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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. 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 ...

  10. 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 ...

  11. 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. ...

  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. 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

  8. 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

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

    ERIC Educational Resources Information Center

    May, Deborah C.; Turnbull, Nancy

    1992-01-01

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

  19. 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. 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

  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. 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

  3. 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

  4. 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

  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. [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

  14. 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

  15. [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

  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. 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

  8. 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.

  9. 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…

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

    NASA Astrophysics Data System (ADS)

    Zhang, Zonghua; Zhao, Yan

    2013-12-01

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

  12. 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

  13. 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

  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. [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

  15. 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

  16. 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

  17. 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

  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. 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

  5. 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

  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. 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

  15. 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

  16. 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

  17. 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

  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. 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

  3. 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

  4. 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

  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