corrections more regular. This method has been very useful for correcting post-traumatic depressions in the face and all areas where the depression has a rigid back support. We consider it the treatment of choice for correcting the funnel chest deformity. PMID:1734631

  3. 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

  4. 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

  5. An Update on the Level of Evidence for Plastic Surgery Research Published in Plastic and Reconstructive Surgery.

    PubMed

    Nguyen, Anson; Mahabir, Raman C

    2016-07-01

    In 2011, Plastic and Reconstructive Surgery (PRS) implemented a level-of-evidence (LOE) pyramid to bring attention to evidence-based medicine and to promote quality of research. The objective of our study was to examine the current, overall quality of plastic surgery research when compared with that of the previous 30 years. Articles from PRS published in 2013 were culled for information, including LOE based on the assigned score from the LOE pyramid. (Animal, cadaver, and basic science studies; reviews; correspondence; and continuing medical education articles were excluded.) The LOE grades were compared with those from 1983, 1993, and 2003. In 2013, 536 articles were published in PRS; of these, 247 met the inclusion criteria and were included in the analysis. The mean LOE in PRS for 2013 was 3.42. For the year 2003, the mean LOE was 4.16; 1993, 4.25; and 1983, 4.42. Analysis of variance indicated significant improvement in research quality over time (P < 0.001). In 2014, 216 of 489 published articles met the inclusion criteria. The mean LOE of PRS articles in 2014 was 3.33, demonstrating continued higher LOE. There was also a decrease in the percentage of level IV and V studies to 47.2% (from 51.4% in 2013), whereas higher quality level I and II studies had increased to 18.1% (from 17.4%). The quality of plastic surgery research has shown a continued upsurge as evidenced by overall improvement in LOE in published articles over the past 3 decades. PMID:27536477

  6. An Update on the Level of Evidence for Plastic Surgery Research Published in Plastic and Reconstructive Surgery

    PubMed Central

    Nguyen, Anson

    2016-01-01

    Summary: In 2011, Plastic and Reconstructive Surgery (PRS) implemented a level-of-evidence (LOE) pyramid to bring attention to evidence-based medicine and to promote quality of research. The objective of our study was to examine the current, overall quality of plastic surgery research when compared with that of the previous 30 years. Articles from PRS published in 2013 were culled for information, including LOE based on the assigned score from the LOE pyramid. (Animal, cadaver, and basic science studies; reviews; correspondence; and continuing medical education articles were excluded.) The LOE grades were compared with those from 1983, 1993, and 2003. In 2013, 536 articles were published in PRS; of these, 247 met the inclusion criteria and were included in the analysis. The mean LOE in PRS for 2013 was 3.42. For the year 2003, the mean LOE was 4.16; 1993, 4.25; and 1983, 4.42. Analysis of variance indicated significant improvement in research quality over time (P < 0.001). In 2014, 216 of 489 published articles met the inclusion criteria. The mean LOE of PRS articles in 2014 was 3.33, demonstrating continued higher LOE. There was also a decrease in the percentage of level IV and V studies to 47.2% (from 51.4% in 2013), whereas higher quality level I and II studies had increased to 18.1% (from 17.4%). The quality of plastic surgery research has shown a continued upsurge as evidenced by overall improvement in LOE in published articles over the past 3 decades. PMID:27536477

  7. 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

  8. Mirror system for photodocumentation in plastic and aesthetic surgery.

    PubMed

    Kühnel, T; Wolf, S

    2005-09-01

    Photodocumentation of the face before aesthetic or plastic surgery is of fundamental importance for at least three reasons: it is an aid to surgical planning, it can be used for illustrative purposes in discussions with the patient, and it satisfies medico-legal requirements for documentation. To achieve efficient and economic documentation of preoperative and postoperative status in aesthetic and reconstructive plastic procedures, the mirror system described here permits the required planes to be documented in a single photograph. The simple and inexpensive technical design allows six planes to be documented in constant and, therefore, comparable quality. Because the patient's data are also documented with the photographic record, the potential for mistaken patient identity is eliminated. No technical training is needed to operate the device and it can, therefore, be readily used by ancillary medical personnel. In a typical nasal surgery department performing about 150 rhinoplasty procedures per annum, the mirror system offers cost and time savings generated as a result of reducing the documentation burden by 750 photographs. PMID:15927161

  9. 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

  10. 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

  11. 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

  12. Knowledge and perceptions of facial plastic surgery among a selected group of professionals in Lagos, Nigeria.

    PubMed

    Adeyemo, W L; Mofikoya, B O; Bamgbose, B O

    2010-04-01

    This was a questionnaire-based study among a selected group of professionals in Lagos, Nigeria to assess their knowledge, attitude and perceptions to facial plastic surgery. A well-structured questionnaire was administered to a group of professionals in the banking industry and the civil service. The respondents were asked if they had heard of 'facial plastic surgery' before and if they were familiar with some selected facial plastic surgery procedures. They were also asked if they had ever considered undergoing facial plastic surgery for any real/perceived facial abnormalities; if they knew any close relatives/friends who had undergone facial plastic surgery and if they considered the result satisfactory or not. A total of 130 respondents participated in the study; of these, 102 (78.5%) respondents had some knowledge of 'facial plastic surgery' while 28 (21.5%) respondents had no prior knowledge of facial plastic surgery. Fifty-five of the 102 respondents had some knowledge of liposuction of the face and neck. Nineteen of the 130 respondents expressed willingness to undergo facial plastic surgery for removal of facial wrinkles and excess fat on the cheeks and neck. Only 17 (13%) of the respondents had ever thought of undergoing facial plastic surgery; of these 17 respondents, nine claimed that their facial appearance was the main reason. Respondents with perceived facial abnormalities were more likely to undergo plastic surgery than those without perceived abnormalities (P=0.000). Twenty-four (18.5%) of the 130 respondents knew of a friend/close relative who had undergone facial plastic surgery before, and the majority (19 of the 24) considered the result of the surgery satisfactory. We conclude that most of the study participants had some knowledge of facial plastic surgery; however, only a few expressed willingness to undergo facial plastic surgery for removal of facial wrinkles and folds/fat on the cheeks and neck. The fact that only a few of the respondents

  13. Introducing Evidence-based Medicine to Plastic and Reconstructive Surgery

    PubMed Central

    Chung, Kevin C.; Swanson, Jennifer A.; Schmitz, DeLaine; Sullivan, Daniel; Rohrich, Rod J.

    2009-01-01

    An effective healthcare system is one in which healthcare spending provides acceptable returns in terms of health outcomes and broad coverage for its citizens. By this measure, the United States healthcare system unfortunately falls short. Tremendous pressure for improvement has given rise to several initiatives designed to decrease healthcare expenditure and improve outcomes, access, and quality of care. The outcomes movement, which is revolutionary in American medicine, has heightened awareness about the need to critically examine our treatment outcomes. However, the early euphoria surrounding the outcomes movement was met with restraint at the realization of its limitations. Although the outcomes movement has verified the effectiveness of many existing treatments in plastic surgery, most of the investments in these projects unfortunately have resulted in few, if any, positive changes for the patient, physician or healthcare system (1). US healthcare is now moving towards the adoption of evidence-based medicine (EBM), which may potentially be another revolution in American healthcare (2). PMID:19337107

  14. 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)

  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. 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 growing interest ... Services, or federal policy. More Health News on: Plastic and Cosmetic Surgery Teen Mental Health Recent Health News Related MedlinePlus Health ...

  17. 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

  18. 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

  19. 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.

  20. 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

  1. 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

  2. Twelve Tips for Improving the General Surgery Resident Night Float Experience.

    PubMed

    Rentea, Rebecca M; Forrester, Jared A; Kugler, Nathan W; Dua, Anahita; Webb, Travis P

    2015-06-01

    Restriction of resident duty hours has resulted in the implementation of night float systems in surgical and medical programs. Many papers have examined the benefits and structure of night float, but few have addressed patient safety issues, quality patient care, and the impact on the residency education system. The objective of this review is to provide practical tips to optimize the night float experience for resident training while continuing to emphasize patient care. The tips provided are based on the experiences and reflections of residents, supervising staff, group discussions, and the available literature in a hospital-based general surgery residency program. Utilizing these resources, we concluded that the night float system addresses resident work hour restrictions; however, it ultimately creates new issues. Adaptations will help achieve a balance between resident education and patient safety. PMID:27073829

  3. 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…

  4. 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

  5. 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

  6. 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...

  7. 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...

  8. 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...

  9. 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

  10. 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

  11. Post-operative brachial plexus neuropraxia: A less recognised complication of combined plastic and laparoscopic surgeries

    PubMed Central

    Thomas, Jimmy

    2014-01-01

    This presentation is to increase awareness of the potential for brachial plexus injury during prolonged combined plastic surgery procedures. A case of brachial plexus neuropraxia in a 26-year-old obese patient following a prolonged combined plastic surgery procedure was encountered. Nerve palsy due to faulty positioning on the operating table is commonly seen over the elbow and popliteal fossa. However, injury to the brachial plexus has been a recently reported phenomenon due to the increasing number of laparoscopic and robotic procedures. Brachial plexus injury needs to be recognised as a potential complication of prolonged combined plastic surgery. Preventive measures are discussed. PMID:25593443

  12. Perioperative Glycemic Control in Plastic Surgery: Review and Discussion of an Institutional Protocol.

    PubMed

    Dortch, John D; Eck, Dustin L; Ladlie, Beth; TerKonda, Sarvam P

    2016-07-01

    Perioperative hyperglycemia is a well-known risk factor for surgical morbidity such as wound healing, infection, and prolonged hospitalization. This association has been reported for a number of surgical subspecialties, including plastic surgery. Specialty-specific guidelines have become increasingly available in the literature. Currently, glucose management guidelines for plastic surgery are lacking. Recognizing that multiple approaches exist for perioperative glucose, protocol-based models provide the necessary structure and guidance for approaching glycemic control. In this article, we review the influence of diabetes on outcomes in plastic surgery patients and propose a practical approach to perioperative blood glucose management based on current Endocrine Society and Mayo Clinic institutional guidelines. PMID:27301370

  13. Computer-based multimedia in plastic surgery education.

    PubMed Central

    Webber, W. B.; Rinehart, G. C.

    1992-01-01

    Rapid developments in communications networks (cellular telephone, direct-link satellite, and international high-speed computer nets) and the continued success of affordable powerful personal computers (desktop, laptop and soon "palmtop" devices) have set the stage for educational materials accessible by electronic means. Computer-based multimedia are sophisticated audiovisual teaching materials built from digitized illustrations, photographs, audio and video recordings viewed by display on a computer screen. The computer interface allows interactive access to information, and connectivity to other sources of information. Computer programmability allows presentation of a single collection of information at different levels of sophistication (the "patient", "medical student" or "surgeon trainee" level, for example), to appeal to different viewer needs. The information may be electronically updated or changed whenever appropriate. This desktop exhibit demonstrates multimedia plastic surgery teaching materials with full-fidelity digital sound, three-dimensional computer graphics, and "picture-in-picture" video capabilities that we have developed since 1989. We have used these materials at St. Louis University for patient informed consent, and the education of medical students and surgical trainees. We are excited that similar multimedia teaching materials are now becoming commercially available in other fields of medical education, attesting to broadening interest among educators and publishers. PMID:1483004

  14. 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

  15. Training of Resident Ophthalmologists in Cataract Surgery: A Comparative Study of Two Approaches

    PubMed Central

    Tzamalis, Argyrios; Lamprogiannis, Lampros; Chalvatzis, Nikolaos; Symeonidis, Chrysanthos; Tsinopoulos, Ioannis

    2015-01-01

    Purpose. To evaluate and compare the efficacy of two different training methods in resident-performed phacoemulsification surgery. Methods. 502 eyes of 467 patients who underwent resident-performed phacoemulsification were included in the study by reviewing their medical records. Residents were allocated into two groups according to the method applied during their training in cataract surgery; Group A included residents that were trained with the “step-by-step” method and Group B those trained with the “one-step” method. Primary outcome was the incidence of main complications, defined as posterior capsular ruptures and/or zonular dehiscence with vitreous loss. Results. Each resident performed a median of 63 phacoemulsification surgeries. A statistically significant difference (p = 0.0032) was noted in the main complications rate between the two groups, yielding a mean of 17.3% in Group A and 7.25% in Group B. Other intraoperative complications were not shown to differ statistically significantly between study groups (p > 0.05). Among the first 40 surgeries of each resident, main complications rate differed also statistically significantly (p = 0.0048) between Group A (21.67%) and Group B (8.5%), while a better surgical performance-yielding statistical significance in Group A (p = 0.017) was indicated in both groups between the 20th and the 30th procedure. Conclusions. Training in cataract surgery using the “one-step” method may lead to an improvement in surgical competency, when measured by complications rates and, therefore, to significantly better quality of training for resident ophthalmologists. PMID:26075088

  16. [Facial plastic surgery as preventive measures for psychic lesions (author's transl)].

    PubMed

    Stellmach, R

    1981-06-26

    Facial plastic surgery offers numerous possibilities of removing disfigurements and deformities of the face and thus preventing or curing psychic lesions. The causes of such disturbances are pointed out. In selected examples the relevant aspects in childhood, in adults and in advanced age are emphasized. Up-to-date advances in microsurgical grafting methods and a more aggressive technique in neck-lifting show that successful plastic surgery of the face always has preventive or curative effects on psychic lesions. PMID:6789178

  17. 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.

  18. 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

  19. 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

  20. 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

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

    PubMed

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

    2016-09-01

    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:27556775

  2. A Systematic Review of Applying Patient Satisfaction Outcomes in Plastic Surgery

    PubMed Central

    Clapham, Philip J.; Pushman, Allison G.; Chung, Kevin C.

    2015-01-01

    Background We performed a systematic review of patient satisfaction studies in the Plastic Surgery literature. The specific aim was to evaluate the status of satisfaction research that has been undertaken to date and to identify areas for improvement. Methods Four medical databases were searched using satisfaction and Plastic Surgery related search terms. Quality of selected articles was assessed by two trained reviewers. Results Out of the total of 2,936 articles gleaned by the search, 178 were included in the final review. The majority of the articles (58%) in our review examined patient satisfaction in breast surgery populations. Additionally, 53% of the articles were limited in scope and only measured features of care in one or two domains of satisfaction. Finally, the majority of the studies (68%) were based solely on the use of ad-hoc satisfaction measurement instruments that did not undergo a formal development. Conclusion Given the important policy implications of patient satisfaction data within Plastic Surgery, we found a need to further refine research on patient satisfaction in Plastic Surgery. The scarcity of satisfaction research in the craniofacial, hand, and other reconstructive specialties, as well as the narrow scope of satisfaction measurement and the use of unvalidated instruments are current barriers preventing Plastic Surgery patient satisfaction studies from producing meaningful results. PMID:20517109

  3. 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

  4. 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

  5. Are Canadian general surgery residents ready for the 80-hour work week? A nationwide survey

    PubMed Central

    Sudarshan, Monisha; Hanna, Wael C.; Jamal, Mohammed H.; Nguyen, Lily H.P.; Fraser, Shannon A.

    2012-01-01

    Background The purpose of this study was to describe Canadian general surgery residents’ perceptions regarding potential implementation of work-hour restrictions. Methods An ethics review board–approved, Web-based survey was submitted to all Canadian general surgery residency programs between April and July 2009. Questions evaluated the perceived effects of an 80-hour work week on length of training, operative exposure, learning and lifestyle. We used the Fisher exact test to compare senior and junior residents’ responses. Results Of 360 residents, 158 responded (70 seniors and 88 juniors). Among them, 79% reported working 75–100 hours per week. About 74% of seniors believed that limiting their work hours would decrease their operative exposure; 43% of juniors agreed (p < 0.001). Both seniors and juniors thought limiting their work hours would improve their lifestyle (86% v. 96%, p = 0.12). Overall, 60% of residents did not believe limiting work hours would extend the length of their training. Regarding 24-hour call, 60% of juniors thought it was hazardous to their health; 30% of seniors agreed (p = 0.001). Both senior and junior residents thought abolishing 24-hour call would decrease their operative exposure (84% v. 70%, p = 0.21). Overall, 31% of residents supported abolishing 24-hour call. About 47% of residents (41% seniors, 51% juniors, p = 0.26) agreed with the adoption of the 80-hour work week. Conclusion There is a training-level based dichotomy of opinion among general surgery residents in Canada regarding the perceived effects of work hour restrictions. Both groups have voted against abolishing 24-hour call, and neither group strongly supports the implementation of the 80-hour work week. PMID:22269303

  6. 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.

  7. 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

  8. [Partial onychectomy and plastic surgery as treatment of ingrown nails].

    PubMed

    Briziarelli, P; Moretti, M; Barbetti, G; Pasquini, F

    1982-05-26

    The Authors report on a technique for a preserving treatment of the ingrowing nail, by means of partial onycectomy associated with plastic repair of soft tissues of the surrounding nail bed. PMID:7088382

  9. 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

  10. 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

  11. 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

  12. Removal of impacted third molars by oral/maxillofacial surgery and general dentistry residents.

    PubMed

    Handelman, S L; Black, P M; Desjardins, P; Gatlin, L; Simmons, L

    1993-01-01

    The post-operative symptoms of patients who had undergone third molar extractions by Oral/Maxillofacial Surgery (OMS) residents were compared with those of patients whose extractions were performed by General Dentistry (GD) residents. The OMS group had more extractions per visit and were more likely to use intravenous sedation than the GD-treated group. No significant differences were found when the provider groups were compared by post-operative symptoms such as osteitis, infection, trismus, or paresthesia/dysthesia. The pain relief due to postoperative analgesics during the immediate 12-hour period was higher for patients treated by GD residents. Multiple regression analysis revealed that this difference was due to the number of teeth extracted and the complexity of the surgical procedure, independent of type of provider. PMID:8153854

  13. [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

  14. [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" (Körper) and "subjective body" (Leib), and the objectives of medical actions are questioned. Through the terminological differentiation between integrity (Integrität), prosperity (Wohlergehen), and well-being (Wohlbefinden), these objectives are qualified and the limits of medical actions are determined. PMID:25604537

  15. 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

  16. [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

  17. Taking evidence-based plastic surgery to the next level: report of the second Summit on Evidence-based Plastic Surgery.

    PubMed

    Eaves, Felmont F; Rohrich, Rod J; Sykes, Jonathan M

    2013-07-01

    Applying the principles of evidence-based medicine has the potential to drastically improve quality of care and patient outcomes. For this reason, evidence-based medicine has been held as one of the 15 most important developments in medicine within the past 100 years. In August of 2010, a broad coalition of leaders from numerous organizations representing societies, boards, journals, foundations, and academic institutions met in Colorado Springs, Colorado, for the first Evidence-Based Plastic Surgery Summit. The summit signaled a sea change in the approach of organized plastic surgery to the promotion of evidence-based medicine within the specialty. It was determined that a strategic, coordinated, and sustained effort to drive an evidence-based medicine culture would accelerate adoption and advance quality of care and patient safety. Over the past 2 years, many of the goals of the initial summit have been met. In order to take our evidence-based medicine efforts to the next level, a second summit was recently held to redefine goals, focus efforts, address barriers, and launch new initiatives with broad consensus. This article documents the outcomes of the second Evidence-Based Plastic Surgery Summit. PMID:23813399

  18. Taking evidence-based plastic surgery to the next level: report of the second summit on evidence-based plastic surgery.

    PubMed

    Eaves, Felmont F; Rohrich, Rod J; Sykes, Jonathan M

    2013-01-01

    Applying the principles of evidence-based medicine has the potential to drastically improve quality of care and patient outcomes. For this reason, evidence-based medicine has been held as one of the 15 most important developments in medicine within the past 100 years. In August of 2010, a broad coalition of leaders from numerous organizations representing societies, boards, journals, foundations, and academic institutions met in Colorado Springs, Colorado, for the first Evidence-Based Plastic Surgery Summit. The summit signaled a sea change in the approach of organized plastic surgery to the promotion of evidence-based medicine within the specialty. It was determined that a strategic, coordinated, and sustained effort to drive an evidence-based medicine culture would accelerate adoption and advance quality of care and patient safety. Over the past 2 years, many of the goals of the initial summit have been met. In order to take our evidence-based medicine efforts to the next level, a second summit was recently held to redefine goals, focus efforts, address barriers, and launch new initiatives with broad consensus. This article documents the outcomes of the second Evidence-Based Plastic Surgery Summit. PMID:23868347

  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. 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

  1. [Plastic surgery of the anorectal area. Indications, technique and outcome].

