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Body Image Sep 2016Our aim was to systematically review the prevalence of body dysmorphic disorder (BDD) in a variety of settings. Weighted prevalence estimate and 95% confidence intervals... (Review)
Review
Our aim was to systematically review the prevalence of body dysmorphic disorder (BDD) in a variety of settings. Weighted prevalence estimate and 95% confidence intervals in each study were calculated. The weighted prevalence of BDD in adults in the community was estimated to be 1.9%; in adolescents 2.2%; in student populations 3.3%; in adult psychiatric inpatients 7.4%; in adolescent psychiatric inpatients 7.4%; in adult psychiatric outpatients 5.8%; in general cosmetic surgery 13.2%; in rhinoplasty surgery 20.1%; in orthognathic surgery 11.2%; in orthodontics/cosmetic dentistry settings 5.2%; in dermatology outpatients 11.3%; in cosmetic dermatology outpatients 9.2%; and in acne dermatology clinics 11.1%. Women outnumbered men in the majority of settings but not in cosmetic or dermatological settings. BDD is common in some psychiatric and cosmetic settings but is poorly identified.
Topics: Adolescent; Adult; Body Dysmorphic Disorders; Body Image; Cross-Cultural Comparison; Cross-Sectional Studies; Dermatology; Female; Humans; Male; Mass Screening; Medicine; Middle Aged; Referral and Consultation; Rhinoplasty; Surgery, Plastic; Young Adult
PubMed: 27498379
DOI: 10.1016/j.bodyim.2016.07.003 -
PloS One 2020Systematic review.
STUDY DESIGN
Systematic review.
BACKGROUND AND OBJECTIVES
Preoperative neuromuscular function is predictive for knee function and return to sports (RTS) after reconstruction of the anterior cruciate ligament (ACL). The aim of this review was to examine the potential benefits of prehabilitation on pre-/postoperative objective, self-reported and RTS-specific outcomes.
METHODS
A systematic search was conducted within three databases. From the 1.071 studies screened, two randomized control trials (RCTs), two control trials (CTs) and two cohort studies (CS) met the inclusion criteria. Methodological quality rating adopted the PEDro- (RCT, CT) or Newcastle-Ottawa-Scale (CS).
RESULTS AND CONCLUSIONS
Methodological quality of the included studies was moderate (PEDro score: 6.5 ± 1.7; range 4 to 9). Two studies reported higher increases of the maximal quadriceps torque from baseline to pre-reconstruction: one study in the limb symmetry index (LSI), and one in both legs of the prehabilitation group compared to the controls. At 12-weeks post-reconstruction, one study (from two) indicated that the prehabilitation group had a lesser post-operative decline in the single-leg-hop for distance LSI (clinically meaningful). Similar findings were found in terms of quadriceps strength LSI (one study). At both pre-reconstruction (three studies) and two-year post-surgery (two studies), the prehabilitation groups reached significantly higher self-reported knee function (clinically meaningful) than the controls. RTS tended to be faster (one study). At two years post-surgery, RTS rates (one study) were higher in the prehabilitation groups. The results provide evidence for the relevance of prehabilitation prior to ACL-reconstruction to improve neuromuscular and self-reported knee function as well as RTS. More high quality confirmatory RCTs are warranted.
REGISTRATION NUMBER
PROSPERO 2017: CRD42017065491.
Topics: Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Clinical Trials as Topic; Female; Humans; Male; Postoperative Complications; Preoperative Period; Plastic Surgery Procedures; Recovery of Function; Return to Sport
PubMed: 33112865
DOI: 10.1371/journal.pone.0240192 -
Journal of Reconstructive Microsurgery Mar 2021Microsurgical free tissue transfer has become a reliable technique with success rates around 99% and around 5% requiring exploration for vascular compromise....
BACKGROUND
Microsurgical free tissue transfer has become a reliable technique with success rates around 99% and around 5% requiring exploration for vascular compromise. Protocols for flap monitoring between plastic surgery units vary. We aimed to elucidate the time period when monitoring is crucial for flap salvage.