    PubMed

    Stratmann, H; Kaminski, M; Lauschke, H; Hirner, A

    2000-01-01

    Anal canal stenosis with alteration of the sensoric continence or mucosal ectropion may occur after anorectal operations. Island flaps with perianal skin or the VY-anoplasty are simple plastic methods to reconstruct the anorectal region and cure patients--who often have suffered for a long time--from anal strictures or mucosal ectropion. In the period from 1994-1998 we reconstructed the anodermal region of seven patients using one of the above mentioned anorectal plastic procedures. Three patients complained of an anal stenosis and one patient suffered from an ectropion of the rectal mucosa after an improperly performed Whitehead hemorrhoidectomy. Three patients had a sensomotoric incontinence twice due to a congenital anal atresia and in one case caused by an accident. All patients were highly pleased after the operation--no complication occurred. PMID:10743037

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

    PubMed Central

    Baltacıoğlu, Esra; Korkmaz, Fatih Mehmet; Bağış, Nilsun; Aydın, Güven; Yuva, Pınar; Korkmaz, Yavuz Tolga; Bağış, 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

  3. 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

    ... General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee. This meeting was announced in the Federal Register of July 7, 2011 (76 FR 39882). The amendment is being made to reflect a... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the...

  4. 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

    ... 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 a... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the...

  5. 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

    ... Federal Register of June 24, 2010 (75 FR 36102). The meeting is postponed so that FDA can review and... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical.... ACTION: Notice. SUMMARY: The meeting of the General and Plastic Surgery Devices Panel of the...

  6. 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

    ... 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). The... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the...

  7. 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…

  8. 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

  9. 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.

  10. 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.

  11. 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…

  12. 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

  13. [Evaluation of surgical skills of French ophthalmology, orthopedic and gastrointestinal surgery residents: Current status and perspectives].

    PubMed

    Tranchart, H; Aurégan, J C; Gaillard, M; Giocanti-Aurégan, A

    2015-10-01

    The purpose of this study was to evaluate the need for nationwide assessment of surgical skills during residency, and to define ideal methods for assessment in three surgical disciplines: ophthalmology, orthopedics and gastrointestinal surgery. Three online questionnaires were sent by e-mail to 784 residents, fellows and hospital practitioners, and 119 university hospital physican-professors. Questionnaires focused on current assessment methods at the regional level, the roles of the surveyed population in these evaluations, potential obstacles to their development and the most relevant methods for practical evaluations. Nine hundred and three questionnaires were sent; 355 participants replied (response rate: 39%). The establishment of systematic assessment seemed necessary to over 90% of the survey population, and this opinion was equitably distributed among all three specialties. Over 60% of respondents felt that current assessment procedures were not satisfactory. In all three specialties, the ideal evaluation method proposed was a real patient procedure. This "in vivo" evaluation was considered applicable in 80% of cases, potential barriers to its development being the resident's anxiety, medical-legal reasons and the lack of objective criteria. The ideal timing of these assessments was bi-annual. Implementation of surgical skills assessment during residency seems necessary. The survey population appears dissatisfied with current arrangements. A step-by-step evaluation combining surgical simulations, animal training and live patient procedures may be appropriate. PMID:26343276

  14. Evaluation of resident's training for endoscopic sinus surgery using a sheep's head.

    PubMed

    Delgado-Vargas, Beatriz; Romero-Salazar, Azucena Lloris; Reyes Burneo, Pablo M; Vásquez Hincapie, Catalina; de Los Santos Granado, Gonzalo; Del Castillo López, Raúl; Frágola Arnau, Claudio; Cobeta Marco, Ignacio

    2016-08-01

    Training in functional endoscopic sinus surgery (FESS) is an essential part of each ENT resident and it takes place on a very fragile area. This study focus on showing the learning curve of FESS, using an anatomical model such as the sheep's head. Four residents in our centre performed dissections. Each of these residents operated eight sheep's head. They performed an endoscopic septoplasty followed by maxillary antrostomy, total ethmoidectomy and frontal sinusotomy on every head. A staff member guided all procedures and checked for the appropriate dissection and complications occurred. Analysis was made upon the residents' performance of their first four septoplasties and eight nasal sides against their subsequent performance of the same. Final procedures presented better outcomes than the initial ones on every step of them. Results were measured by means of decrease of time (P < 0.0001) and complications, showing no major complications on the latest ones. Sheep's head is a suitable substitute for the cadaveric human head, to obtain the surgical skills needed for FESS procedures. Sheep's nasal cavity allows gaining dexterity and it is an easy model to obtain. PMID:26739302

  15. Accessibility and Availability of Online Information for Orthopedic Surgery Residency Programs

    PubMed Central

    Davidson, Austin R.; Loftis, Christopher M.; Throckmorton, Thomas W.

    2016-01-01

    Abstract Background Prospective orthopedic residency applicants commonly use one of three databases to identify potential programs: Accreditation Council of Graduate Medical Education (ACGME), American Medical Association (FREIDA), or Orthogate. org. In addition, institutional websites are typically the primary source of information once programs are identified. We sought to evaluate the databases and websites used by prospective orthopedic surgery applicants for content and accessibility. We hypothesized that information would be more available in comparison to previous studies but would still fail to provide complete, up to date program information for the prospective applicant. Methods Three online databases were queried in December 2014 to compile a list of orthopedic residency programs in the United States. This combined list was used as a basis for evaluating individual institution websites. Previously described criteria were used to evaluate the availability of information contained within orthopedic surgery residency websites. Results At the time of online review, 157 programs were identified. Depending on the database in question, up to 33% of programs either did not provide a link or listed a non-functioning link. Among the variety of evaluated criteria, inclusion of the information varied between 12% and 97% for the individual program websites. Conclusions Online databases are useful in listing programs, but individual program details and direct functional links are lacking. Most program websites contain varying degrees of desired information; however, not all programs maintain websites which consistently provide information to satisfy the evaluated criteria in this study. Improved online accessibility and availability of information for residency programs would increase their visibility and utility for prospective applicants. PMID:27528832

  16. Venous Thromboembolism Prophylaxis in Plastic Surgery: A Literature Review.

    PubMed

    Hernandez, Sergio; Valdes, Jorge; Salama, Moises

    2016-06-01

    Venous thromboembolism (VTE) is a major health concern because it increases morbidity and mortality after a surgical procedure. A number of well-defined, evidence-based guidelines are available delineating suitable use of prophylaxis to prevent deep vein thrombosis and pulmonary embolism. Despite the available literature, there are clear gaps between recommendations and clinical practice, affecting the incidence of VTE. Plastic surgeons underuse the substantiated literature and risk stratification tools that are available to decrease the incidence of VTE in the office-based surgical setting because of fear of bleeding or hematoma complications postoperatively. Venous thromboembolism creates an economic burden on both the patient and the healthcare system. The intent of this literature review is to determine existing VTE risk using assessment models available to aid in the implementation of protocols for VTE prevention, specifically for high-risk cosmetic surgical patients in office-based settings. PMID:27501651

  17. Comparison of Neurosensory Assessment Methods in Plastic Surgery.

    PubMed

    Karagoz, Huseyin; Ozturk, Sinan; Siemionow, Maria

    2016-08-01

    Sensory assessment of the skin is essential to document the function of the sensory fibers of the tested nerves. The Semmes-Weinstein monofilaments, disk-criminator, electrodiagnostic testing, and Pressure-Specified Sensory Device (PSSD) have been currently used to assess sensory function of peripheral nerves. None of these methods is optimal because of different drawbacks; however, an increasing number of articles, which recognize the reliability of PSSD, have been published during the last decade. In this review, following a short overview on basic physiology and assessment methods of the skin sensory receptors, we compared the sensory assessment methods and summarized the applications of the PSSD in the field of different clinical areas, mainly peripheral neuropathies, breast, and flap surgery. PMID:27404470

  18. Nurses' experiences of leech therapy in plastic and reconstructive surgery.

    PubMed

    Reynolds, Alison; OBoyle, Colm

    2016-07-14

    The aim of this study was to explore nurses' experience of using leech therapy. Leech therapy is useful in promoting revascularisation of skin grafts. Nurse disquiet in their role as leech therapists has been noted. This study explored the experience of Irish nurses. A qualitative design with an interview schedule was used to learn about emotional and practical clinical experiences. Interviews were carried out with seven nurses working with leeches in reconstructive surgery in 2013. These interviews were coded and explored for themes. Results revealed that many nurses feel aversion to the use of leeches. This may be associated with the use of a parasitic organism as treatment in conflict with the nurse's role in cross infection. It was also found that management of a nurse's own and patient's emotional responses is required. In conclusion, preparation for the role of leech therapy beyond the purely practical is necessary, and should explore affective responses of the practitioner and patients. PMID:27409780

  19. [Plastic and reconstructive surgery of the bronchial tree].

    PubMed

    Petrov, D; Dzhambazov, V; Goranov, E; Plochev, M

    1999-01-01

    Bronchoplastic and reconstructive operations (BPRO) are a major issue in the broad methodological spectrum of thoracic surgery. It is the aim of the study to analyze the indications, operative technique and results of such operations on the basis of experience gained in the Clinic of Thoracic Surgery over a 5-year period. A total of 19 patients (14 men and 5 women) at mean age 50.7 y (range 16 to 70 y) are operated. By histological variant of the tumor operated on, the patients are distributed as follows: carcinoid--4 cases, fibromas--1, squamous cell carcinoma--10, adenocarcinoma--1, bronchoalveolar carcinoma--1, small-cell carcinoma--1 and leiomyosarcoma--one. The reconstructive operations performed include: isolated bronchus resection--2, right upper lobectomy with cuff resection--7, right upper bilobectomy with cuff resection--2, left upper lobectomy with cuff resection--7 (in two instances in conjunction with angioplasty), and left lower lobectomy with cuff resection and angioplasty--one. No intraoperative and perioperative lethality (within 30 days) is recorded. An overweight female patient with diabetes hardly lending itself to compensation develops severe suppuration. In two instances serious concurrent complications necessitate reoperation. Overall postoperative hospital stay--20 days; without the 3 severe complications--12.8 days. One patient dies of brain metastases within 6 months of the intervention. The survivorship term in the remainder varies from 1 year to 4 years 9 months, averaging 31 months. There are no stenoses or granulations of the anastomoses requiring endoscopic treatment. Presumably, BPRO are an adequate therapeutic approach to patients presenting centrally located malignant and benign tumors. The results of their application in the series being examined are estimated as very good. PMID:11484251

  20. Medical Specialty Society Sponsored Data Registries – Opportunities in Plastic Surgery

    PubMed Central

    Hume, Keith M.; Crotty, Catherine A.; Simmons, Christopher J.; Neumeister, Michael W.; Chung, Kevin C.

    2014-01-01

    Clinical data registries are commonly used worldwide and are implemented for a variety of purposes ranging from physician or facility clinic logs for tracking patients, collecting outcomes data, to measuring quality improvement or safety of medical devices. In the United States, the Food and Drug Administration has used data collected through registries to facilitate the drug and device regulatory process, ongoing surveillance during the product life-cycle, and for disease appraisals. Furthermore, the Centers for Medicare and Medicaid Services, in certain instances, base registry participation and submitting data to registries as factors for reimbursement decisions. The purpose of this article is to discuss the use of clinical data registries, the role that medical specialty societies, in particular the American Society of Plastic Surgeons and The Plastic Surgery Foundation, can have in the development and management of registries, and the opportunities for registry use in Plastic Surgery. As outcomes data are becoming essential measures of quality healthcare delivery, participating in registry development and centralized data collection has become a critical effort for Plastic Surgery to engage in to proactively participate in the national quality and performance measurement agenda. PMID:23806935

  1. The Application of Three-Dimensional Surface Imaging System in Plastic and Reconstructive Surgery.

    PubMed

    Li, Yanqi; Yang, Xin; Li, Dong

    2016-02-01

    Three-dimensional (3D) surface imaging system has gained popularity worldwide in clinical application. Unlike computed tomography and magnetic resonance imaging, it has the ability to capture 3D images with both shape and texture information. This feature has made it quite useful for plastic surgeons. This review article is mainly focusing on demonstrating the current status and analyzing the future of the application of 3D surface imaging systems in plastic and reconstructive surgery.Currently, 3D surface imaging system is mainly used in plastic and reconstructive surgery to help improve the reliability of surgical planning and assessing surgical outcome objectively. There have already been reports of its using on plastic and reconstructive surgery from head to toe. Studies on facial aging process, online applications development, and so on, have also been done through the use of 3D surface imaging system.Because different types of 3D surface imaging devices have their own advantages and disadvantages, a basic knowledge of their features is required and careful thought should be taken to choose the one that best fits a surgeon's demand.In the future, by integrating with other imaging tools and the 3D printing technology, 3D surface imaging system will play an important role in individualized surgical planning, implants production, meticulous surgical simulation, operative techniques training, and patient education. PMID:27015345

  2. 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

  3. Acellular Dermal Matrix in Reconstructive Breast Surgery: Survey of Current Practice among Plastic Surgeons

    PubMed Central

    Ibrahim, Ahmed M. S.; Koolen, Pieter G. L.; Ashraf, Azra A.; Kim, Kuylhee; Mureau, Marc A. M.; Lee, Bernard T.

    2015-01-01

    Background: Acellular dermal matrices (ADMs) in plastic surgery have become increasingly popular particularly for breast reconstruction. Despite their advantages, questions exist regarding their association with a possible increased incidence of complications. We describe a collective experience of plastic surgeons’ use of ADMs in reconstructive breast surgery using an internet-based survey. Methods: Members of the American Society of Plastic Surgeons were recruited through voluntary, anonymous participation in an online survey. The web-based survey garnered information about participant demographics and their experience with ADM use in breast reconstruction procedures. After responses were collected, all data were anonymously processed. Results: Data were ascertained through 365 physician responses of which 99% (n = 361) completed the survey. The majority of participants were men (84.5%) between 51 and 60 years (37.4%); 84.2% used ADM in breast reconstruction, including radiated patients (79.7%). ADM use was not favored for nipple reconstruction (81.5%); 94.6% of participants used drains, and 87.8% administered antibiotics postoperatively. The most common complications were seroma (70.9%) and infection (16%), although 57.4% claimed anecdotally that overall complication rate was unchanged after incorporating ADM into their practice. High cost was a deterrent for ADM use (37.5%). Conclusions: Plastic surgeons currently use ADM in breast reconstruction for both immediate and staged procedures. Of those responding, a majority of plastic surgeons will incorporate drains and use postoperative antibiotics for more than 48 hours. PMID:25973359

  4. 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

  5. Research and development of additional aids for dermatologic and plastic surgery.

    PubMed

    Goldman, L; Stefanovsky, D; Gregory, R O; Bauman, W; Koch, M

    1983-01-01

    Increasing numbers of accessories continue to be found to make laser surgery more effective for dermatologic and plastic surgery. Argon laser surgery aids are available to increase the dilatation of the superficial vessels and to localize increasing numbers of red cell masses. Laser probes for intravascular thrombogenesis and thrombolysis have now been adapted for intradermal and deep dermal tissues and for cardiology. Studies on laser effects on platelets and heat transmission and thromboembolic phenomena are lacking. Investigative studies are developing for laser fiber optic probes for laser-induced fluorescence, not only for oncology, but also for studies of metabolism of tissues and also for spectroscopy. The use of different wavelengths and shorter pulses, more flexible fiber-optics transmission for all laser systems, combinations of laser systems into a single operating probe, as well as the increased use of lasers for diagnosis and treatment will all stimulate the development of new aids for laser surgery. Cooperative programs developed jointly by dermatologic and plastic surgeons will make for great progress in skin and soft-tissue laser surgery. PMID:6865638

  6. 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.

  7. “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

  8. [Fifty years of plastic surgery in the Netherlands. VIII. Craniofacial surgery].

    PubMed

    Vaandrager, J M; van der Meulen, J C

    2000-06-01

    Craniofacial surgery has developed its own identity in the last 3 decades. The Frenchman Tessier can be seen as the founding father. His concept of intracranial correction of craniofacial malformations is still valid today. There have been many new developments such as distraction osteogenesis and biodegradable miniplate fixation. Microvascular surgery and vascularised calvarial bone grafts help to obtain more predictable results. Three-dimensional CT imaging techniques and modelling result in better surgical planning and help to understand the underlying pathology. Biomolecular knowledge of gene mutations leads to better understanding of the clinical diagnosis. The future will bring minimalisation of surgery and more therapy focused on biomolecular science. The psychosocial welfare of the patient will play a central role in the multidisciplinary team treatment. PMID:10876706

  9. 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

  10. Utility of Daily Mobile Tablet Use for Residents on an Otolaryngology Head & Neck Surgery Inpatient Service.

    PubMed

    Crowson, Matthew G; Kahmke, Russel; Ryan, Marisa; Scher, Richard

    2016-03-01

    The objective of this study was to investigate the utility of electronic tablets and their capacity to increase hospital floor productivity, efficiency, improve patient care information safety, and to enhance resident education and resource utilization on a busy Otolaryngology - Head & Neck Surgery inpatient service. This was a prospective cohort study with a 2-week pre-implementation period with standard paper census lists without mobile tablet use, and a 2-week post-implementation period followed with electronic tablets used to place orders, look up pertinent clinical data, educate patients as appropriate, and to record daily to-dos that would previously be recorded on paper. The setting for the study was Duke University Medical Center in Durham, North Carolina, with 13 Otolaryngology residents comprising the study population. The time for inpatient rounding was shorter with the use tablets (p = 0.037). There was a non-significant trend in the number of times a resident had to leave rounds to look up a clinical query on a computer, with less instances occurring in the post-implementation study period. The residents felt that having a tablet facilitated more detailed and faster transfer of information, and improved ease of documentation in the medical record. Seventy percent felt tablets helped them spend more time with patients, 70 % could spend more time directly involved in rounds because they could use the tablet to query information at point-of-care, and 80 % felt tablets improved morale. The utility of a mobile tablet device coupled with the electronic health record appeared to have both quantitative and qualitative improvements in efficiency, increased time with patients and attendance at academic conferences. Tablets should be encouraged but not mandated for clinical and educational use. PMID:26645319

  11. 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

  12. Validity, Reliability, and the Questionable Role of Psychometrics in Plastic Surgery

    PubMed Central

    2014-01-01

    Summary: This report examines the meaning of validity and reliability and the role of psychometrics in plastic surgery. Study titles increasingly include the word “valid” to support the authors’ claims. Studies by other investigators may be labeled “not validated.” Validity simply refers to the ability of a device to measure what it intends to measure. Validity is not an intrinsic test property. It is a relative term most credibly assigned by the independent user. Similarly, the word “reliable” is subject to interpretation. In psychometrics, its meaning is synonymous with “reproducible.” The definitions of valid and reliable are analogous to accuracy and precision. Reliability (both the reliability of the data and the consistency of measurements) is a prerequisite for validity. Outcome measures in plastic surgery are intended to be surveys, not tests. The role of psychometric modeling in plastic surgery is unclear, and this discipline introduces difficult jargon that can discourage investigators. Standard statistical tests suffice. The unambiguous term “reproducible” is preferred when discussing data consistency. Study design and methodology are essential considerations when assessing a study’s validity. PMID:25289354

  13. 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.

  14. 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

  15. 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

  16. 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

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

    PubMed

    Mazzoleni, F

    2014-06-30

    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

  18. 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

  19. Cataract Surgery

    MedlinePlus

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

  20. 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

  1. 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

    ... 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... Administration (FDA). The meeting will be open to the public. Name of Committee: General and Plastic...

  2. 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

    ... 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... Administration (FDA). The meeting will be open to the public. Name of Committee: General and Plastic...

  3. 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

    ... 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... Administration (FDA). The meeting will be open to the public. Name of Committee: General and Plastic...

  4. 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

    ... 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... Administration (FDA). The meeting will be open to the public. Name of Committee: General and Plastic...

  5. 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

    ... 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... Administration (FDA). The meeting will be open to the public. Name of Committee: General and Plastic...

  6. 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

    ... 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... Administration (FDA). The meeting will be open to the public. Name of Committee: General and Plastic...

  7. 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

    ... 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... Administration (FDA). The meeting will be open to the public. Name of Committee: General and Plastic...

  8. Patient Safety in Plastic Surgery: Identifying Areas for Quality Improvement Efforts

    PubMed Central

    Hernandez-Boussard, Tina; McDonald, Kathryn M.; Rhoads, Kim F.; Curtin, Catherine M.

    2016-01-01

    Summary Background Improving quality of healthcare is a global priority. Before quality benchmarks are established, we first must understand rates of adverse events. This project assessed risk-adjusted rates of inpatient adverse events for soft tissue reconstructive procedures. Methods Patients receiving soft tissue reconstructive procedures from 2005–2010 were extracted from the Nationwide Inpatient Sample. Inpatient adverse events were identified using patient safety indicators (PSI), established measures developed by Agency for Healthcare Research and Quality. Results We identified 409,991 patient with soft tissue reconstruction and 16,635 (4.06%) had a PSI during their hospital stay. PSIs were associated with increased risk-adjusted mortality, longer length of stay, and decreased routine disposition (p<.01). Patient characteristics associated with a higher risk-adjusted rate per 1,000 patients at risk (RAR) included older age, men, non-white, and public payer (p<.05). Overall, plastic surgery patients had significantly lower RAR compared to other surgical inpatients for all events evaluated except for failure to rescue and postoperative hemorrhage or hematoma, which were not statistically different. RAR of hematoma hemorrhage were significantly higher in patients receiving size-reduction surgery, and these rates were further accentuated when broken down by gender and payer. Conclusions In general, plastic surgery patients had lower rates of in-hospital adverse events than other surgical disciplines, but PSIs were not uncommon. With the establishment of national basal PSI rates in plastic surgery patients, benchmarks can be devised and target areas for quality improvement efforts identified. Further prospective studies should be designed to elucidate the drivers of adverse events identified in this population. PMID:24108144

  9. 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

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Laser surgical instrument for use in general and... Surgical Devices § 878.4810 Laser surgical instrument for use in general and plastic surgery and in dermatology. (a) Identification. (1) A carbon dioxide laser for use in general surgery and in dermatology is...

  10. 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

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Laser surgical instrument for use in general and... Surgical Devices § 878.4810 Laser surgical instrument for use in general and plastic surgery and in dermatology. (a) Identification. (1) A carbon dioxide laser for use in general surgery and in dermatology is...

  11. Caprini Scores, Risk Stratification, and Rivaroxaban in Plastic Surgery: Time to Reconsider Our Strategy

    PubMed Central

    2016-01-01

    Summary: Limited data are available regarding the pathophysiology of venous thromboembolism in plastic surgery patients. In an effort to identify patients at greater risk, some investigators promote individual risk assessment using Caprini scores. However, these scores do not correlate with relative risk values. Affected patients cannot be reliably predicted (97% false positive rate). Caprini scores make many body contouring patients candidates for chemoprophylaxis, an intervention that introduces risks related to anticoagulation. Caprini has financial conflicts with several companies that manufacture products such as enoxaparin, commonly used for chemoprophylaxis. Rivaroxaban, taken orally, has been used by some plastic surgeons as an alternative to enoxaparin injections. However, this medication is not United States Food and Drug Administration approved for venous thromboembolism prophylaxis in plastic surgery patients, and a reversal agent is unavailable. This article challenges the prevailing wisdom regarding individual risk stratification and chemoprophylaxis. Alternative methods to reduce risk for all patients include safer anesthesia methods and Doppler ultrasound surveillance. Clinical findings alone are unreliable in diagnosing deep venous thromboses. Only by using a reliable diagnostic tool such as Doppler ultrasound are we able to learn more about the natural history of this problem in our patients. Such knowledge is likely to better inform our treatment recommendations. PMID:27482481

  12. Caprini Scores, Risk Stratification, and Rivaroxaban in Plastic Surgery: Time to Reconsider Our Strategy.

    PubMed

    Swanson, Eric

    2016-06-01

    Limited data are available regarding the pathophysiology of venous thromboembolism in plastic surgery patients. In an effort to identify patients at greater risk, some investigators promote individual risk assessment using Caprini scores. However, these scores do not correlate with relative risk values. Affected patients cannot be reliably predicted (97% false positive rate). Caprini scores make many body contouring patients candidates for chemoprophylaxis, an intervention that introduces risks related to anticoagulation. Caprini has financial conflicts with several companies that manufacture products such as enoxaparin, commonly used for chemoprophylaxis. Rivaroxaban, taken orally, has been used by some plastic surgeons as an alternative to enoxaparin injections. However, this medication is not United States Food and Drug Administration approved for venous thromboembolism prophylaxis in plastic surgery patients, and a reversal agent is unavailable. This article challenges the prevailing wisdom regarding individual risk stratification and chemoprophylaxis. Alternative methods to reduce risk for all patients include safer anesthesia methods and Doppler ultrasound surveillance. Clinical findings alone are unreliable in diagnosing deep venous thromboses. Only by using a reliable diagnostic tool such as Doppler ultrasound are we able to learn more about the natural history of this problem in our patients. Such knowledge is likely to better inform our treatment recommendations. PMID:27482481

  13. 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

  14. 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

  15. 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

  16. Evidence-based Medicine in Facial Plastic Surgery: Current State and Future Directions.

    PubMed

    Dedhia, Raj; Hsieh, Tsung-Yen; Tollefson, Travis T; Ishii, Lisa E

    2016-08-01

    Evidence-based medicine (EBM) encompasses the evaluation and application of best available evidence, incorporation of clinical experience, and emphasis on patient preference and values. Different scales are used to rate levels of evidence. Translating available data for interventions to clinical practice guidelines requires an assessment of both the quality of evidence and the strength of recommendation. Essential to the practice of EBM is evaluating the effectiveness of an intervention through outcome measures. This article discusses principles essential to EBM, resources commonly used in EBM practice, and the strengths and limitations of EBM in facial plastic and reconstructive surgery. PMID:27400841

  17. [Factitious disorder and self-mutilation in hand and plastic surgery].

    PubMed

    Sproedt, J; von Campe, A; Bonaccio, M; Grünert, J G

    2010-02-01

    Self-mutilation in the context of factitious disorder can lead to prolonged and complicated treatment in every medical field. Because of a prevalence of 1-5% in hospitalised patients, it is important to be aware of this disorder to protect patients from self- and foreign-induced harm. Often the patient history gives important hints. The different manifestations of this disorder, the specific doctor-patient relationship, several techniques of confrontation and current treatment are presented. Clinical cases from the fields of hand and plastic surgery are presented. PMID:20205067

  18. 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

  19. 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

  20. 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

  1. An Evidence-Based Medicine Curriculum Improves General Surgery Residents' Standardized Test Scores in Research and Statistics

    PubMed Central

    Trickey, Amber W.; Crosby, Moira E.; Singh, Monika; Dort, Jonathan M.

    2014-01-01

    Background The application of evidence-based medicine to patient care requires unique skills of the physician. Advancing residents' abilities to accurately evaluate the quality of evidence is built on understanding of fundamental research concepts. The American Board of Surgery In-Training Examination (ABSITE) provides a relevant measure of surgical residents' knowledge of research design and statistics. Objective We implemented a research education curriculum in an independent academic medical center general residency program, and assessed the effect on ABSITE scores. Methods The curriculum consisted of five 1-hour monthly research and statistics lectures. The lectures were presented before the 2012 and 2013 examinations. Forty residents completing ABSITE examinations from 2007 to 2013 were included in the study. Two investigators independently identified research-related item topics from examination summary reports. Correct and incorrect responses were compared precurriculum and postcurriculum. Regression models were calculated to estimate improvement in postcurriculum scores, adjusted for individuals' scores over time and postgraduate year level. Results Residents demonstrated significant improvement in postcurriculum examination scores for research and statistics items. Correct responses increased 27% (P < .001). Residents were 5 times more likely to achieve a perfect score on research and statistics items postcurriculum (P < .001). Conclusions Residents at all levels demonstrated improved research and statistics scores after receiving the curriculum. Because the ABSITE includes a wide spectrum of research topics, sustained improvements suggest a genuine level of understanding that will promote lifelong evaluation and clinical application of the surgical literature. PMID:26140115

  2. 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

  3. Body image, psychosocial functioning, and personality: how different are adolescents and young adults applying for plastic surgery?

    PubMed

    Simis, K J; Verhulst, F C; Koot, H M

    2001-07-01

    This study addressed three questions: (1) Do adolescents undergoing plastic surgery have a realistic view of their body? (2) How urgent is the psychosocial need of adolescents to undergo plastic surgery? (3) Which relations exist between bodily attitudes and psychosocial functioning and personality? From 1995 to 1997, 184 plastic surgical patients aged 12 to 22, and a comparison group of 684 adolescents and young adults from the general population aged 12 to 22 years, and their parents, were interviewed and completed questionnaires and standardised rating scales. Adolescents accepted for plastic surgery had realistic appearance attitudes and were psychologically healthy overall. Patients were equally satisfied with their overall appearance as the comparison group, but more dissatisfied with the specific body parts concerned for operation, especially when undergoing corrective operations. Patients had measurable appearance-related psychosocial problems. Patient boys reported less self-confidence on social areas than all other groups. There were very few patient-comparison group differences in correlations between bodily and psychosocial variables, indicating that bodily attitudes and satisfaction are not differentially related to psychosocial functioning and self-perception in patients than in peers. We concluded that adolescents accepted for plastic surgery have considerable appearance-related psychosocial problems, patients in the corrective group reporting more so than in the reconstructive group. Plastic surgeons may assume that these adolescents in general have a realistic attitude towards their appearance. are psychologically healthy, and are mainly dissatisfied about the body parts concerned for operation. corrective patients more so than reconstructive patients. Introverted patients may need more attention from plastic surgeons during the psychosocial assessment. PMID:11464971

  4. Eugène Apert and his Contributions to Plastic Surgery

    PubMed Central

    Lee, Dennis S.; Chung, Kevin C.

    2015-01-01

    French pediatrician Eugène Apert is best known for his 1906 description of the eponymous Apert’s Syndrome: the widely recognized congenital condition that is known as acrocephalosyndactyly, which is characterized by distinct craniofacial deformities and bilateral syndactyly of the hands and feet. Subsequent efforts to study and treat this condition have led to contributions from numerous medical and surgical specialties under the guidance of plastic surgery. Apert’s influence on medicine, however, extends far beyond what can be appreciated by the impact of his eponymous syndrome. Considered one of France’s eminent pediatricians, Apert additionally made important contributions to the study of adult diseases. He was also a founding member of the French Eugenics Society, serving as its secretary general and president in a tenure that lasted for most of his career. Apert’s medical contributions within the context of this scientific ideology make him an important and potentially controversial figure in medicine. PMID:20179491

  5. The performance and publication of cost-utility analyses in plastic surgery: Making our specialty relevant

    PubMed Central

    Thoma, Achilleas; Ignacy, Teegan A; Ziolkowski, Natalia; Voineskos, Sophocles

    2012-01-01

    Increased spending and reduced funding for health care is forcing decision makers to prioritize procedures and redistribute funds. Decision making is based on reliable data regarding the costs and benefits of medical and surgical procedures; such a study design is known as an economic evaluation. The onus is on the plastic surgery community to produce high-quality economic evaluations that support the cost effectiveness of the procedures that are performed. The present review focuses on the cost-utility analysis and its role in deciding whether a novel technique/procedure/technology should be accepted over one that is prevalent. Additionally, the five steps in undertaking a cost-utility (effectiveness) analysis are outlined. PMID:23997587

  6. 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

  7. Registries and evidence-based medicine in craniofacial and plastic surgery.

    PubMed

    Drolet, Brian C; Lorenzi, Nancy M

    2012-01-01

    Evidence-based medicine is a vital process for maintaining and improving quality and value in health care. However, evidence-based practice is most limited by the availability of research and outcomes data. Although randomized controlled trials (RCTs) have been identified by numerous research organizations as the criterion standard for research methodology (eg, "level I evidence"), the execution of well-designed RCTs has proved either challenging or impossible in many surgical fields and with rare disease conditions. In particular, craniofacial and plastic surgery has been noted to be lacking in both the number and quality of RCTs. Many reasons are discussed for this dearth of research including inadequate sample size and challenges in randomization, blinding, and clinical equipoise. Yet, data for outcomes assessment are highly valued by surgeons and by consumers and payers. Therefore, alternative and more practical means for research and data collection must be sought. Observational studies of clinical practice are particularly useful for outcomes assessment despite relegation to a lower tier of evidence (eg, "level II evidence"). Functional databases with well-defined processes for data collection, called medical data registries, are an essential informatics tool to collect and store outcomes data and produce high-quality observational, practice-based research studies. A properly designed and implemented registry can provide surgeons with an abundance of data to perform research and quality improvement projects. In fact, registries may be superior in many ways to RCTs for craniofacial and plastic surgeons both pragmatically and functionally. In this commentary, we discuss the production of such registries in the framework of evidence-based practice and the relevant studies in craniofacial surgery. PMID:22337430

  8. [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

  9. [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

  10. 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…

  11. 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

    ... was announced in the Federal Register of November 17, 2009 (74 FR 59194). The amendment is being made... INFORMATION: In FR Doc. E9-27491, appearing on page 59194, in the Federal Register of Tuesday, November 17... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the...

  12. Plastic Surgery and Acellular Dermal Matrix: Highlighting Trends from 1999 to 2013

    PubMed Central

    Daar, David A; Gandy, Jessica R; Clark, Emily G; Mowlds, Donald S; Paydar, Keyianoosh Z; Wirth, Garrett A

    2016-01-01

    The last decade has ushered in a rapidly expanding global discussion regarding acellular dermal matrix (ADM) applications, economic analyses, technical considerations, benefits, and risks, with recent emphasis on ADM use in breast surgery. This study aims to evaluate global trends in ADM research using bibliometric analysis. The top nine Plastic Surgery journals were determined by impact factor (IF). Each issue of the nine journals between 1999 and 2013 was accessed to compile a database of articles discussing ADM. Publications were further classified by IF, authors’ geographic location, study design, and level of evidence (LOE, I-V). Productivity index and productivity share were calculated for each region. In total, 256 ADM articles were accessed. The annual global publication volume increased significantly by 4.2 (0.87) articles per year (p<0.001), with a mean productivity index of 36.3 (59.0). The mean impact factor of the nine journals increased significantly from 0.61 (0.11) to 2.47 (0.99) from 1993 to 2013 (p<0.001). Despite this increase in the global ADM literature, the majority of research was of weaker LOE (level I: 2.29% and level II: 9.17%). USA contributed the most research (87%), followed by Asia (4.76%) and Western Europe (4.71%). USA contributed the greatest volume of research. Regarding clinical application of ADM, the majority of publications focused on ADM use in breast surgery, specifically breast reconstruction (154 articles, 60.2%). The majority of research was of lower LOE; thus, efforts should be made to strengthen the body of literature, particularly with regard to cost analysis. PMID:27579264

  13. Plastic Surgery and Acellular Dermal Matrix: Highlighting Trends from 1999 to 2013.

    PubMed

    Daar, David A; Gandy, Jessica R; Clark, Emily G; Mowlds, Donald S; Paydar, Keyianoosh Z; Wirth, Garrett A

    2016-05-01

    The last decade has ushered in a rapidly expanding global discussion regarding acellular dermal matrix (ADM) applications, economic analyses, technical considerations, benefits, and risks, with recent emphasis on ADM use in breast surgery. This study aims to evaluate global trends in ADM research using bibliometric analysis. The top nine Plastic Surgery journals were determined by impact factor (IF). Each issue of the nine journals between 1999 and 2013 was accessed to compile a database of articles discussing ADM. Publications were further classified by IF, authors' geographic location, study design, and level of evidence (LOE, I-V). Productivity index and productivity share were calculated for each region. In total, 256 ADM articles were accessed. The annual global publication volume increased significantly by 4.2 (0.87) articles per year (p<0.001), with a mean productivity index of 36.3 (59.0). The mean impact factor of the nine journals increased significantly from 0.61 (0.11) to 2.47 (0.99) from 1993 to 2013 (p<0.001). Despite this increase in the global ADM literature, the majority of research was of weaker LOE (level I: 2.29% and level II: 9.17%). USA contributed the most research (87%), followed by Asia (4.76%) and Western Europe (4.71%). USA contributed the greatest volume of research. Regarding clinical application of ADM, the majority of publications focused on ADM use in breast surgery, specifically breast reconstruction (154 articles, 60.2%). The majority of research was of lower LOE; thus, efforts should be made to strengthen the body of literature, particularly with regard to cost analysis. PMID:27579264

  14. 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

  15. 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

  16. Esthetic impact of gingival plastic surgery from the dentistry students’ perspective

    PubMed Central

    Ayyildiz, Erdem; Tan, Enes; Keklik, Hakan; Demirtag, Zulfikar; Celebi, Ahmet Arif; Pithon, Matheus Melo

    2016-01-01

    Objective: The aim of the this study was to evaluate the perception of smile esthetics and alterations in cases of gingival plastic surgery for correction of a gummy smile, by means of alterations in smile photograph among dentistry degree students. Materials and Methods: A frontal smile photograph of a 40-year-old woman having normal occlusion was used with diverse compositions of gingival exposure level and crown length of maxillary teeth. The eight photographs were evaluated by 216 dentistry students in five class groups (1st, 2nd, 3rd, 4th and 5th classes). Results: The results revealed that almost all of the class’ students perceived differences between images, additionally, the highest percentage of students that answered “no difference” was 12% at 1st class’ students. 1st and 2nd class’ students most liked photograph which is 2.5 mm gingival display and 3rd class students liked two different photographs which are 2.5 mm gingival display and 2 mm gingival display whereas 4th class students preferred two different photographs which are 1.5 mm gingival display and 1 mm gingival display, 5th class students preferred photograph which is 1.5 mm gingival display as the most. Conclusion: Esthetic perception of smile improve as a student passes to higher study classes in terms of gingival exposure. The harmonious display of gingiva exhibits an important effect in the smile esthetics rather than reduced or excessive display. PMID:27403061

  17. The presentation of plastic surgery visual data from 1816 to 1916: The evolution of reproducible results.

    PubMed

    Freshwater, M Felix

    2016-09-01

    All scientific data should be presented with sufficient accuracy and precision so that they can be both analyzed properly and reproduced. Visual data are the foundation upon which plastic surgeons advance knowledge. We use visual data to achieve reproducible results by discerning details of procedures and differences between pre- and post-surgery images. This review highlights how the presentation of visual data evolved from 1816, when Joseph Carpue published his book on nasal reconstruction to 1916, when Captain Harold Gillies began to treat over 2000 casualties from the Battle of the Somme. It shows the frailties of human nature that led some authors such as Carl von Graefe, Joseph Pancoast and Thomas Mutter to record inaccurate methods or results that could not be reproduced, and what measures other authors such as Eduard Zeis, Johann Dieffenbach, and Gurdon Buck took to affirm the accuracy of their results. It shows how photography gradually supplanted illustration as a reference standard. Finally, it shows the efforts that some authors and originators took to authenticate and preserve their visual data in what can be considered the forerunners of clinical registries. PMID:27453409

  18. 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

  19. [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

  20. LASIK - Laser Eye Surgery

    MedlinePlus

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

  1. What Is Refractive Surgery?

    MedlinePlus

    ... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy Publications EyeNet Ophthalmology ... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Find an Ophthalmologist Advanced ...

  2. 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

  3. 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

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

    PubMed

    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

  5. Course Review: North East Microsurgery Training Course and Workshop: A New Two Day Microsurgery Course for Trainees in Plastic Surgery, Otolaryngology and Oral and Maxillofacial Surgery.

    PubMed

    Honeyman, Calum Sinclair

    2016-09-01

    Undertaking a microsurgical course is a key adjunct to trainee development in plastic surgery, otololaryngology and oral and maxillofacial surgery. Traditionally, these courses last approximately 5 days and can cost upward of US $2000 (£1500).The North East Microsurgery Training Course and Workshop is a new 2-day course costing just US $760 (£500). This course was set up in 2015 by reconstructive microsurgeon Mr Maniram Ragbir at the Freeman Hospital in Newcastle, England.The aim of the course is provide maximum hands-on experience in microsurgery for surgical trainees interested in relevant specialties under close supervision of experienced consultant faculty. It is a must for younger trainees learning microsurgery or more senior trainees looking to improve their skills. PMID:26835827

  6. 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

  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. “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

  9. 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

  10. A brief history of the development of plastic surgery in The Netherlands East-Indies from World War I until the independence of Indonesia (1914-1950).