METHODS
A systematic search of literature was performed in PubMed, Cochrane Library, Medline, and Scopus databases from 1966 to July 2018 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, identifying 3,844 studies with mention of free flap and monitoring or timing or salvage or compromise. Studies were screened for relevance according to predetermined inclusion criteria. Data was extracted from included studies relating to flap type, monitoring, timing and reason for failure, and success of salvage intervention.
RESULTS
A total of 109 studies featuring 44,031 free flaps were included. A total of 2,549 (5.8%) flaps required return to theater for compromise; 926 (2.1%) were lost and 1,654 (3.7%) were salvaged. In the first 24 hours postoperatively 93.8% of explored flaps are successfully salvaged, by day 2: 83.33%, day 3: 12.1%, and beyond day 4: none were successful. Of the 355 flaps where the cause of failure was reported, 59.5% was venous, 27.9% was arterial, 2.3% was a combination of both, and 10.2% was hematoma or infection. The proportion of flap failures at various recipient sites was highest in the trunk/viscera (7%, 95% confidence interval [CI] 0.00, 0.36), followed by limbs (5%, 95% CI 0.02, 0.08), head and neck (3%, 95% CI 0.02, 0.04), and breast (<1%; 95% CI 0.00, 0.02).
CONCLUSION
Close flap monitoring is of most value in the first 48 hours postoperatively, facilitating rapid detection of vascular compromise, early salvage, and better outcomes. The location of the flap has implications on its success and certain recipient sites may need particular attention to improve chances of success.
Topics: Free Tissue Flaps; Humans; Postoperative Complications; Plastic Surgery Procedures; Retrospective Studies; Salvage Therapy; Surgery, Plastic
PubMed: 33395711
DOI: 10.1055/s-0040-1722182 -
Journal of Wound Care Dec 2021Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and severe skin and mucosal reactions that are associated with high mortality. Despite the... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and severe skin and mucosal reactions that are associated with high mortality. Despite the severity, an evidence-based treatment protocol for SJS/TEN is still lacking.
METHOD
In this systematic review and meta-analysis, the PubMed database was searched using the following terms: [Stevens-Johnson syndrome] OR [toxic epidermal necrolysis] AND [therapy] OR [treatment] over a 20-year period (1999-2019) in the German and English language. All clinical studies reporting on the treatment of SJS/TEN were included, and epidemiological and diagnostic aspects of treatment were analysed. A meta-analysis was conducted on all comparative clinical studies that met the inclusion criteria.
RESULTS
A total of 88 studies met the inclusion criteria, reporting outcomes in 2647 patients. Treatment was either supportive or used systemic corticosteroid, intravenous immunoglobulin, plasmapheresis, cyclosporine, thalidomide or cyclophosphamide therapy. The meta-analysis included 16 (18%) studies, reporting outcomes in 976 (37%) patients. Systemic glucocorticoids showed a survival benefit for SJS/TEN patients in all analyses compared with other forms of treatment. Cyclosporine treatment also showed promising results, despite being used in a small cohort of patients. No beneficial effects on mortality could be demonstrated for intravenous immunoglobulins.
CONCLUSION
Glucocorticoids and cyclosporine may be tentatively recommended as the most promising immunomodulatory therapies for SJS/TEN, but these results should be investigated in future prospective controlled trials.
Topics: Cohort Studies; Cyclosporine; Humans; Immunoglobulins, Intravenous; Retrospective Studies; Skin; Stevens-Johnson Syndrome
PubMed: 34881995
DOI: 10.12968/jowc.2021.30.12.1012 -
Orbit (Amsterdam, Netherlands) Oct 2017This is a systematic review of eyebrow reconstruction options, using the PubMed database, as well as dermatology and plastic surgery texts. Eyebrow reconstruction... (Review)
Review
This is a systematic review of eyebrow reconstruction options, using the PubMed database, as well as dermatology and plastic surgery texts. Eyebrow reconstruction options in various clinical scenarios (small, large, medial, lateral, and total defects) are presented. The goals of eyebrow reconstruction are to provide structural, functional, and aesthetic restoration. A good understanding of various eyebrow reconstruction techniques is essential for plastic, dermatologic, and oculoplastic surgeons.