    PubMed

    Haeseker, B

    1990-05-01

    This study of surgical operations published in the Medical Journal of the Netherlands East-Indies over the period 1914-1950, supplemented with a series of interviews with retired Dutch East-Indian surgeons and their relatives, shows a vivid interest in plastic surgery from World War I until the independence of Indonesia. One can conclude that plastic surgery was performed more frequently and on a larger scale than in Holland, due to a larger number of patients, specific tropical pathology and often a longer patient delay, requiring extensive reconstructive procedures. The East-Indian publications on plastic surgical topics outnumber the Dutch ones enormously. PMID:2190665

  11. 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

  12. 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.

  13. 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

  14. 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

  15. 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

  16. 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

  17. Multiaxial mechanical properties and constitutive modeling of human adipose tissue: a basis for preoperative simulations in plastic and reconstructive surgery.

    PubMed

    Sommer, Gerhard; Eder, Maximilian; Kovacs, Laszlo; Pathak, Heramb; Bonitz, Lars; Mueller, Christoph; Regitnig, Peter; Holzapfel, Gerhard A

    2013-11-01

    A preoperative simulation of soft tissue deformations during plastic and reconstructive surgery is desirable to support the surgeon's planning and to improve surgical outcomes. The current development of constitutive adipose tissue models, for the implementation in multilayer computational frameworks for the simulation of human soft tissue deformations, has proved difficult because knowledge of the required mechanical parameters of fat tissue is limited. Therefore, for the first time, human abdominal adipose tissues were mechanically investigated by biaxial tensile and triaxial shear tests. The results of this study suggest that human abdominal adipose tissues under quasi-static and dynamic multiaxial loadings can be characterized as a nonlinear, anisotropic and viscoelastic soft biological material. The nonlinear and anisotropic features are consequences of the material's collagenous microstructure. The aligned collagenous septa observed in histological investigations causes the anisotropy of the tissue. A hyperelastic model used in this study was appropriate to represent the quasi-static multiaxial mechanical behavior of fat tissue. The constitutive parameters are intended to serve as a basis for soft tissue simulations using the finite element method, which is an apparent method for obtaining promising results in the field of plastic and reconstructive surgery. PMID:23811521

  18. Level of billing as a function of resident documentation and orthopedic subspecialty at an academic multispecialty orthopedic surgery practice.

    PubMed

    Dezfuli, Bobby; Smith, Jordan L

    2012-11-01

    Documentation, coding, and billing for physician-patient encounters have evolved over time and have significant variability. Appropriate and complete documentation of these encounters can contribute to the financial viability of private and academic medical centers. The objectives of this study were to assess the financial effect of documentation on billing and to compare the authors' institution's distribution of billing level compared with Medicare normative data. Four orthopedic surgery subspecialty clinics were evaluated at a university outpatient clinic over a 1-year period. A single full-day clinic per week was used for each subspecialty. Residents dictated the majority of the reports. All reports were transcribed by medical transcriptionists and coded by certified professional coders. The sports medicine subspecialty generated the highest volume of patient clinic visits, followed by foot and ankle, trauma, and spine (P<.01). The majority of the reports were billed at level 3 (P<.05). Significant differences existed between subspecialty and percentage distribution of billing level (P<.05). Compared with Medicare normative data, a significantly greater percentage of level 3 reports and a lower percentage of level 2 and 4 reports existed in the orthopedic practice (P<.01). The estimated loss of revenue from the fewer level 4 reports was $81,281.11 for 1 year. These findings highlight the need for greater educational interventions to improve provider documentation, coding, and billing. The effect of new electronic medical record systems that prompt providers to include key evaluation and management components will likely affect practices and warrant further analysis. PMID:23127460

  19. 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

  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. 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

  2. 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)

  3. 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

  4. 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

  5. Plastic paradise: transforming bodies and selves in Costa Rica's cosmetic surgery tourism industry.

    PubMed

    Ackerman, Sara L

    2010-10-01

    Long popular as a nature tourism destination, Costa Rica has recently emerged as a haven for middle class North Americans seeking inexpensive, state-of-the-art cosmetic surgery. This paper examines "cosmetic surgery tourism" in Costa Rica as a form of medicalized leisure, situated in elite private spaces and yet inextricably linked to a beleaguered national medical program. Through historical context and ethnographic analysis of activities at medical hotels and clinics, I describe how the recovery industry operates on the embodied subjectivities of visiting patients and their local caretakers. Recovery sociality and healing landscapes facilitate patients' transition through a period of post-surgical liminality and provide nostalgic transport to an imagined medical arcadia, while clinicians are attracted by a neoliberal promise of prosperity and autonomy. Ultimately, Costa Rica's transformation into a paradise of medical consumption and self-optimization is contingent on a mythology that obscures growing uncertainties and inequities in the nation's broader medical landscape. PMID:21082485

  6. Google Glass in the Operating Room: The Plastic Surgeon's Perspective.

    PubMed

    Sinkin, Jeremy C; Rahman, Omar F; Nahabedian, Maurice Y

    2016-07-01

    New technologies and innovations are common in the delivery of modern health care. Google Glass is one such device gaining increased attention in medical specialties. The authors surveyed residents and attending physicians in the Department of Plastic Surgery, MedStar Georgetown University Hospital, on their experience using Google Glass in the operating room. Ease of use, quality of images, gaze disruption, and distraction during surgery were measured. Overall, subjects found the device to be comfortable and satisfying to wear and use during surgery to capture images of good quality. Despite some identified weaknesses, Google Glass is a unique technology with a promising plastic surgical application in the operating room. PMID:27348661

  7. 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

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

    PubMed Central

    Laub, Donald R.

    2015-01-01

    Abstract 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

  9. 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

  10. 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

  11. 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

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

    PubMed

    Steinman, Howard K; Clever, Henry; Dixon, Anthony

    2016-04-01

    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

  13. Cosmetic ear surgery

    MedlinePlus

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... 31. Thorne CH. Otoplasty. In: Neligan PC, ed. Plastic Surgery . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap ...

  14. Mastoid emissary vein: anatomy and clinical relevance in plastic & reconstructive surgery.

    PubMed

    Kim, Leo K P; Ahn, Chris S; Fernandes, Antonio E L

    2014-06-01

    The mastoid emissary vein (MEV) is an anatomical structure with limited description in the literature and its importance is even less recognized in the plastic surgical field. Investigations in its anatomy and physiology have described its anthropological significance in transition to bipedalism and preferential intracranial venous flow into the vertebral plexus in the upright man. Inadvertant injury of vessels of this size pose a significant problem due not only to difficulty with haemostasis but also from their bidirectional flow and close proximity to the sigmoid sinus where cases of thromboembolism have been described. Recognition of this common anatomical structure and how to manage bleeding from the vessel it is important for the surgeon operating in this area and even more so for the craniofacial surgeon who operates on complex craniosynostotic patients where the MEV may be the sole dominant drainage pathway of the brain. We conducted a study on 106 cadaveric dry skull specimens looking at the incidence, position and caliber of mastoid emissary foramina. 83.7% of skulls were found to have at least one foramen with a mean diameter of 1.64 mm and the largest specimen measuring 7 mm. PMID:24713148

  15. 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.

  16. 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

  17. 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.

  18. Trends in ophthalmology resident surgical experience from 2009 to 2015

    PubMed Central

    Chadha, Nisha; Liu, Ji; Maslin, Jessica S; Teng, Christopher C

    2016-01-01

    Background Resident procedure minimums have been established in surgical training programs to ensure adequate training experience. However, achievement of these minimums may fluctuate. Review of resident experience is essential for maintaining successful training curricula. Objective To evaluate trends in ophthalmology resident surgical experience from 2009 to 2015. Methods This was a database study reviewing Accreditation Council for Graduate Medical Education ophthalmology resident surgical case logs. Case logs from 2,797 US ophthalmology residents were reviewed for trends in average surgical cases performed by residents as primary surgeon in the area of cataract, cornea, retina, glaucoma, pediatrics, plastics, and trauma from 2009 to 2015. Results Significant trends in resident surgical experience were demonstrated in the areas of cataract, retina, and glaucoma, while experience in cornea, pediatrics, plastics, and trauma remained stable. These trends included an increase in average cases of phacoemulsification cataract surgery from 143.8 to 173.6, vitreous tap/inject procedures from 31.3 to 93.1, and glaucoma shunt surgery from 4.5 to 6.7, with a decline in average cases of nonphacoemulsification cataract surgery from 3.8 to 2.2, retinal photocoagulation from 59.6 to 45.5, and filtering surgery from 6 to 4.5. Conclusion Trends in ophthalmology surgical experience in cataract, retina, and glaucoma paralleled new surgical or therapeutic developments as well as practice pattern shifts in these fields. Educators should be cognizant of the impact of such trends on resident experience and determine if curricular adjustments should be made to maintain comprehensive education of physicians-in-training. PMID:27418803

  19. Resident and Faculty Perceptions of Program Strengths and Opportunities for Improvement: Comparison of Site Visit Reports and ACGME Resident Survey Data in 5 Surgical Specialties.

    PubMed

    Caniano, Donna A; Yamazaki, Kenji; Yaghmour, Nicholas; Philibert, Ingrid; Hamstra, Stanley J

    2016-05-01

    Background Resident and faculty views of program strengths and opportunities for improvement (OFIs) offer insight into how stakeholders assess key elements of the learning environment. Objective This study sought (1) to assess the degree to which residents and faculty in 359 programs in 5 surgical specialties (obstetrics and gynecology, orthopaedic surgery, otolaryngology, plastic surgery, and surgery) were aligned or divergent in their respective views of program strengths and OFIs; and (2) to evaluate whether responses to selected questions on the Accreditation Council for Graduate Medical Education (ACGME) Resident Survey correlated with strengths or OFIs identified by the residents during the site visit. Methods Faculty and resident lists of program strengths and OFIs in site visit reports for 2012 and 2013 were aggregated, analyzed, and compared to responses on the Resident Survey. Results While there was considerable alignment in resident and faculty perceptions of program strengths and OFIs, some attributes were more important to one or the other group. Collegiality was valued highly by both stakeholder groups. Responses to 2 questions on the ACGME Resident Survey were associated with resident-identified OFIs in site visit reports pertaining to aspects of the didactic program and responsiveness to resident suggestions for improvement. Conclusions The findings offer program leadership additional insight into how 2 key stakeholder groups view elements of the learning environment as program strengths or OFIs and may serve as useful focal areas for ongoing improvement activities. PMID:27168915

  20. American Society of Plastic Surgeons

    MedlinePlus

    ... doctor who is a member of the American Society of Plastic Surgeons (ASPS®), you can rest assured ... ASPS The Plastic Surgery Foundation Copyright © 2016 American Society of Plastic Surgeons | Privacy Policy | Sitemap | Terms and ...

  1. Periodontal plastic surgery.

    PubMed

    Zucchelli, Giovanni; Mounssif, Ilham

    2015-06-01

    The aim of the present article is to summarize current knowledge in terms of the etiology, diagnosis, prognosis and surgical treatment of gingival recession. Whilst the main etiological factors (i.e. toothbrushing trauma and bacterial plaque) are well established, challenges still remain to be solved in the diagnostic, prognostic and classification processes of gingival recession, especially when the main reference parameter - the cemento-enamel junction - is no longer detectable on the affected tooth or when there is a slight loss of periodontal interdental attachment. Root coverage in single type gingival recession defects is a very predictable outcome following the use of various surgical techniques. The coronally advanced flap, with or without connective tissue grafting, is the technique of choice. The adjunctive use of connective tissue grafts improves the probability of achieving complete root coverage. Surgical coverage of multiple gingival recessions is also predictable with the coronally advanced flap and the coronally advanced flap plus the connective tissue graft, but no data are available indicating which, and how many, gingival recessions should be treated adjunctively with connective tissue grafting in order to limit patient morbidity and improve the esthetic outcome. None of the allograft materials currently available can be considered as a full substitute for the connective tissue graft, even if some recent results are encouraging. The need for future studies with patient-based outcomes (i.e. esthetics and morbidity) as primary objectives is emphasized in this review. PMID:25867992

  2. Periodontal Plastic Surgery Procedures

    MedlinePlus

    ... Classified Ads Member Directory Find a Periodontist Update Form Professional Education Networking Opportunities AAP Resource Programs Organization Information AAP Committees and Task Forces AAP Volunteer ...

  3. Plastic and Cosmetic Surgery

    MedlinePlus

    ... size of large ears 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 Nose: ...

  4. 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

  5. [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

  6. 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

  7. Otolaryngology residency and fellowship training. The resident's perspective.

    PubMed

    Miller, R H

    1994-10-01

    Based on the success rate of US otolaryngology graduates on the American Board of Otolaryngology Certification Examination, it would appear that otolaryngology training is quite good. However, it is not clear that all aspects of training are equal in quality, not only between programs but also within a single program. One indication that there may be areas of weakness is the fact that despite the perceived national shortages of primary care physicians in the United States and the overabundance of specialists, 25% of the approximately 260 graduating otolaryngology residents extend their training beyond specialty training to subspecialty levels (Manpower Committee of the American Academy of Otolaryngology-Head and Neck Surgery, unpublished data obtained from chief resident questionnaires, 1990-1992). The most popular area of fellowship training is facial plastic surgery, followed by neurotology and head and neck oncology. Pediatric otolaryngology fellowships make up most of the balance. Most of the fellowships are well structured and are 1 year in duration. Others are more like apprenticeships and may be of shorter duration. A few are 2 years long and include a significant research commitment reserved for individuals entering academic practice. PMID:7917188

  8. Breast augmentation surgery

    MedlinePlus

    ... the shape of your breasts. Talk with a plastic surgeon if you are considering breast augmentation. Discuss ... mammograms or breast x-rays before surgery. The plastic surgeon will do a routine breast exam. Several ...

  9. A Randomized Controlled Trial of Skin Care Protocols for Facial Resurfacing: Lessons Learned from the Plastic Surgery Educational Foundation’s Skin Products Assessment Research Study

    PubMed Central

    Pannucci, Christopher J.; Reavey, Patrick L.; Kaweski, Susan; Hamill, Jennifer B.; Hume, Keith M.; Wilkins, Edwin G.; Pusic, Andrea L.

    2011-01-01

    Background The Skin Products Assessment Research (SPAR) Committee was created by the Plastic Surgery Educational Foundation (PSEF) in 2006. SPAR study aims were to (1) develop an infrastructure for PSEF-conducted, industry sponsored research in facial aesthetic surgery and (2) test the research process by comparing outcomes of the Obagi Nu-Derm System (ONDS) versus conventional therapy as treatment adjuncts for facial resurfacing procedures. Methods The SPAR study was designed as a multi-center, double-blind, randomized controlled trial (RCT). The study was conducted in women with Fitzpatrick type I-IV skin, moderate to severe facial photo damage, and peri-ocular and/or peri-oral fine wrinkles. Patients underwent chemical peel or laser facial resurfacing and were randomized to ONDS or a standard care regimen. The study endpoints were time to re-epithelization, erythema, and pigmentation changes. Results Fifty-six women were enrolled and 82% were followed beyond re-epithelization. There were no significant differences in mean time to re-epithelialization between ONDS and control groups. The ONDS group had a significantly higher median erythema score on day of surgery (after 4 weeks of product use) which did not persist after surgery. Test-retest photo evaluations demonstrated that both inter- and intra-rater reliability were adequate for primary study outcomes. Conclusions In a clinical RCT, we demonstrated no significant difference in time to re-epithelization between patients who used the ONDS or a standard care regimen as an adjunct to facial resurfacing procedures. The SPAR research team has also provided a discussion of future challenges for PSEF sponsored clinical research for readers of this article. PMID:21364435

  10. [Artificial ossification of muscular flap after plastic surgery of the bone cavity under the effect of electric current].

    PubMed

    Tkachenko, S S; Mussa, M; Rutskiĭ, V V

    1978-03-01

    Experiments in rabbits revealed that transplantation of a muscular flap on the central feeding pedicle in the tibis medullary canal and its electro-stimulation with direct microelectric current of 18-20 muA with the alternating polarity speeded up the process of reorganization of the muscular flap in the depth of which new osseous tissue was forming. Electrostimulation of osteogenesis in case of the muscular plastic transplantation promotes restoration of the anatomic integrity of the bone. PMID:667330

  11. A Fast-Track Referral System for Skin Lesions Suspicious of Melanoma: Population-Based Cross-Sectional Study from a Plastic Surgery Center

    PubMed Central

    Hansen, Lone Bak

    2016-01-01

    Introduction. To minimize delay between presentation, diagnosis, and treatment of cutaneous melanoma (CM), a national fast-track referral system (FTRS) was implemented in Denmark. The aim of this study was to analyze the referral patterns to our department of skin lesions suspicious of melanoma in the FTRS. Methods. Patients referred to the Department of Plastic Surgery and Breast Surgery in Zealand University Hospital were registered prospectively over a 1-year period in 2014. A cross-sectional study was performed analyzing referral patterns, including patient and tumor characteristics. Results. A total of 556 patients were registered as referred to the center in the FTRS for skin lesions suspicious of melanoma. Among these, a total of 312 patients (56.1%) were diagnosed with CM. Additionally, 41 (7.4%) of the referred patients were diagnosed with in situ melanoma. Conclusion. In total, 353 (63.5%) patients had a malignant or premalignant melanocytic skin lesion. When only considering patients who where referred without a biopsy, the diagnostic accuracy for GPs and dermatologists was 29% and 45%, respectively. We suggest that efforts of adequate training for the referring physicians in diagnosing melanocytic skin lesions will increase diagnostic accuracy, leading to larger capacity in secondary care for the required treatment of malignant skin lesions. PMID:27525117

  12. 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

  13. Melting the Plastic Ceiling: Overcoming Obstacles to Foster Leadership in Women Plastic Surgeons.

    PubMed

    Silva, Amanda K; Preminger, Aviva; Slezak, Sheri; Phillips, Linda G; Johnson, Debra J

    2016-09-01

    The underrepresentation of women leaders in plastic surgery echoes a phenomenon throughout society. The importance of female leadership is presented, and barriers to gender equality in plastic surgery, both intrinsic and extrinsic, are discussed. Strategies for fostering women in leadership on an individual level and for the specialty of plastic surgery are presented. PMID:27556609

  14. 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

  15. Gaspare Tagliacozzi, pioneer of plastic surgery and the spread of his technique throughout Europe in "De Curtorum Chirurgia per Insitionem".

    PubMed

    Tomba, P; Viganò, A; Ruggieri, P; Gasbarrini, A

    2014-01-01

    Gaspare Tagliacozzi's innovative surgical technique, which consisted of reconstructing parts of the face by grafting, was masterfully described in the work that made him famous, "De Curtorum Chirurgia per Insitionem." It was published by Gaspare Bindoni the Younger in 1597 in Venice, who was granted the exclusive right to print it by the Senate. However, in the same year in Venice Roberto Meietti published an unauthorized edition; nevertheless, this edition was soon discovered. The great demand for the text even abroad was soon testified by a 3rd edition published in Frankfurt in 1598, similar to the Bindoni edition but in another format and with a different title. This has caused confusion among bibliographers and Authors. Two centuries later, in 1831 in Berlin, a 4th edition was printed, thus suggesting renewed interest in rhinoplasty procedures, which surgeons Van Graefe and Dieffenbach promoted in Germany. However, few people know that the integral text of Tagliacozzi's De Curtorum was also published by Jacques Manget in his "Bibliotheca Chirurgica," printed in Venice in 1721. The name of the illustrator of the three fourteenth-century editions, whose illustrations in the text are compared, is not known. Instead the name of the artist, Tiburzio Passerotti, who painted Tagliacozzi's portrait holding his De Curtorum open at the ninth woodcut shortly before it was printed, is well known. The impact of Tagliacozzi's technique on modern surgery is supported by experience of the last century as well as recent years, mostly in musculoskeletal oncology reconstruction. PMID:24610608

  16. 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

  17. 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

  18. 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…

  19. Resident recruitment.

    PubMed

    Longmaid, H Esterbrook

    2003-02-01

    This article has introduced the reader to the critical components of successful recruitment of radiology residents. With particular attention to the ACGME institutional and program requirements regarding resident recruitment, and an explanation of the support systems (ERAS and NRMP) currently available to those involved in applicant review and selection, the article has sought to delineate a sensible approach to recruitment. Successful recruiters have mastered the essentials of these programs and have learned to adapt the programs to their needs. As new program directors work with their departments' resident selection committees, they will identify the factors that faculty and current residents cite as most important in the successful selection of new residents. By structuring the application review process, exploiting the power of the ERAS, and crafting a purposeful and friendly interview process, radiology residency directors can find and recruit the residents who best match their programs. PMID:12585436

  20. Awareness among medical fraternity regarding the role of plastic surgeon

    PubMed Central

    Kumar, Vijay; Singh, Arun Kumar; Faisal, Ameer; Nandini, R.

    2011-01-01

    The field of plastic surgery, while being famous for aesthetic surgery, also includes craniofacial surgery, hand surgery, burn surgery, microsurgery, reconstructive plastic surgery and paediatric plastic surgery. The magnanimous progress in these areas, though a hot topic in conferences, remains cryptic to the layman and also to generalists who are and will remain to be the most important referral source of these patients.[1] Hence, it becomes the duty of plastic surgeons themselves to spread awareness regarding their chosen field of endeavour. PMID:22279287

  1. Laparoscopic Colorectal Training Gap in Colorectal and Surgical Residents

    PubMed Central

    Soliman, Mark; Williamson, Paul; Ferrara, Andrea

    2016-01-01

    Background and Objectives: Laparoscopic colorectal surgery is an established safe procedure with demonstrated benefits. Proficiency in this specialty correlates with the volume of cases. We examined training in this surgical field for both general surgery and colon and rectal surgery residents to determine whether the number of cases needed for proficiency is being realized. Methods: We examined the Accreditation Council for Graduate Medical Education (ACGME) and American Board of Colorectal Surgeons (ABCRS) operative statistics for graduating general surgery and colon and rectal surgery residents. Results: Although the number of advanced laparoscopy cases had increased for general surgery residents, there was still a significant gap in case volume between the average number of laparoscopic colorectal operations performed by graduating general surgery residents (21.6) and those performed by graduating colon and rectal surgery residents (81.9) in 2014. Conclusion: There is a gap between general surgery and colon and rectal surgery residency training for laparoscopic colorectal surgery. General surgery residents are not meeting the volume of cases necessary for proficiency in colorectal surgery. This deficit represents a structural difference in training. PMID:27493468

  2. 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

  3. A virtual cataract surgery course for ophthalmologists-in-training.

    PubMed

    Li, Emily; Fay, Peter; Greenberg, Paul B

    2013-08-01

    Virtual reality (VR) surgery simulation is an emerging teaching tool to train residents in cataract surgery. The widespread adoption of virtual surgery has been limited, however, by high costs and the absence of standardized curricula and evidence demonstrating the impact of VR training on resident surgical outcomes. We outline a resident virtual cataract surgery course--freely accessible online--that we hope will contribute to the development of a standardized VR cataract surgery curriculum. PMID:23923120

  4. 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. ...

  5. [Legal Framework of Autologous Fat Usage in Point-of-Care Treatments in Plastic and Aesthetic Surgery - Risks of Criminal Prosecution and Infringement of Medical Law Due to Pharmaceutical Regulations].

    PubMed

    Faltus, T

    2016-08-01

    The use of autologous fat, especially for (stem) cell-assisted lipotransfer in plastic and aesthetic surgery, has regularly been regarded as the manufacture and application of so called Advanced Therapy Medicinal Products (ATMP). However, the in-house production of such pharmaceuticals at the point-of-care (PoC) in the surgeon's practice is not permitted without an official manufacturing license. Therefore, before beginning such treatments, a pharmaceutical manufacturing license has to be granted to the surgeon to avoid criminal prosecution and negative consequences due to infringement of professional regulations. Because such a license is linked to compliance with GMP standard, in-house manufacturing of such pharmaceuticals also implies extra technical and personnel expenses. The surgeon is obliged to check that the available autologous fat based applications are in compliance with pharmaceutical legislation. Repeated infringements of pharmaceutical regulations are incompatible with medical reliability - a prerequisite for the license to practice medicine. PMID:27547930

  6. The advent of the restorative plastic surgeon.

    PubMed

    Carty, Matthew J; Pribaz, Julian J; Talbot, Simon G; Caterson, Edward J; Pomahac, Bohdan

    2014-01-01

    Plastic surgery is presently typified by the existence of discrete clinical identities, namely that of the cosmetic plastic surgeon and the reconstructive plastic surgeon. The emergence of vascularized composite allotransplantation has been accompanied by the development of a third distinct clinical identity, that of the restorative plastic surgeon. The authors describe the core competencies that characterize this new identity, and discuss the implications of the advent of this new professional paradigm. PMID:24374677

  7. Ethics and the facial plastic surgeon.

    PubMed

    Sethi, Neeraj

    2016-09-01

    The facial plastic surgeon potentially has a conflict of interest when confronted with the patients requesting surgery, due to the personal gain attainable by agreeing to perform surgery. The aim of this review is to discuss the potential harm the surgeon can inflict by carrying out facial plastic surgery, beyond the standard surgical complications of infection or bleeding. It will discuss the desire for self-improvement and perfection and increase in the prevalence facial plastic surgery. We address the principles of informed consent, beneficence and non-maleficence, as well as justice and equality and how the clinician who undertakes facial plastic surgery is at risk of breaching these principles without due care and diligence. PMID:26254909

  8. Development of hand surgery: education of hand surgeons.

    PubMed

    Omer, G E

    2000-07-01

    An organized experience in the care of hand injuries and infections was not available until World War II, when military hand centers were established. Dr Sterling Bunnell was designated as a special civilian consultant to the Secretary of War. The surgeons in the military services during World War II became the nucleus of the American Society for Surgery of the Hand (ASSH). Following World War II and the Korean War there was a major shift toward medical subspecialization, and the growth of surgery of the hand as a subspecialty parallels that trend. The ASSH initiated a coordinated effort to improve the educational experience, and in 1967 the ASSH Resident Training Committee was evaluating hand training programs. The ASSH developed a comprehensive program in continuing medical education, and received full accreditation from the American Medical Association Council on Medical Education. The American Medical Association has included hand surgery on its list of designated specialties since 1975. In 1973, the bylaws of the American Board of Medical Specialties were revised to provide special certification. The ASSH developed a proposal for a certificate of added qualification in surgery of the hand that was presented to the three primary boards (orthopaedic, plastic, surgery) and the ad hoc joint Committee on Surgery of the Hand was organized in 1982. An application for a certificate of added qualification in surgery was developed by the Joint Committee on Surgery of the Hand and approved by all three boards in 1985 and the ABMS in 1986. The first examination for the certificate of added qualification in surgery was held in 1989. PMID:10913201

  9. Cosmetic Surgery

    MedlinePlus

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

  10. 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)

  11. Elective plastic surgical procedures in adolescence.

    PubMed

    McGrath, Mary H; Schooler, Wesley G

    2004-10-01

    Adolescent patients are seeking plastic surgery to correct deformities or perceived deformities in increasing numbers. It is essential for the physician to understand the influence of perceived body image irregularity that motivates patients of all ages to request plastic surgery. The increased demand for plastic surgical procedures among young patients is caused partially to increased media exposure to the available procedures offered by plastic surgeons. A successful aesthetic procedure can have a positive influence on a mature, well-motivated teenager, while surgery on a psychologically unstable adolescent can be damaging to the patient. The American Society for Aesthetic Plastic Surgery has developed guidelines for the appropriate selection of teenagers for aesthetic plastic surgery [26]. First, the physician must "assess physical maturity, because operating on a feature that has not yet fully developed could interfere with growth or negate the benefits of surgery in later years." Second, the physician should explore emotional maturity and expectations of the teenager. The teenager should understand the goals and limitations of the proposed surgery and have realistic expectations. Third, only board certified plastic surgeons who operate in accredited facilities should perform these procedures, to ensure the safety of the teenager and the quality of the procedure. Finally, teenagers and their parents should understand the risks of surgery, postoperative restrictions on activity, and typical recovery times. The referring physician and surgeon must be aware of the positive or negative effects that plastic surgery can have on the life of a teenager and be able to select patients who have the motivation, maturity, psychosocial, and emotional attributes that will lead to patient satisfaction. PMID:15625989

  12. [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

  13. The Ethics of Aesthetic Surgery

    PubMed Central

    Mousavi, SR

    2010-01-01

    Advances in plastic and reconstructive surgery have revolutionized the management of patients suffering from disfiguring congenital abnormalities, burns and skin cancers. The demand for aesthetic surgery has increased in recent years, as our culture has become more concerned with image and appearance. Several ethical considerations such as patient's right for informed counseling, beneficience and maleficience need to be given careful consideration. PMID:20606994

  14. [Louis Ombrédanne (1871-1956) pediatric and plastic surgeon].

    PubMed

    Glicenstein, J

    2015-04-01

    One of the fathers of pediatric surgery in France, Louis Ombrédanne (1871-1956) was a great plastic surgeon. During his residency he was initiated to plastic surgery by Charles Nélaton (1851-1911). Both wrote two books: "La rhinoplastie" and "Les autoplasties", taking stock of these techniques in the early 20th century. In 1906, he was the first to describe the pectoral muscle flap for immediate breast reconstruction after mastectomy. He used this flap in conjunction with an axillo thoracic flap. From 1908 to 1941, Louis Ombrédanne practised pediatric surgery, most of which was devoted in reconstruction of congenital and acquire anomalies. From 1924 to 1941, he was Professor of pediatric surgery at the hospital Enfants-Malades in Paris. In 1907, Louis Ombrédanne created a prototype of an ether inhaler as a safe anesthetic device. The device was successfully used for fifty years in Europe. PMID:25534012

  15. Surgical residency training and international volunteerism: a national survey of residents from 2 surgical specialties

    PubMed Central

    Matar, Wadih Y.; Trottier, Daniel C.; Balaa, Fady; Fairful-Smith, Robin; Moroz, Paul

    2012-01-01

    Background Many low- and middle-income countries (LMICs) lack basic surgical resources, resulting in avoidable disability and mortality. Recently, residents in surgical training programs have shown increasing interest in overseas elective experiences to assist surgical programs in LMICs. The purpose of this study was to survey Canadian surgical residents about their interest in international volunteerism. Methods We sent a web-based survey to all general and orthopedic surgery residents enrolled in surgical training programs in Canada. The survey assessed residents’ interests, attitudes and motivations, and perceived barriers and aids with respect to international volunteerism. Results In all, 361 residents completed the survey for a response rate of 38.0%. Half of the respondents indicated that the availability of an international surgery elective would have positively influenced their selection of a residency program. Excluding the 18 residents who had volunteered during residency, 63.8% of the remaining residents confirmed an interest in international volunteering with “contributing to an important cause,” “teaching” and “tourism/cultural enhancement” as the leading reasons for their interest. Perceived barriers included “lack of financial support” and “lack of available organized opportunities.” All (100%) respondents who had done an international elective during residency confirmed that they would pursue such work in the future. Conclusion Administrators of Canadian surgical programs should be aware of strong resident interest in global health care and accordingly develop opportunities by encouraging faculty mentorships and resources for global health teaching. PMID:22854155

  16. Plastics Technology.

    ERIC Educational Resources Information Center

    Barker, Tommy G.

    This curriculum guide is designed to assist junior high schools industrial arts teachers in planning new courses and revising existing courses in plastics technology. Addressed in the individual units of the guide are the following topics: introduction to production technology; history and development of plastics; safety; youth leadership,…

  17. Teaching plastic surgeons how to be better teachers.

    PubMed

    Weber, Robert A; Armstrong, Elizabeth G

    2012-05-01

    The purpose of this article is to introduce plastic surgeons to a theory of adult education. Most surgeons have been hired by their parent institution because of their clinical skills, and rightly so. At the same time, these same surgeons choose or are expected to be involved to varying degrees in the surgical education process with medical students, surgical residents, fellows, and allied health workers. Likewise, busy surgical residents are also expected to teach other residents and students, and yet these two groups of teachers of surgery have little or no training in the theory and practice of adult education. This article has four major sections. The first is a scenario designed to bring to mind a context and set of ideas with which the reader is already familiar. The second provides new information, Kolb's theory of adult learning and Arseneau and Rodenberg's teaching principles, and discusses their implications. The third section is designed to give the reader an opportunity to work with the new knowledge and practice possible applications, and the fourth encourages the reader to use the new knowledge in concrete ways in a real-world environment. PMID:22544100

  18. Robotic surgery

    MedlinePlus

    Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance ... computer station and directs the movements of a robot. Small surgical tools are attached to the robot's ...

  19. 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 ...

  20. Lung surgery

    MedlinePlus

    ... Pneumonectomy; Lobectomy; Lung biopsy; Thoracoscopy; Video-assisted thoracoscopic surgery; VATS ... You will have general anesthesia before surgery. You will be asleep and unable to feel pain. Two common ways to do surgery on your lungs are thoracotomy and video- ...

  1. Foot Surgery

    MedlinePlus

    ... About Feet » Foot Health Information Surgery When is Foot Surgery Necessary? Many foot problems do not respond ... restore the function of your foot. Types of Foot Surgery Fusions: Fusions are usually performed to treat ...

  2. 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

  3. 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

  4. 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…

  5. [Pregnancy during residency].

    PubMed

    Maas, S M; van 't Hoff, B W; Rings, E H; van der Waals, F W; Büller, H A

    1992-12-19

    The number of female residents in the Netherlands has steadily increased in recent years. Due to the increased time on waiting lists to enter residency programmes and to the increased duration of training, female residents will be older during their residencies. This will probably result in an increased number of pregnancies during residencies. A questionnaire regarding pregnancy during residency was sent to 191 residents in two university hospitals in the Netherlands. The response rate was 74.3%. Fifty percent of the male and only 19% of the female residents had children. No negative effects of a pregnancy on their training were experienced or anticipated by the residents. However, a negative effect on the functioning of the department was expected. No formal provisions, like replacements were available and many solutions to replace pregnant colleagues depended on the flexibility of the colleagues. The wish to have children was high and equally distributed among male and female residents, 92% and 96%, resp. Given the difficulty to seek a permanent position and to have children after residency, the choice of many female residents will be to have their children during residency. This increase in number of pregnancies requires anticipation of the residency programme directors. They should take the lead in proposing adequate regulations. PMID:1470257

  6. Plastic Bronchitis.

    PubMed

    Rubin, Bruce K

    2016-09-01

    Plastic bronchitis is an uncommon and probably underrecognized disorder, diagnosed by the expectoration or bronchoscopic removal of firm, cohesive, branching casts. It should not be confused with purulent mucous plugging of the airway as seen in patients with cystic fibrosis or bronchiectasis. Few medications have been shown to be effective and some are now recognized as potentially harmful. Current research directions in plastic bronchitis research include understanding the genetics of lymphatic development and maldevelopment, determining how abnormal lymphatic malformations contribute to cast formation, and developing new treatments. PMID:27514587

  7. 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…

  8. Brain surgery

    MedlinePlus

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... Before surgery, the hair on part of the scalp is shaved and the area is cleaned. The doctor makes ...

  9. 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 ...

  10. 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 ...

  11. 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.

  12. Orthopedic surgery.

    PubMed

    Gehrig, Laura M B

    2011-09-01

    Orthopedic surgery is a specialty of surgery dedicated to the prevention, diagnosis, and treatment of diseases and injuries of the musculoskeletal system in all age groups. Careers in orthopedic surgery span the spectrum from general orthopedics to those of subspecialty expertise in orthopedic trauma, hand, pediatrics, total joint, foot and ankle, sports medicine, and oncology to name a few. PMID:21871990

  13. 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

  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. Strabismus Surgery

    MedlinePlus

    ... used. Some surgeons prescribe an antibiotic or combination antibiotic/steroid drop or ointment after surgery. More technical ... Screening Recommendations Loading... Most Common Searches Adult ...

  16. 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

  17. 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…

  18. Residency Decisions: Another Look.

    ERIC Educational Resources Information Center

    Davidson, Barry S.

    The process of determining student's residency status for fee payment at the University of Nevada-Reno is described and supplemental information forms that are used at the university are included. At the University of Nevada-Reno, residency decisions are the responsibility of admissions office professional staff. The university has a formal…

  19. Life After Residency.

    PubMed

    Sorrel, Amy Lynn

    2016-04-01

    Many residents don't receive any formal business training. The University of Texas at Austin Dell Medical School created a crash course to teach residents some of the business and job-hunting basics they'll need. PMID:27049910

  20. Training in breast surgery in Spain.

    PubMed

    Miguelena, José M; Domínguez Cunchillos, Fernando

    2016-01-01

    Breast surgery is a key part of training and competency in general surgery in Spain and is a "frontier area" that can be efficiently managed by general surgeons and gynecologists. The main objective of the training process consists of the surgical treatment of breast cancer, including conservative surgery, oncoplastic and reconstructive techniques. This article analyses the current status of breast surgery training in Spain and schematically proposes potential targets of the different training programs, to improve access and training for surgeons and residents in this area, taking into account the RD 639/2014 and European regulation. The priority is to specify the level of training that should be achieved, in relation to the group of professionals involved, considering their area of competency: surgery resident, educational programs, and surgeons with special dedication to this area. PMID:27059252

  1. Elucidating Reasons for Resident Underutilization of Electronic Adverse Event Reporting.

    PubMed

    Hatoun, Jonathan; Suen, Winnie; Liu, Constance; Shea, Sandy; Patts, Gregory; Weinberg, Janice; Eng, Jessica

    2016-07-01

    Reasons for resident underutilization of adverse event (AE) reporting systems are unclear, particularly given frequent resident exposure to AEs and near misses (NMs). Residents at an academic medical center were surveyed about AEs/NMs, barriers to reporting, patient safety climate, and educational interventions. A total of 350 of 527 eligible residents (66%) completed the survey; 77% of respondents reported involvement in an AE/NM, though only 43% had used the reporting system. Top barriers to reporting were not knowing what or how to report. Surgeons reported more than other residents (surgery, 61%; medical, 38%; hospital-based, 15%; P < .01), yet more often felt that systems were unlikely to change after reporting (surgery, 49%; medical, 28%; hospital-based. 18%; P < .01). Residents preferred discussions with supervisors (52%) and department-led conferences (46%) to increased reporting. Efforts to increase resident reporting should address common barriers to reporting as well as department-specific differences in resident knowledge, perceptions of system effectiveness, and educational preferences. PMID:25753451

  2. Rhabdomyosarcoma: Surgery

    MedlinePlus

    ... is and what type of operation is done. Physical changes after surgery can range from little more than a scar to changes in appearance or in how some parts of the body function, which may require physical rehabilitation. For more on surgery as a treatment ...

  3. 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

  4. 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

  5. Resident involvement in postoperative conversations: an underused opportunity

    PubMed Central

    Lorenzen, Allison W.; Sherman, Scott K.; Rosenbaum, Marcy; Kapadia, Muneera R.

    2016-01-01

    Background Because of established attending-patient and family relationships and time constraints, residents are often excluded from the immediate postoperative conversation with family. Interpersonal and communication skills are a core competency, and the postoperative conversation is an opportunity to develop these skills. Our objective is to assess attitudes, experience, and comfort regarding resident participation during postoperative conversations with families. Materials and methods Residents and attending surgeons in an academic surgery center were surveyed regarding resident involvement in the postoperative conversation with families. Paper surveys wereadministeredanonymously.Nonparametricstatisticscomparedresponses. Results There were 45 survey respondents (23 residents, 22 attendings). All residents rated postoperative conversations with families, as “important” or “very important”. Residents reported being “comfortable” or “very comfortable” with postoperative conversations. However, on average, residents reported fewer than 10 postoperative conversation experiences per year. Feedback was received by <30% on postoperative communication skills, but 88% wanted feedback. Most attendings reported it is “important” or “very important” for residents to communicate well with families during postoperative conversations, but rated residents’ performance as significantly lower than the residents’ self-assessments (P < 0.001). Attendings on average were only “somewhat comfortable” or “moderately comfortable” with residents conducting postoperative conversations with families, and only 68% reported allowing residents to do so. When bad news was involved, only 27% allowed resident participation. Most attendings (86%) believed residents need more opportunities with postoperative conversations. Conclusions Although most residents reported being comfortable with postoperative conversations, these survey results indicate that they have

  6. Facilty Focus: Residence Halls.

    ERIC Educational Resources Information Center

    Hunnewell, James F., Jr.