Topics: Eyebrows; Hair; Humans; Ophthalmologic Surgical Procedures; Plastic Surgery Procedures; Skin Transplantation; Surgical Flaps
PubMed: 28700281
DOI: 10.1080/01676830.2017.1337171 -
Facial Plastic Surgery Clinics of North... Aug 2015Systematic reviews and meta-analyses hold a unique position in the pyramid of evidence. They can provide transparent and rigorous summaries to answer many clinical... (Meta-Analysis)
Meta-Analysis Review
Systematic reviews and meta-analyses hold a unique position in the pyramid of evidence. They can provide transparent and rigorous summaries to answer many clinical questions in facial plastic surgery. They can also identify areas of research deficiency, create new knowledge, and support guidelines or policies. A well-conducted systematic review follows a structured process to minimize bias and ensure reproducibility. When appropriate, a meta-analysis is incorporated to provide a statistical synthesis that combines the results of individual studies. This powerful quantitative method is becoming more prevalent in facial plastic surgery. This article provides a practical framework to understand and conduct this valuable type of research.
Topics: Face; Humans; Plastic Surgery Procedures; Surgery, Plastic
PubMed: 26208766
DOI: 10.1016/j.fsc.2015.04.001 -
Journal of Plastic, Reconstructive &... Jan 2023The health research agenda has historically been led by researchers; however, their priorities may not necessarily align with those of patients, caregivers and... (Review)
Review
BACKGROUND
The health research agenda has historically been led by researchers; however, their priorities may not necessarily align with those of patients, caregivers and clinicians. Research priority setting initiatives identify and prioritise topics which lack evidence. This is particularly important in plastic surgery, a speciality lacking high-quality evidence to definitively answer many common clinical questions. Research priorities direct research activity and funding, so their selection process must be representative and transparent. This review appraised all priority setting initiatives in plastic surgery using the reporting guideline for priority setting of health research (REPRISE).
METHODS
OVID Medline, EMBASE, CINAHL and the James Lind Alliance (JLA) repository were searched (inception - 11/06/21) using search terms for 'research priority setting' and 'plastic and reconstructive surgery'. Dual-author screening and data extraction were conducted, according to PRISMA.
RESULTS
Of 3899 de-duplicated citations, 17 were included. Most studies were conducted in national (14/17), high-income (16/17) settings. More priority setting initiatives focussed on burns (6/17) and hand surgery (4/17) than other subspecialties. The JLA (5/17) and qualitative (5/17) approaches were most used for prioritisation, followed by Delphi techniques (3/17), other surveys (3/17) and mixed methods (1/17). A minority included patient (8/17) or multi-disciplinary (8/17) stakeholders. Few reported strategies for implementing research priorities (6/17) or measuring their impact (2/17).
CONCLUSIONS
Stakeholders from lower-income countries are underrepresented in priority setting initiatives for plastic surgery, despite the global burden of disease. Future studies should recruit more patient and multidisciplinary stakeholders, to achieve meaningful consensus. Clear implementation strategies are needed to maximise impact.
Topics: Humans; Surgery, Plastic; Surveys and Questionnaires; Caregivers; Research Personnel; Research; Biomedical Research; Health Priorities
PubMed: 36516507
DOI: 10.1016/j.bjps.2022.10.035 -
Plastic and Reconstructive Surgery Jul 2023Crowdsourcing uses online platforms to collect large data from laypersons and has been increasingly used over the past 5 years to answer questions about aesthetic and...
BACKGROUND
Crowdsourcing uses online platforms to collect large data from laypersons and has been increasingly used over the past 5 years to answer questions about aesthetic and functional outcomes following plastic and reconstructive surgery. This systematic review evaluates crowdsourcing articles in plastic and reconstructive surgery based on study topic, participants, and effect size in the hopes of describing best practices.
METHODS
A systematic search strategy was developed with a licensed librarian and attending plastic surgeon to query all articles using crowdsourcing in plastic and reconstructive surgery. Covidence systematic review manager was used by two independent reviewers to import articles, screen abstracts, evaluate full texts, and extract data.
RESULTS
A search run on October 8, 2021, yielded 168 studies, of which 45 were ultimately included. Craniofacial surgery and aesthetic surgery collectively constituted over half of studies. Participants in plastic surgery crowdsourcing studies are more commonly from the United States, female, straight, 25 to 35 years old; have completed college; and earn $20,000 to $50,000 per year. Studies typically assessed aesthetic perceptions, cost approximately $350, ran a median of 9 days, included approximately 60 unique survey items, and included approximately 40 unique human images.