    2002-01-01

    Describes the Western Ridge Residence at Colorado College and Beard Hall at Wheaton College. The buildings feature multiple levels that take advantage of views and also help create a "homey" feeling. (EV)

  7. 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)

  8. [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

  9. 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

  10. 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.

  11. Cosmetic Surgery

    MedlinePlus

    ... defect or cosmetic flaw that has diminished their self-esteem over time. It's important to remember that cosmetic ... can create both physical changes and changes in self-esteem. But if you are seeking surgery with the ...

  12. Maze Surgery

    MedlinePlus

    ... for Hemodialysis Ventricular Assist Devices Maze Surgery | Share Electrical impulses in your heart muscle (the myocardium) cause your heart to beat (contract). This electrical signal begins in the sinoatrial (SA) node, located ...

  13. Thyroid Surgery

    MedlinePlus

    ... thyroid surgery, requiring treatment with thyroid hormone (see Hypothyroidism brochure ). This is especially true if you had ... Nodules Goiter Graves’ Disease Hashimoto’s Thyroiditis Hyperthyroidism (Overactive) Hypothyroidism (Underactive) Iodine Deficiency Low Iodine Diet Radioactive Iodine ...

  14. 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 ...

  15. Rodding Surgery

    MedlinePlus

    ... Rods can be made of stainless steel or titanium. Regular rods do not expand. They have many ... v regular), the rod materials (stainless steel v titanium) and the age for a first rodding surgery. ...

  16. 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

  17. 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

  18. Tissue-resident macrophages: then and now.

    PubMed

    Davies, Luke C; Taylor, Philip R

    2015-04-01

    Macrophages have been at the heart of immune research for over a century and are an integral component of innate immunity. Macrophages are often viewed as terminally differentiated monocytic phagocytes. They infiltrate tissues during inflammation, and form polarized populations that perform pro-inflammatory or anti-inflammatory functions. Tissue-resident macrophages were regarded as differentiated monocytes, which seed the tissues to perform immune sentinel and homeostatic functions. However, tissue-resident macrophages are not a homogeneous population, but are in fact a grouping of cells with similar functions and phenotypes. In the last decade, it has been revealed that many of these cells are not terminally differentiated and, in most cases, are not derived from haematopoiesis in the adult. Recent research has highlighted that tissue-resident macrophages cannot be grouped into simple polarized categories, especially in vivo, when they are exposed to complex signalling events. It has now been demonstrated that the tissue environment itself is a major controller of macrophage phenotype, and can influence the expression of many genes regardless of origin. This is consistent with the concept that cells within different tissues have diverse responses in inflammation. There is still a mountain to climb in the field, as it evolves to encompass not only tissue-resident macrophage diversity, but also categorization of specific tissue environments and the plasticity of macrophages themselves. This knowledge provides a new perspective on therapeutic strategies, as macrophage subsets can potentially be manipulated to control the inflammatory environment in a tissue-specific manner. PMID:25684236

  19. Tissue-resident macrophages: then and now

    PubMed Central

    Davies, Luke C; Taylor, Philip R

    2015-01-01

    Macrophages have been at the heart of immune research for over a century and are an integral component of innate immunity. Macrophages are often viewed as terminally differentiated monocytic phagocytes. They infiltrate tissues during inflammation, and form polarized populations that perform pro-inflammatory or anti-inflammatory functions. Tissue-resident macrophages were regarded as differentiated monocytes, which seed the tissues to perform immune sentinel and homeostatic functions. However, tissue-resident macrophages are not a homogeneous population, but are in fact a grouping of cells with similar functions and phenotypes. In the last decade, it has been revealed that many of these cells are not terminally differentiated and, in most cases, are not derived from haematopoiesis in the adult. Recent research has highlighted that tissue-resident macrophages cannot be grouped into simple polarized categories, especially in vivo, when they are exposed to complex signalling events. It has now been demonstrated that the tissue environment itself is a major controller of macrophage phenotype, and can influence the expression of many genes regardless of origin. This is consistent with the concept that cells within different tissues have diverse responses in inflammation. There is still a mountain to climb in the field, as it evolves to encompass not only tissue-resident macrophage diversity, but also categorization of specific tissue environments and the plasticity of macrophages themselves. This knowledge provides a new perspective on therapeutic strategies, as macrophage subsets can potentially be manipulated to control the inflammatory environment in a tissue-specific manner. PMID:25684236

  20. Open heart surgery

    MedlinePlus

    ... Heart bypass surgery (coronary artery bypass graft - CABG) Heart transplant Heart valve surgery Hypoplastic left heart repair Minimally ... Heart bypass surgery Heart bypass surgery - minimally invasive Heart transplant Heart valve surgery Hypoplastic left heart syndrome Patent ...

  1. 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 ...

  2. Plastic surgeons: a gender comparison.

    PubMed

    Capek, L; Edwards, D E; Mackinnon, S E

    1997-02-01

    This study surveyed plastic surgeons for the purpose of identifying gender-related differences within the specialty. A confidential 108-item questionnaire was mailed to all female members and candidates of the American Society of Plastic and Reconstructive Surgeons (ASPRS) and to an equal number of male colleagues. The survey was conducted between September of 1992 and October of 1993 using a modified Dillman five-step computerized method. The response rate was 73 percent for women (157 of 216) and 57 percent for men (124 of 216). Of those who responded, 65 percent of women and 89 percent of men were married (p < 0.01). Fifty-two percent of women and 86 percent of men had biologic children (p < 0.001). The majority of surgeons surveyed (97 percent) were in full-time surgical practice. Many women reported delaying childbearing until they had begun full-time practice of plastic surgery (p < 0.001). No significant gender-related differences were noted with respect to medical school rank, training history, advanced degrees, subspecialty practiced, hospital affiliation, or hours worked. Women surgeons in academic practice held lower rank than men and were less likely to be tenured (p < 0.04). Gross annual income was lower for women (p < 0.001). In contrast to men (27 percent), most women (89 percent) perceived sexual discrimination and harassment (p < 0.001). The majority of plastic surgeons were satisfied with their financial situation (80 percent), work (94 percent), and family life (76 percent). Over 90 percent of both women and men were happy with their career choice and would encourage medical students to become surgeons. Plastic surgeons do not differ in training or professional practice characteristics. Discrimination and harassment and unequal promotion and remuneration of women in the university environment are problems that need to be eliminated. PMID:9030134

  3. Oral and maxillofacial surgery: outcomes and attitudes.

    PubMed

    Hutton, C E

    1991-05-01

    A survey of 56 former oral and maxillofacial surgery residents at one institution indicated that they believe their specialty was satisfying and rewarding and their training prepared them well for practice, but that they were lacking in business skills and knowledge. Those who elected not to take the American Board examination did so because they saw no advantages. The stress and demands of residency and practice were not major factors for those who had experienced divorce. PMID:2019900

  4. 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

  5. Fastballs a Fast Track to 'Tommy John Surgery'?

    MedlinePlus

    ... injury," Keller, chief resident in the department of orthopedic surgery at Henry Ford Hospital in Detroit, said ... said senior study author Dr. Vasilios Moutzouros, an orthopedic surgeon at Henry Ford Hospital. "Our research should ...

  6. 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

  7. 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

  8. Herniation of the cervical disk in plastic surgeons.

    PubMed

    Tzeng, Yuan-Sheng; Chen, Shyi-Gen; Chen, Tim-Mo

    2012-12-01

    Herniations of the cervical disk in plastic surgeons are far more common in practice than the paucity of reported cases would indicate. A likely explanation may be the peculiar, nonergonomic positions that plastic surgeons must hold during surgery while wearing a headlight and loupes. From January 2003 to December 2006, at Tri-Service General Hospital, Taiwan, 4 plastic surgeons experienced herniations of the cervical disk. Magnetic resonance imaging study indicated there was disk herniation or bulging with spinal cord impingement. Two plastic surgeons received cervical diskectomy, corpectomy with strut reconstruction using titanium cages. These 2 surgeons were symptom-free 2 years after their operations. The other 2 plastic surgeons were under conservative physical therapy with persistent symptoms. The clinical evidence indicated that cervical disk herniation is an occupational hazard in plastic surgeons. To prevent prolonged hyperflexion and twisting of the neck, we proposed wearing a cervical brace during surgery for the plastic surgeons at Tri-Service-General Hospital since January 2008. No more plastic surgeons have experienced herniation of the cervical disk since then. The results indicated that wearing a cervical brace may be an effective measure to protect plastic surgeons from cervical disk disease. PMID:23154341

  9. Evaluation of the orthopedic residency training program in Saudi Arabia and comparison with a selected Canadian residency program

    PubMed Central

    Al-Ahaideb, Abdulaziz; Alrabai, Hamza M; Alrehaili, Osama A; Aljurayyan, Abdulaziz N; Alsaif, Ranyah M; Algarni, Nizar; Al-Khawashki, Hazem M; Algarni, Abdulrahman D

    2014-01-01

    Objective The primary aim of the present study was to assess the quality of the Saudi Orthopedic Residency Program. Methodology As a comparator, a cross-sectional survey involving 76 Saudi residents from different training centers in Saudi Arabia namely; Riyadh, Jeddah, Medina, Abha, and Dammam and 15 Canadian. Results The results showed that Canadian residents read more peer-reviewed, scholarly articles compared with Saudi residents (P=0.002). The primary surgical role for residents was to hold retractors during surgery. The survey respondents strongly supported the ability to recommend removal of incompetent trainers. Saudi trainees were more apprehensive of examinations than Canadian trainees (P<0.0001). Most residents preferred studying multiple-choice questions before examinations. Saudi and Canadian participants considered their programs to be overcrowded. Unlike Canadian participants, Saudi trainees reported an inadequate level of training (P<0.0001). Conclusion Educational resources should be readily accessible and a mentorship system monitoring residents’ progress should be developed. The role of the resident must be clearly defined and resident feedback should not be ignored. Given the importance of mastering basic orthopedic operative skills for residents, meaningful remedial action should be taken with incompetent trainers. PMID:25278788

  10. 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

  11. 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…

  12. Robotic Surgery

    PubMed Central

    Lanfranco, Anthony R.; Castellanos, Andres E.; Desai, Jaydev P.; Meyers, William C.

    2004-01-01

    Objective: To review the history, development, and current applications of robotics in surgery. Background: Surgical robotics is a new technology that holds significant promise. Robotic surgery is often heralded as the new revolution, and it is one of the most talked about subjects in surgery today. Up to this point in time, however, the drive to develop and obtain robotic devices has been largely driven by the market. There is no doubt that they will become an important tool in the surgical armamentarium, but the extent of their use is still evolving. Methods: A review of the literature was undertaken using Medline. Articles describing the history and development of surgical robots were identified as were articles reporting data on applications. Results: Several centers are currently using surgical robots and publishing data. Most of these early studies report that robotic surgery is feasible. There is, however, a paucity of data regarding costs and benefits of robotics versus conventional techniques. Conclusions: Robotic surgery is still in its infancy and its niche has not yet been well defined. Its current practical uses are mostly confined to smaller surgical procedures. PMID:14685095

  13. Evaluating source separation of plastic waste using conjoint analysis.

    PubMed

    Nakatani, Jun; Aramaki, Toshiya; Hanaki, Keisuke

    2008-11-01

    Using conjoint analysis, we estimated the willingness to pay (WTP) of households for source separation of plastic waste and the improvement of related environmental impacts, the residents' loss of life expectancy (LLE), the landfill capacity, and the CO2 emissions. Unreliable respondents were identified and removed from the sample based on their answers to follow-up questions. It was found that the utility associated with reducing LLE and with the landfill capacity were both well expressed by logarithmic functions, but that residents were indifferent to the level of CO2 emissions even though they approved of CO2 reduction. In addition, residents derived utility from the act of separating plastic waste, irrespective of its environmental impacts; that is, they were willing to practice the separation of plastic waste at home in anticipation of its "invisible effects", such as the improvement of citizens' attitudes toward solid waste issues. PMID:18207727

  14. 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

  15. Aesthetic surgery of the female genitalia.

    PubMed

    Dobbeleir, Julie M L C L; Landuyt, Koenraad Van; Monstrey, Stan J

    2011-05-01

    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

  16. 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)

  17. 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.…

  18. 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

  19. 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

  20. 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.…

  1. 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 ...

  2. 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

  3. A brief history of endoscopic spine surgery.

    PubMed

    Telfeian, Albert E; Veeravagu, Anand; Oyelese, Adetokunbo A; Gokaslan, Ziya L

    2016-02-01

    Few neurosurgeons practicing today have had training in the field of endoscopic spine surgery during residency or fellowship. Nevertheless, over the past 40 years individual spine surgeons from around the world have worked to create a subfield of minimally invasive spine surgery that takes the point of visualization away from the surgeon's eye or the lens of a microscope and puts it directly at the point of spine pathology. What follows is an attempt to describe the story of how endoscopic spine surgery developed and to credit some of those who have been the biggest contributors to its development. PMID:26828883

  4. 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

  5. Plastic bag clip discovered in partial colectomy accompanying proposal for phylogenic plastic bag clip classification.

    PubMed

    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

  6. Plastic encapsulated parts

    SciTech Connect

    Castillo, T.

    1994-10-01

    Plastic semiconductor packages were characterized as possible alternatives for canned devices, which are susceptible to internal shorts caused by conductive particles. Highly accelerated stress testing (HAST) as well as electrical and mechanical testing were conducted on plastic technology devices.

  7. Plasticity and Geotechnics

    NASA Astrophysics Data System (ADS)

    Yu, Hai-Sui

    Plasticity and Geotechnics is the first attempt to summarize and present, in one volume, the major developments achieved to date in the field of plasticity theory for geotechnical materials and its applications to geotechnical analysis and design.

  8. 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.…

  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. 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

  12. Global Health Simulation During Residency.

    PubMed

    Rosenman, Jane R; Fischer, Philip R; Arteaga, Grace M; Hulyalkar, Manasi; Butteris, Sabrina M; Pitt, Michael B

    2016-01-01

    Resident participation in international health electives (IHEs) has been shown to be beneficial, yet not all residents have the opportunity to participate. We sought to determine whether participating in simulated global health cases, via the standardized Simulation Use for Global Away Rotations (SUGAR) curriculum, was useful for all pediatric residents, not merely those planning to go on an IHE. Pediatric residents in our program took part in 2 SUGAR cases and provided feedback via an online survey. Thirty-six of 40 residents participated (90%); 72% responded to the survey. Three of 10 residents not previously planning to work in resource-limited settings indicated participation in SUGAR made them more likely to do so. Nearly all residents (88%) felt SUGAR should be part of the residency curriculum. All felt better prepared for working cross-culturally. While designed to prepare trainees for work in resource-limited settings, SUGAR may be beneficial for all residents. PMID:27583300

  13. Global Health Simulation During Residency

    PubMed Central

    Rosenman, Jane R.; Fischer, Philip R.; Arteaga, Grace M.; Hulyalkar, Manasi; Butteris, Sabrina M.; Pitt, Michael B.

    2016-01-01

    Resident participation in international health electives (IHEs) has been shown to be beneficial, yet not all residents have the opportunity to participate. We sought to determine whether participating in simulated global health cases, via the standardized Simulation Use for Global Away Rotations (SUGAR) curriculum, was useful for all pediatric residents, not merely those planning to go on an IHE. Pediatric residents in our program took part in 2 SUGAR cases and provided feedback via an online survey. Thirty-six of 40 residents participated (90%); 72% responded to the survey. Three of 10 residents not previously planning to work in resource-limited settings indicated participation in SUGAR made them more likely to do so. Nearly all residents (88%) felt SUGAR should be part of the residency curriculum. All felt better prepared for working cross-culturally. While designed to prepare trainees for work in resource-limited settings, SUGAR may be beneficial for all residents. PMID:27583300

  14. American Academy of Otolaryngology--Head and Neck Surgery

    MedlinePlus

    ... Program offers experience reviewing scholarly articles in Otolaryngology–Head and Neck Surgery to PGY-2 residents and above. Receive ... Log in © Copyright 2016. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, VA 22314-2857 ...

  15. Thermal destruction behavior of plastic and non-plastic wastes in a laboratory scale facility

    SciTech Connect

    Gupta, A.K.; Ilanchezhian, E.; Missoum, A.; Keating, E.L.

    1994-12-31

    Experimental and theoretical studies are presented from a laboratory scale thermal destruction facility on the destruction behavior of surrogate plastic and non-plastic solid wastes. The non-plastic waste was cellulosic while the plastic waste contained compounds such as polyethylene, polyvinyl chloride, polystyrene, polypropylene, nylon, rubber and polyurethane or any of their desired mixtures. A series of combustion tests were performed with samples containing varying composition of plastic and non-plastic. Experimental results are presented on combustion parameters (CO, excess air, residence time) and toxic emissions (dioxin, furan, metals). Equilibrium thermochemical calculations are presented on the thermal destruction behavior of samples under conditions of pyrolysis, combustion, and pyrolysis followed by combustion. Special interest is on the effect of waste properties and input operational parameters on chemistry and product composition. STANJAN and SOLGASMIX computer codes were used in the chemical equilibrium study. Analysis and interpretation of the data reveal the effect of waste feed composition on combustion parameters and dioxin, furan and metals emission. Equilibrium calculation results are used to describe the experimentally observed trends for the thermal destruction behavior of the wastes. The results show significant influence of plastic on combustion characteristics, and dioxin, furan and metals emission.

  16. 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

  17. 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…

  18. 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.

  19. 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

  20. [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

  1. The psychological safety of breast implant surgery.

    PubMed

    McGrath, Mary H

    2007-12-01

    One positive consequence of the challenge to silicone breast implants has been renewed interest in the psychological dimensions of plastic surgery. When asked questions about the psychological outcomes of women with breast implants, plastic surgery responded with work that is changing the very framework on which concepts such as body image and quality of life are founded. In the course of exploring the psychological impact of breast augmentation, traditional ways of thinking about patient characteristics and motivations have been called into question. There is a new focus on evidence-based outcomes research and an active search for methods that are valid, reliable, and sensitive enough to recognize and measure the emotional impact of changing physical appearance. With more information about psychiatric comorbidities and the identification of variables that influence patients' attitudes, augmentation mammaplasty with implants is better understood. Meanwhile, a new generation of investigators has been stimulated to study and reinterpret the psychodynamics of the aesthetic surgery experience. PMID:18090819

  2. 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 ...

  3. 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 ...

  4. 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 ( ...

  5. Refractive corneal surgery - discharge

    MedlinePlus

    Nearsightedness surgery - discharge; Refractive surgery - discharge; LASIK - discharge; PRK - discharge ... You had refractive corneal surgery to help improve your vision. This surgery uses a laser to reshape your cornea. It corrects ...

  6. 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

  7. 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

  8. The history of women in surgery.

    PubMed

    Wirtzfeld, Debrah A

    2009-08-01

    The history of women in surgery in Western civilization dates to 3500 before common era (BCE) and Queen Shubad of Ur. Ancient history reveals an active role of women in surgery in Egypt, Italy and Greece as detailed in surgical texts of the time. During the middle ages, regulations forbade women from practising surgery unless they assumed their husbands' practices upon their deaths or unless they were deemed fit by a "competent" jury. King Henry VIII proclaimed that "No carpenter, smith, weaver or women shall practise surgery." The modern period of surgery opens with women impersonating men to practise medicine and surgery (Dr. Miranda Stewart). The first female physicians (Dr. Elizabeth Blackwell and Dr. Emily Jennings Stowe) and surgeons (Dr. Mary Edwards Walker and Dr. Jennie Smillie Robertson) in North America found it difficult to obtain residency education after completing medical school. Dr. Jessie Gray was Canada's "First Lady of Surgery" and the first woman to graduate from the Gallie program at the University of Toronto in the 1940s. Currently, the ratio of women in surgical training is far less than that of women in medical school. The reasons that women choose surgery include appropriate role models and intellectual/technical challenge. Lack of mentorship and lifestyle issues are the strongest deterrents. Consideration of a "controllable lifestyle" by surgical administrators will help with the recruitment of women into surgery. PMID:19680519

  9. Expansion of the Coordinator Role in Orthopaedic Residency Program Management

    PubMed Central

    Murphy, Laurie A.; Murphy, James E.

    2008-01-01

    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. Polymer thermolysis for plastics recycling

    SciTech Connect

    Madras, G.; Smith, J.M.; McCoy, B.J.

    1996-12-31

    One approach to plastics recycling is the thermolytic degradation of polymer in solution to simpler molecules. We have investigated fundamental aspects of polymer thermolysis in a steady-state flow reactor operated at low temperatures (relative to pyrolysis) and at pressures high enough to maintain a liquid solution. The molecular-weight distributions (MWDs) of the feed and effluent at each condition were examined by gel permeation chromatography (GPC) as a function of residence time. In general the polymers are degraded by either random chain scission, and/or by depolymerization to specific low molecular-weight compounds (e.g., monomers, dimers,...). The experimental data for MWDs were interpreted with rate expressions based on continuous kinetics, and rate coefficients and activation energies were determined for the specific and random degradation processes. Experimental results are described for poly(styrene-allyl alcohol), poly(x-methyl styrene), and poly(methyl methacrylate). 10 refs.

  11. Exit Survey of Senior Residents: Cost Conscious but Uninformed.

    PubMed

    Long, Theodore; Silvestri, Mark T; Dashevsky, Meir; Halim, Andrea; Fogerty, Robert L

    2016-05-01

    Background Cost awareness, to ensure physician stewardship of limited resources, is increasingly recognized as an important skill for physicians. The Accreditation Council for Graduate Medical Education has made cost awareness part of systems-based practice, a core competency of resident education. However, little is known about resident cost awareness. Objective We sought to assess senior resident self-perceived cost awareness and cost knowledge. Methods In March 2014, we conducted a cross-sectional survey of all emergency medicine, internal medicine, obstetrics and gynecology, orthopaedic surgery pediatrics, and medicine-pediatrics residents in their final year at Yale-New Haven Hospital. The survey examined attitudes toward health care costs and residents' estimates of order prices. We considered resident price estimates to be accurate if they were between 50% and 200% of the Connecticut-specific Medicare price. Results We sent the survey to 84 residents and received 47 completed surveys (56% response rate). Although more than 95% (45 of 47) felt that containing costs is the responsibility of every clinician, and 49% (23 of 47) agreed that cost influenced their decision when ordering, only 4% (2 of 47) agreed that they knew the cost of tests being ordered. No residents accurately estimated the price of a complete blood count with differential, and only 2.1% (1 of 47) were accurate for a basic metabolic panel. The overall accuracy of all resident responses was 25%. Conclusions In our study, many trainees exit residency with self-identified deficiencies in knowledge about costs. The findings show the need for educational approaches to improve cost awareness among trainees. PMID:27168897

  12. Reliability and accuracy of resident evaluations of surgical faculty.

    PubMed

    Risucci, D A; Lutsky, L; Rosati, R J; Tortolani, A J

    1992-09-01

    This study examines the reliability and accuracy of ratings by general surgery residents of surgical faculty. Twenty-three of 33 residents anonymously and voluntarily evaluated 62 surgeons in June, 1988; 24 of 28 residents evaluated 64 surgeons in June, 1989. Each resident rated each surgeon on a 5-point scale for each of 10 areas of performance: technical ability, basic science knowledge, clinical knowledge, judgment, peer relations, patient relations, reliability, industry, personal appearance, and reaction to pressure. Reliability analyses evaluated internal consistency and interrater correlation. Accuracy analyses evaluated halo error, leniency/severity, central tendency, and range restriction. Ratings had high internal consistency (coefficient alpha = 0.97). Interrater correlations were moderately high (average Pearson correlation = 0.63 among raters). Ratings were generally accurate, with halo error most prevalent and some evidence of leniency. Ratings by chief residents had the least halo. Results were generally replicable across the two academic years. We conclude that anonymous ratings of surgical faculty by groups of residents can provide a reliable and accurate evaluation method, ratings by chief residents are most accurate, and halo error may pose the greatest threat to accuracy, pointing to the need for greater definition of evaluation items and scale points. PMID:10121283

  13. #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

  14. #SocialMedia for the Academic Plastic Surgeon-Elevating the Brand.

    PubMed

    Humphries, Laura S; Curl, Brandon; Song, David H

    2016-01-01

    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

  15. 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.

  16. Laparoscopic Cholecystectomy Performed by Residents: A Retrospective Study on 569 Patients

    PubMed Central

    Fontana, Stefano; Zetti, Giorgio; Cortese, Ferdinando

    2014-01-01

    Introduction. Aim of this study was to evaluate the safety of laparoscopic cholecystectomy performed by residents. Materials and Methods. We retrospectively reviewed 569 elective laparoscopic cholecystectomies. Results. Duration of surgery was 84 ± 39 min for residents versus  66 ± 47 min for staff surgeons, P < 0.001. Rate of conversion was 3.2% for residents versus 2.7% for staff surgeons, P = 0.7. There was no difference in the rates of intraoperative and postoperative complications for residents (1.2% and 3.2%) versus staff surgeons (1.5% and 3.1%), P = 0.7 and P = 0.9. Postoperative hospital stay was 3.3 ± 1.8 days for residents versus  3.4 ± 3.2 days for staff surgeons, P = 0.6. One death in patients operated by residents (1/246) and one in patients operated by staff surgeons (1/323) were found, P = 0.8. No difference in the time to return to normal daily activities between residents (11.3 ± 4.2 days) and staff surgeons (10.8 ± 5.6 days) was found, P = 0.2. Shorter duration of surgery when operating the senior residents (75 ± 31 minutes) than the junior residents (87 ± 27 minutes), P = 0.003. Conclusion. Laparoscopic cholecystectomy performed by residents is a safe procedure with results comparable to those of staff surgeons. PMID:25379566

  17. What makes a great resident? The programme director perspective.

    PubMed

    Barry, Matthew

    2014-06-01

    A career in orthopedic surgery in the United Kingdom is highly competitive. Great residents are trainees who understand that ultimately, they are responsible for their own training. They need to work with their Training Program Director to plan their career, to develop as surgeons, to reflect on their performance and any feedback they receive, be flexible, and plan ahead. There is competition but it is fair for everyone and the great resident will excel within this environment and will be successful in the long term. PMID:24488728

  18. Asian upper lid blepharoplasty surgery.

    PubMed

    Lee, Charles K; Ahn, Sang Tae; Kim, Nakyung

    2013-01-01

    Upper lid blepharoplasty is the most common plastic surgery procedure in Asia and has consistently maintained its position as cultural acceptance and techniques have evolved. Asian upper lid blepharoplasty is a complex procedure that requires comprehensive understanding of the anatomy and precise surgical technique. The creation of the supratarsal crease has gone through many evolutions in technique but the principles and goals remain the same: a functional, natural-appearing eyelid crease that brings out the beauty of the Asian eye. Recent advances have improved functional and aesthetic outcomes of Asian upper lid blepharoplasty. PMID:23186767

  19. [Robotic surgery].

    PubMed

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

    2013-10-01

    Due to the fast spread of laparoscopic cholecystectomy, surgical procedures have been changed essentially. The new techniques applied for both abdominal and thoracic procedures provided the possibility for minimally invasive access with all its advantages. Robots - originally developed for industrial applications - were retrofitted for laparoscopic procedures. The currently prevailing robot-assisted surgery is ergonomically more advantageous for the surgeon, as well as for the patient through the more precise preparative activity thanks to the regained 3D vision. The gradual decrease of costs of robotic surgical systems and development of new generations of minimally invasive devices may lead to substantial changes in routine surgical procedures. PMID:24144815

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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.

  5. Ophthalmology residency training in Jordan: an evaluation of quality and comparison with international standards

    PubMed Central

    Al-Salem, Khalil M.; Al-Sarayra, Fawwaz A.; Abu Al-Dabaat, Mohammad; Shihadeh, Wisam; Al-Salem, Mohammad M.; Al-Salem, Mahmoud K.; Schaal, Shlomit

    2014-01-01

    AIM To evaluate Jordanian ophthalmology residency programs in achieving competencies outlined by the International Council of Ophthalmology (ICO) and residents' satisfaction with available training programs in Jordan, and to highlight weakness points that may be improved and strengthened. METHODS A closed-ended questionnaire was circulated to all ophthalmologists who completed their training in Jordanian institutions between 2006 and 2011, to measure the quality of residency training and satisfaction level with regards to clinical conferences, journal clubs, scientific lectures, wet lab sessions, simulations, outpatient clinics and operating room training. Barriers to a successful board exam were cited. All ophthalmologists had official residency training in Jordanian Hospitals; this includes military, university, governmental and private sector hospitals. RESULTS Sixty-one questionnaires completed out of 69 circulated. Males (75.4%) were more than females. Mean age was 32.5±3.27y. A total 21 (34.4%) responders expressed an overall satisfaction, 38 (62.3%) were dissatisfied and 2 (3.3%) were equivocal. Respondents reported insufficient exposure to low-vision rehabilitation 57 (93.4%), or refraction and glasses prescription 34 (55.7%). Regarding operative experiences, the mean cataract extraction per-resident was 43 cataracts; the number of phacoemulsification surgery was 2.96 per-resident, 46 (75.4%) of responders never did a single phacoemulsification during residency. Nine (14.8%) had training in refractive surgery, and 15 (24.6%) assisted orbital surgery. Forty-four (72.1%) never assisted in vitreoretinal surgery. Among The graduates surveyed, 14 (23.0%) passed Jordanian licensing board exam at the first attempt, and felt that their residency programs adequately prepared them for the examinations. CONCLUSION Around two thirds (62.3%) of ophthalmologists expressed dissatisfaction with residency training at Jordanian programs, further study is required to assess

  6. 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

  7. Plastics and health risks.

    PubMed

    Halden, Rolf U

    2010-01-01

    By 2010, the worldwide annual production of plastics will surpass 300 million tons. Plastics are indispensable materials in modern society, and many products manufactured from plastics are a boon to public health (e.g., disposable syringes, intravenous bags). However, plastics also pose health risks. Of principal concern are endocrine-disrupting properties, as triggered for example by bisphenol A and di-(2-ethylhexyl) phthalate (DEHP). Opinions on the safety of plastics vary widely, and despite more than five decades of research, scientific consensus on product safety is still elusive. This literature review summarizes information from more than 120 peer-reviewed publications on health effects of plastics and plasticizers in lab animals and humans. It examines problematic exposures of susceptible populations and also briefly summarizes adverse environmental impacts from plastic pollution. Ongoing efforts to steer human society toward resource conservation and sustainable consumption are discussed, including the concept of the 5 Rs--i.e., reduce, reuse, recycle, rethink, restrain--for minimizing pre- and postnatal exposures to potentially harmful components of plastics. PMID:20070188

  8. 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

  9. [Our surgical heritage. Surgery in ancient Egypt].

    PubMed

    Oelschlegel, F F; Luther, B; Arnst, C B

    1986-01-01

    In its 3,000 years History the surgery of the Old Egypt came on to an important development. Some of the antique instruments used in traumatology, the general surgery and in cosmetic-plastic operations, are in a scarcely modified manner employed for the same purposes in modern surgical interventions nowadays. The surgical diagnostics and therapy of that time is demonstrated by the surgical instruments stock being in the possession of the "Agyptisches Museum" of the "Staatlichen Museen zu Berlin". The surgery of Egypt transferred its leading part to the prosperous medical schools of Greece at the late period of the Old Egyptian empire (1085-332 B.C.). Its surgical diagnostics and therapy depending on an empirical rationalism, the applied instruments but also its ethical attitude towards the patients have been one of the dedisive bases influencing the development of the surgery in the antiquity. PMID:3532623

  10. Stress in Family Practice Residents

    PubMed Central

    Rudner, Howard L.

    1986-01-01

    Sources and levels of stress, as well as coping mechanisms, perceived by residents in both years of a two-year family practice residency program in Toronto are described. In addition, differences between first- and second-year residents, and between women and men residents, regardless of year, are examined. Results of the survey indicate that the levels of stress are relatively high throughout the two years of residency training. The three most stressful aspects of being a resident are time pressures, fatigue, and lack of self-confidence. Female residents appear to report a higher level of stress than males, especially in trying to combine a personal and a professional life. Specific coping mechanisms include talking to others, adjusting attitudes and feelings, or strategic use of time. Recommendations aimed at helping family medicine residency programs deal with the problem of stress in residents are suggested. A current major province-wide research study including all interns and residents in Ontario is described. PMID:21267263

  11. 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

  12. 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)

  13. 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

  14. 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.

  15. American board of vascular surgery: the first 7 years.

    PubMed

    Stanley, James C; Veith, Frank J

    2004-01-01

    The American Board of Vascular Surgery (ABVS) was incorporated in 1996 with a vision of improved training standards and certification of vascular surgeons. At that time, 91% of those holding American Board of Surgery Certificates of Added Qualifications in Vascular Surgery supported the formation of the ABVS. Subsequent events have led to a clear definition of specific educational issues important to the vascular surgery community. Unresolved issues relate to the need to complete a general surgery residency before beginning a vascular surgery fellowship, the continued inclusion of vascular surgery as a primary component of general surgery training, and the absence of a designated Residency Review Committee for Vascular Surgery. These issues have persisted since the inception of the ABVS. An application for the ABVS to become an American Board of Medical Specialties (ABMS) primary board was submitted in 2002 with a preliminary hearing before a liaison committee composed of American Medical Association and ABMS members. The American Board of Surgery (ABS) and a minority of the vascular surgery community vigorously opposed the application. The perceived divisiveness created by their actions contributed to the application's initial rejection and the necessity for an appeal. Certain ABS directors have recently stated that they would consider approving multiple track-type training that could allow single certification in vascular surgery, following 5 to 6 years of postgraduate training after medical school. The ABVS cautiously supports this action, recognizing that this radical change for the ABS may not be feasible given the broad-ranging interests of general surgery and restrictive ABMS guidelines for certifying medical specialists. The impact of not resolving the critical issues facing vascular surgery in a timely manner is that there will be inadequate numbers of competent vascular surgeons to provide for society's needs. An independent ABMS-approved ABVS provides a

  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. Reinforced plastics durability

    SciTech Connect

    Pritchard, G.

    1999-01-01

    Written especially for first-time users of reinforced plastics. The book offers substantial introductory information with key concepts. Chapters examine the long-term threats to the integrity of reinforced plastics: outdoor weathering, solvent/water attack, high temperatures, and repetitive stress.

  18. Laser processing of plastics

    NASA Astrophysics Data System (ADS)

    Atanasov, Peter A.

    1995-03-01

    CO2-laser processing of plastics has been studied experimentally and theoretically. Welding of cylindrical parts made from polycarbonate and polypropylene, cutting of polymethyl-methacrylate plates, and drilling holes in polypropylene are presented as examples. A good coincidence between theoretical and experimental results in case of laser welding has been found. Some practical aspects of laser processing of plastics has been given.

  19. 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 ...

  20. The lateral canthus in cosmetic surgery.

    PubMed

    Glassman, Michael L; Hornblass, Albert

    2002-02-01

    Normally contoured eyelid fissures will enhance the appearance of patients who undergo cosmetic eyelid surgery. The shape and integrity of the lateral canthal structures frequently affect the configuration of the eyelid fissure. Undetected canthal abnormalities may lead to untoward postoperative functional and cosmetic results. An understanding of the etiology and detection of lateral canthal pathology and the treatment of the lateral can thus as a functional unit in cosmetic surgery will enable the plastic surgeon to avoid these complications and enhance surgical results. PMID:15062327

  1. Can a Plastic Surgeon be a Department Chairman?….Really?

    PubMed

    Neumeister, M W

    2016-04-01

    There is significant responsibility in being a Department of Surgery Chairman within a medical school. The Chairman is appointed by the Dean of Medicine to lead surgery in a path that serves the mission of the school. The Department of Surgery Chairman is charged with facilitating the academic, operational, and programmatic surgical initiatives of the School of Medicine. Traditionally the Chairman of Surgery has been a general surgeon but now our educational and clinical experiences have changed making traditional leadership less intuitive. Plastic surgeons appointed as current Chairman of the Department of Surgery are rare in the United States. Whereas, general surgeons may have less interaction with other surgical sub-specialties today, Plastic surgeons have more interaction crossing all disciplines of surgery. Innovation and creativity that defines our discipline, seems to fit well with Department leadership where strategic planning, vision and curriculum development, and the pursuit of academic and clinical quality remain core essentials to plastic surgery. This article is an editorial of my philosophy as a plastic surgeon leading a Department of Surgery. PMID:27096204

  2. Residents' working hours in a consortium-wide surgical education program.

    PubMed

    Mittal, Vijay; Salem, Madhavi; Tyburski, James; Brocato, Joseph; Lloyd, Larry; Silva, Yvan; Silbergleit, Allen; Shanley, Charles; Remine, Stephen

    2004-02-01

    Traditional work schedules of surgical residents have been cited as a factor that negatively influences education and the quality of patient care. Demands by federal and state legislators as well as the general public have forced a re-evaluation of the issue. Long working hours and resulting sleep deprivation affect the lives of residents profoundly, but the question remains does it lower the quality of medical care? The justification for the long hours is that they are vital to medical education, but residents are so drained by their schedules that they are rarely in the best state of mind to learn from their experiences. Under the scrutiny of the Resident Review Committee (RRC), many programs and institutions have been cited in the recent past in violation of resident working hour requirements. As a result, many institutions have implemented reforms, thereby reducing the number of citations they received. In spite of having the highest number of citations, the field of general surgery has failed to show any improvement. The Oakland Health Education Programme Center for Medical Education (OHEP), a consortium of 16 teaching hospitals in the State of Michigan, set out to review the components of general surgery residency training in order to be able to make recommendations that might assist program directors in making appropriate changes where necessary to enhance resident education and the quality of patient care as well as to meet the personal demands of residents. Questionnaires on residents' attitudes concerning their working hours and possible reforms were sent to all general surgery residency programs in the OHEP consortium. The questionnaire consisted of 25 questions divided into three major sections: the first section encompassed demographic information including current work hours and on-call schedules. The second section consisted of questions relating to attitudes toward work hours and the options for change. The third section consisted of questions that

  3. 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.

  4. Plastic surgeons and the Internet: results of a worldwide survey.

    PubMed

    Koch, Horst; Dabernig, Jörg; Allert, Sixtus; Puchinger, Markus; Scharnagl, Erwin

    2002-11-01

    To obtain information on the use of the Internet, 3,139 survey forms were sent out to plastic surgeons throughout the world. More than 90% of the 565 respondents have access to the Internet and 85.5% use electronic mail for professional matters. They use the World Wide Web to search the literature, to read scientific articles, and to obtain information on congresses. A substantial proportion of the contributors have a positive attitude toward virtual congresses on the Internet and most would welcome a newsgroup dedicated to plastic surgery. Perceived apprehensions include secure transmission of sensitive data, slow data transmission, and the lack of structure and of an authority to control the contents of the Internet. Virtual congresses and a newsgroup on plastic surgery seem to be worthwhile future goals. Some problems pointed out in this survey have already been solved, at least partially, and possible solutions for the rest are discussed. PMID:12439012

  5. Analysis of the 50 most cited papers in craniofacial surgery.

    PubMed

    Tahiri, Youssef; Fleming, Tara M; Greathouse, Travis; Tholpady, Sunil S

    2015-12-01

    The intent of this study is to discuss the most prominent literature in craniofacial surgery. To do so, using the ISI Web of Science, a ranking by average number of citations per year of the top 50 craniofacial surgery articles was compiled. All plastic surgery journals listed in the "Surgery" category in the ISI Web of Knowledge Journal Citation Reports 2013 Science Edition were considered. Journal of publication, country of origin, collaborating institutions, topic of interest, and level of evidence were analyzed. The total number of citations ranged from 47 to 1017. Average number of citations per year ranged from 46.2 to 8.6. The oldest article in the top 50 was published in 1988 and the most recent in 2009. The majority of the articles came from Plastic and Reconstructive Surgery with 28 of the 50. The majority of the articles, originated from the United States (56%). Reconstruction of acquired defects was the most commonly examined topic at 46.2%; followed by articles discussing reconstruction of congenital defects (23.1%). The most common level of evidence was level 3. This extensive examination of the craniofacial literature highlights the important part that craniofacial surgery takes in the field of plastic surgery. PMID:26541748

  6. Pediatric heart surgery - discharge

    MedlinePlus

    ... reduced appetite Alternate Names Congenital heart surgery - discharge; Patent ductus arteriosus ligation - discharge; Hypoplastic left heart repair - ... of the aorta Congenital heart defect - corrective surgery Patent ductus arteriosus Pediatric heart surgery Tetralogy of Fallot ...

  7. Scoliosis surgery - child

    MedlinePlus

    Spinal curvature surgery - child; Kyphoscoliosis surgery - child; Video-assisted thoracoscopic surgery - child; VATS - child ... may also do the procedure using a special video camera. A surgical cut in the back is ...

  8. 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 ...

  9. Tennis elbow surgery - discharge

    MedlinePlus

    ... epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... long as you are told. This helps ensure tennis elbow will not return. You may be prescribed ...

  10. 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 ...

  11. Pediatric heart surgery

    MedlinePlus

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... after the baby is born. For others, your child may be able to safely wait for months ...

  12. 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

  13. Role of surgical residents in undergraduate surgical education

    PubMed Central

    Pelletier, Marc; Belliveau, Paul

    1999-01-01

    Objectives To identify the role and impact of surgical residents on the various activities of a senior (4th year) surgical clerkship, and to explore students’ perceptions of differences between the teaching behaviours of attending physicians and residents. Design A survey by questionnaire. Setting McGill University, Montreal. Method A 67-item questionnaire was administered to fourth-year medical students at the end of their 8-week surgical clerkship. Analysis of the data was performed using the Wilcoxon signed-rank test, Dunn’s multiple comparison test and mean average. Main outcome measures Overall satisfaction with the clerkship, teaching behaviours and teaching of clinical skills and basic principles. Results Overall satisfaction with the clerkship was 6.31 out of 10. Surgical residents were perceived as being significantly more active than the attending staff in 14 out of 15 teaching behaviours. They were also seen as important in teaching certain clinical skills such as suturing, assisting in the operating room and managing emergency situations. They also contributed significantly to teaching the basic principles of surgery such as infections, surgical bleeding and fluid and electrolytes. On a 10-point scale, students felt that more learning was achieved by independent reading, tutorials and residents’ teaching than by other teaching modalities, including attending physicians’ and nurses’ teaching. Conclusions Medical students perceive surgical residents as being significantly more active in their education process than the attending staff. Residents appear to be responsible for teaching various technical and patient management skills necessary for patient care. Along with independent reading and tutorials, resident teaching contributes a significant portion of the medical student’s acquisition of knowledge and appears to contribute to the students’ choice of surgery as a career. PMID:10593247

  14. Have Endovascular Procedures Negatively Impacted General Surgery Training?

    PubMed Central

    Grabo, Daniel J.; DiMuzio, Paul J.; Kairys, John C.; McIlhenny, Stephen E.; Crawford, Albert G.; Yeo, Charles J.

    2007-01-01

    Objective: Technological advances in vascular surgery have changed the field dramatically over the past 10 years. Herein, we evaluate the impact of endovascular procedures on general surgery training. Methods: National operative data from the Residency Review Committee for Surgery were examined from 1997 through 2006. Total major vascular operations, traditional open vascular operations and endovascular procedures were evaluated for mean number of cases per graduating chief general surgery resident (GSR) and vascular surgery fellow (VSF). Results: As endovascular surgical therapies became widespread, GSR vascular case volume decreased 34% over 10 years, but VSF total cases increased 78%. GSR experience in open vascular operations decreased significantly, as evidenced by a 52% decrease (P < 0.0001) in elective open AAA repair. VSFs have also seen significant decreases in open vascular procedures. Experience in endovascular procedures has increased for both general surgery and vascular residents, but the increase has been much larger in absolute number for VSFs. Conclusions: GSR experience in open vascular procedures has significantly decreased as technology has advanced within the field. Unlike VSFs, this loss has not been replaced by direct experience with endovascular training. These data demonstrate the impact technology can have on how we currently train general surgeons. New educational paradigms may be necessary in which either vascular surgery as an essential component is abandoned or training in catheter-based interventions becomes required. PMID:17717451

  15. 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…

  16. 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…

  17. 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…

  18. Resident Care Guide. Third Edition.

    ERIC Educational Resources Information Center

    Woodbridge State School, NJ.

    The third edition of the Woodbridge State School Cottage Life Department Resident Care Guide is explained to be a developmental status scale devised in 1969 as part of a 5-year study for the purposes of measuring the entire population's self-help training abilities. The department is said to serve 954 residents; 424 are non-ambulatory and 530 are…

  19. 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)

  20. Transoral Surgery

    PubMed Central

    Rock, Jack P.; Tomecek, Frank J.; Ross, Lawrence

    1993-01-01

    The transoral approaches have become commonplace in modern neurosurgical practice for treatment of ventral midline lesions of the clivus and upper cervical spine. Although the standard technique of transoral surgery is conceptually simple, anatomic relationships are not so readily appreciated. The present study was undertaken in an effort to define more clearly the midline anatomic relationships as they pertain to the standard transoral and transpalatine operations. The anatomic relationships involved in planning microsurgical transoral approaches were examined in 15 human cadavers. Landmarks approximating the midline of the skull base and the upper cervical spinal canal were defined to assist the surgeon's orientation. Measurements were made in axial, sagital, and parasagittal planes to various neurovascular structures in the posterior cranial fossa and upper cervical spinal canal. The study revealed that, for the standard transoral and transoral-transpalatine dissections, the carotid arteries, abducens nerves, interior petrosal sinuses, hypoglossal nerves, and vertebral arteries would be a greatest risk being 0.76, 1.06, 1.51, 1.34, and 1.52 cm from the midline at specified locations. The measurements and the computed tomography images provide a useful reference for the surgeon. ImagesFigure 1Figure 9 PMID:17170899

  1. 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

  2. Synaptic plasticity and phosphorylation

    PubMed Central

    Lee, Hey-Kyoung

    2009-01-01

    A number of neuronal functions, including synaptic plasticity, depend on proper regulation of synaptic proteins, many of which can be rapidly regulated by phosphorylation. Neuronal activity controls the function of these synaptic proteins by exquisitely regulating the balance of various protein kinase and protein phosphatase activity. Recent understanding of synaptic plasticity mechanisms underscores important roles that these synaptic phosphoproteins play in regulating both pre- and post-synaptic functions. This review will focus on key postsynaptic phosphoproteins that have been implicated to play a role in synaptic plasticity. PMID:16904750

  3. Polaroid photographic referral for skin cancer--a potentially useful method of reducing time to surgery.

    PubMed

    Khan, F; McGregor, J C

    1999-06-01

    A prospective trial was conducted on twenty-five patients referred by dermatologists during 1998 using a referral letter and an accompanying polaroid photograph for prospective plastic surgical management of skin cancers. Using the description and the photograph, suitable patients were given dates for operation without requiring a plastic surgery out-patient clinic appointment. This enabled, not only a saving in the cost of an out-patient appointment, but a significant reduction in waiting time to surgery. PMID:10461694

  4. Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training.

    PubMed

    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

  5. 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

  6. Dreaming in plastic

    NASA Astrophysics Data System (ADS)

    Korzhov, Marianna; Andelman, David; Shikler, Rafi

    2008-07-01

    Plastic is one of the most versatile materials available. It is cheap, flexible and easy to process, and as a result it is all around us - from our computer keyboards to the soles of our shoes. One of its most common applications is as an insulating coating for electric wires; indeed, plastic is well known for its insulating characteristics. It came as something of a surprise, therefore, when in the late 1970s a new generation of plastics was discovered that displayed exactly the opposite behaviour - the ability to conduct electricity. In fact, plastics can be made with a whole range of conductivities - there are polymer materials that behave like semiconductors and there are those that can conduct as well as metals. This discovery sparked a revolution in the electronics community, and three decades of research effort is now yielding a range of stunning new applications for this ubiquitous material.

  7. 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.)

  8. 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

  9. 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.

  10. Extruded plastic scintillation detectors

    SciTech Connect

    Anna Pla-Dalmau, Alan D. Bross and Kerry L. Mellott

    1999-04-16

    As a way to lower the cost of plastic scintillation detectors, commercially available polystyrene pellets have been used in the production of scintillating materials that can be extruded into different profiles. The selection of the raw materials is discussed. Two techniques to add wavelength shifting dopants to polystyrene pellets and to extrude plastic scintillating strips are described. Data on light yield and transmittance measurements are presented.

  11. 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.

  12. 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

  13. The Outcomes Movement and Evidence Based Medicine in Plastic Surgery

    PubMed Central

    Kowalski, Evan.; Chung, Kevin C.

    2012-01-01

    Synopsis Evidence based medicine is analyzed from its inception. The authors take the reader through the early formation of ‘scientific medicine’ that has evolved into the multi-purpose tool it has become today. Early proponents and their intentions that sparked evidence base and outcomes are presented: the work of David Sackett, Brian Haynes, Peter Tugwell, and Victor Neufeld is discussed - how they perceived the need for better clinical outcomes that led to a more formalized evidence based practice. The fundamentals are discussed objectively in detail and potential flaws are presented that guide the reader to deeper comprehension. PMID:23506764

  14. 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

  15. 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.

  16. The possibility for use of venous flaps in plastic surgery

    SciTech Connect

    Baytinger, V. F. Kurochkina, O. S. Selianinov, K. V.; Baytinger, A. V.; Dzyuman, A. N.

    2015-11-17

    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.

  17. 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

  18. Different Aspects of Informed Consent in Aesthetic Surgeries

    PubMed Central

    Nejadsarvari, Nasrin; Ebrahimi, Ali

    2014-01-01

    Providing an informed consent has an important role in promotion of medical treatments and reduction of judiciary litigations in this process. Today with cultural changes and wide propagation that is usually charming, the request for aesthetic surgery has an increasing trend. These problems with complexity of cosmetic surgeries lead to deeper differences of information between plastic surgeons and patients, so the discussion on giving information to a patient is of great importance. Regarding the elective choice of aesthetic surgeries, there is a need on providing a standard informed consent form. There are some problems on advertisements of aesthetic surgeries by non-plastic surgeons, taking insufficient or incorrect information to the patients affecting the patients’ autonomy. In fact, correct operative information should be share with the patients. Probable complications and alternative procedures should be presented to the patient to choose an operative option freely and without any charming. Obtaining a written informed consent can protect researchers and their sponsor institutions from any litigation. Patients with psychiatric problems can not benefit from aesthetic surgery and also they have no competency for giving any informed consent. So psychiatric problems can even worsen the surgical interventions. In this article, fundamentals of plastic surgery to provide an informed consent were reviewed and the legal and ethical considerations were evaluated. PMID:25489529

  19. Income, race, and surgery in Maryland.

    PubMed Central

    Gittelsohn, A M; Halpern, J; Sanchez, R L

    1991-01-01

    BACKGROUND. We describe common surgical and medical hospital admission rates for Maryland residents, exploring systematic effects of race and income. METHODS. The data comprise Maryland hospital discharges and population estimates for 1985 to 1987. Patient income is the race-specific median family income of residence zip code. Logistic regression is used to measure incidence by race, income, and residence for surgical and medical reasons for admission. RESULTS. Population rates for discretionary orthopedic, vascular, and laryngologic surgery tend to increase with community income levels. Coronary and carotid artery surgery rates are two to three times higher among Whites. The more discretionary the procedure, the lower is the relative incidence among Blacks. By contrast, admission rates for most medical reasons decline with increasing income levels and are elevated among Blacks. The affluent receive coronary artery procedures whereas the poor are hospitalized for coronary artery disease. CONCLUSIONS. Blacks and the poor appear to have higher illness burdens requiring hospital care. Discretionary surgeries have a White predominance and increase with income; medical admissions have a Black predominance and decline with income. Race and community income level are important factors in differential hospital utilization rates. PMID:1951800

  20. Impaired production of interleukin-2 after surgery.

    PubMed Central

    Akiyoshi, T; Koba, F; Arinaga, S; Miyazaki, S; Wada, T; Tsuji, H

    1985-01-01

    The capacity of peripheral blood mononuclear cells (PBM) to produce interleukin-2 (IL-2) was studied serially before and following operation in patients undergoing various surgical procedures. In patients who had major surgery, significant decrease in IL-2 activity was observed 1, 3 and 6 days after operation as compared to that before surgery, although there was no significant change throughout the post-operative course in patients undergoing minor surgery. IL-2 activity returned to the pre-operative level by the 8th post-operative day. However, it remained significantly depressed 8 days after surgery in patients who had undergone major surgical procedures of more increasing severity. Distribution of T cell subsets, especially OKT4 positive cells, did not differ significantly from the pre-operative value throughout the post-operative course. However, the depressed production of IL-2 3 days after surgery could be abolished when adherent cells were removed from PBM by plastic adherence procedures. These results indicated that adherent cells, but not quantitative change in T cell subsets, might be responsible for the depression of IL-2 production after surgery. PMID:3871677

  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. 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

  3. 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

  4. 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

  5. Measuring "humanism" in medical residents.

    PubMed

    Merrill, J M; Boisaubin, E V; Laux, L; Lynch, E C; Roessler, R; Thornby, J I

    1986-02-01

    The American Board of Internal Medicine (ABIM) has charged directors of residency programs with evaluating "humanistic attributes" in residents seeking certification. To investigate whether traditional measures of residents' performance assess humanistic attributes, 38 second- and third-year medical residents completed the Totalitarian-Authoritarian-Dogmatism (TAD) and Rokeach tests for attitudinal assessment. Five primary sources were used to measure performance. When the measures of performance and attitude were correlated, two negative correlations with "antipathy toward patients" were found: professional maturity (r = -.43, P less than .01) and compassion and concern for patients (r = -.35, P less than .04). The TAD Opinionnaire and the special performance evaluation detect "nonhumanistic dimensions" that routine faculty assessments do not. Since the new Likert scale distributed by ABIM does not differ materially from the rating form used at Baylor for 2 1/2 years, it is unlikely that "humanistic attributes" will be measured by the ABIM's new scale. PMID:3945843

  6. 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)

  7. [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

  8. 38 CFR 51.70 - Resident rights.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.70 Resident rights. The resident has a...; (iii) Physicians of the resident's choice (to provide care in the nursing home, physicians must...

  9. 38 CFR 51.70 - Resident rights.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.70 Resident rights. The resident has a...; (iii) Physicians of the resident's choice (to provide care in the nursing home, physicians must...

  10. 38 CFR 51.70 - Resident rights.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.70 Resident rights. The resident has a...; (iii) Physicians of the resident's choice (to provide care in the nursing home, physicians must...

  11. 38 CFR 51.70 - Resident rights.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.70 Resident rights. The resident has a...; (iii) Physicians of the resident's choice (to provide care in the nursing home, physicians must...

  12. 38 CFR 51.70 - Resident rights.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.70 Resident rights. The resident has a...; (iii) Physicians of the resident's choice (to provide care in the nursing home, physicians must...

  13. The plasticity of clays

    USGS Publications Warehouse

    Group, F.F.

    1905-01-01

    (1) Sand injures plasticity little at first because the grains are suspended in a plastic mass. It is only when grains are abundant enough to come in contact with their neighbors, that the effect becomes serious, and then both strength and amount of possible flow are injured. (2) Certain rare organic colloids increase the plasticity by rendering the water viscous. (3) Fineness also tends to increase plasticity. (4) Plane surfaces (plates) increase the amount of possible flow. They also give a chance for lubrication by thinner films, thus increasing the friction of film, and the strength of the whole mass. The action of plates is thus twofold ; but fineness may be carried to such an extent as to break up plate-like grains into angular fragments. The beneficial effects of plates are also decreased by the fact that each is so closely surrounded by others in the mass. (5) Molecular attraction is twofold in increasing plasticity. As the attraction increases, the coherence and strength of the mass increase, and the amount of possible deformation before crumbling also increases. Fineness increases this action by requiring more water. Colloids and crystalloids in solution may also increase the attraction. It is thus seen to be more active than any other single factor.

  14. Atlantoaxial rotatory fixation in a child after bilateral otoplastic surgery.

    PubMed

    Tauchi, Ryoji; Imagama, Shiro; Ito, Zenya; Ando, Kei; Muramoto, Akio; Matsui, Hiroki; Matsumoto, Tomohiro; Ukai, Junichi; Kobayashi, Kazuyoshi; Shinjo, Ryuichi; Nakashima, Hiroaki; Ishiguro, Naoki

    2014-07-01

    Atlantoaxial rotatory fixation (AARF), which is a dislocation or subluxation of the atlantoaxial joint, is a well-recognized condition in children. We present a case of AARF after otoplastic surgery for bilateral cryptotia performed by plastic surgeons. The pediatric patient presented with neck pain and torticollis after the surgery, and an orthopedic surgeon diagnosed AARF. The patient was treated successfully with conservative treatment incorporating mild manual manipulation, neck traction, and a collar for 1.5 months. Physicians should consider the possibility of AARF when a patient presents with neck pain and torticollis after otoplastic surgery; diagnosis and treatment should be started immediately. PMID:23754633

  15. 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.

  16. Optical properties of plastic materials for medical vision applications

    NASA Astrophysics Data System (ADS)

    Sultanova, N. G.; Kasarova, S. N.; Nikolov, I. D.

    2012-12-01

    Several types of optical polymer materials suitable for ophthalmic or medical vision applications have been studied. We have measured refractive indices of studied plastics at various wavelengths in the visible and near-infrared spectral regions. Important optical characteristics as Abbe numbers, dispersion coefficients and curves, principal and relative partial dispersion have been evaluated. Calculated refractometric data at many laser emission wavelengths used for medical surgery, therapy and diagnostics is included. As an example of a medical vision application of plastics, optical design of a micro-triplet for use in disposable endoscopes is presented.

  17. Heterogeneity and plasticity of T helper cells.

    PubMed

    Zhu, Jinfang; Paul, William E

    2010-01-01

    CD4 T helper (Th) cells play critical roles in adaptive immune responses. They recruit and activate other immune cells including B cells, CD8 T cells, macrophages, mast cells, neutrophils, eosinophils and basophils. Based on their functions, their pattern of cytokine secretion and their expression of specific transcription factors, Th cells, differentiated from naïve CD4 T cells, are classified into four major lineages, Th1, Th2, Th17 and T regulatory (Treg) cells, although other Th lineages may exist. Subsets of the same lineage may express different effector cytokines, reside at different locations or give rise to cells with different fates, whereas cells from different lineages may secrete common cytokines, such as IL-2, IL-9 and IL-10, resulting in massive heterogeneity of the Th cell population. In addition, the pattern of cytokine secretion may switch from that of one lineage toward another under certain circumstances, suggesting that Th cells are plastic. Tregs are also more heterogeneous and plastic than were originally thought. In this review, we summarize recent reports on heterogeneity and plasticity of Th cells, and discuss potential mechanisms and implications of such features that Th cells display. PMID:20010916

  18. 24 CFR 964.140 - Resident training.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...: (1) Community organization and leadership training; (2) Organizational development training for Resident Management Corporations and duly elected Resident Councils; (3) Public housing policies,...

  19. 24 CFR 964.140 - Resident training.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...: (1) Community organization and leadership training; (2) Organizational development training for Resident Management Corporations and duly elected Resident Councils; (3) Public housing policies,...

  20. Consumer hazards of plastics.

    PubMed Central

    Wiberg, G S

    1976-01-01

    The modern consumer is exposed to a wide variety of plastic and rubber products in his day to day life: at home, work, school, shopping, recreation and play, and transport. A large variety of toxic sequellae have resulted from untoward exposures by many different routes: oral, dermal, inhalation, and parenteral. Toxic change may result from the plastic itself, migration of unbound components and additives, chemical decomposition or toxic pyrolysis products. The type of damage may involve acute poisoning, chronic organ damage, reproductive disorders, and carcinogenic, mutagenic and teratogenic episodes. Typical examples for all routes are cited along with the activites of Canadian regulatory agencies to reduce both the incidence and severity of plastic-induced disease. PMID:1026409