CONCLUSIONS
Crowdsourcing is a relatively new, low-cost method of garnering high-volume data from laypersons that may further our understanding of public perception in plastic and reconstructive surgery. As with other nascent fields, there is significant variability in number of subjects used, subject compensation, and methodology, indicating an opportunity for quality improvement.
Topics: Humans; Female; Adult; Surgery, Plastic; Crowdsourcing; Plastic Surgery Procedures; Surveys and Questionnaires; Esthetics
PubMed: 36727828
DOI: 10.1097/PRS.0000000000010232 -
Aesthetic Surgery Journal. Open Forum 2023TikTok (San Jose, CA) is a popular and rapidly growing social media platform. With beauty and skincare among the top 5 most popular categories, TikTok represents an... (Review)
Review
TikTok (San Jose, CA) is a popular and rapidly growing social media platform. With beauty and skincare among the top 5 most popular categories, TikTok represents an important platform for plastic surgery education and communication. However, given the vast array of content shared daily, regulating content for veracity is challenging. It may also be an important and potentially overlooked avenue for the dissemination of inaccurate information pertaining to plastic surgery. This systematic review evaluates TikTok's impact on plastic surgery. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines, a systematic literature review was performed of the use of TikTok within the plastic surgery field. The following databases were queried: PubMed (National Institutes of Health; Bethesda, MD), EMBASE (Elsevier; Amsterdam, the Netherlands), and PsychInfo (American Psychological Association; Washington, DC). The search captured 31 studies of which 7 were included in the final analysis. The studies examined the following areas: gender-affirming surgery ( = 1), breast reconstruction ( = 1), aesthetic surgical procedures ( = 1), plastic surgeon profiles ( = 1), and profiles of videos relating to plastic surgery hashtags ( = 3). The videos' quality was assessed using the DISCERN scale. Physician videos scored notably higher than nonphysician videos. The mean DISCERN score across all the videos ( = 386) was 1.91 (range: 1.44-3.00), indicating poor quality. TikTok is a popular medium for sharing plastic surgery content. The existing literature has demonstrated overall poor-quality information on plastic surgery, and further study is needed to evaluate its impact in terms of perceptions of the specialty and healthcare behaviors. Future work should focus on promoting accurate, high-quality videos, potentially including a peer-review function for healthcare content. This can leverage TikTok's potential for disseminating content while upholding patient safety.
PubMed: 37868688
DOI: 10.1093/asjof/ojad081 -
Annals of Plastic Surgery Nov 2016Increasingly affordable three-dimensional (3D) printing technologies now make it possible for surgeons to create highly customizable patient-tailored products. This... (Review)
Review
BACKGROUND
Increasingly affordable three-dimensional (3D) printing technologies now make it possible for surgeons to create highly customizable patient-tailored products. This process provides the potential to produce individualized artificial and biologic implants, regenerative scaffolds, and cell-specific replacement tissue and organs. The combination of accurate volumetric analysis and production of 3D printed biologic materials are evolving techniques that demonstrate great promise in achieving an accurate and naturally appearing anthropomorphic reconstruction. This systematic review summarizes the current published literature and known ongoing research on 3D printing in the field of plastic and reconstructive surgery (PRS).
METHODS
Three medical databases (PubMed, Ovid MEDLINE, and Google Scholar) as well as recent news articles and university websites were searched using PRS and industry-related search terms. Inclusion criteria consisted of any publication or reputable news or academic article in electronic or printed media directly studying or commenting on the use of 3D printing technology in relation to PRS. The current literature was critically appraised, and quality of selected articles was assessed and manually filtered for relevance by 2 reviewers.
RESULTS
A total of 1092 articles were identified from the aforementioned sources discussing 3D printing in medicine. The 3D printing in relation to biologic and surgical applications was discussed in 226 articles. Within this subset, 103 articles were included in the review. Of those selected, 5 were pertinent to surgical planning, training, and patient education; 4 to upper extremity and hand prosthetics; 24 to bone and craniomaxillofacial (CMF) reconstruction; 10 to breast reconstruction; 20 to nose, ear, and cartilage reconstruction; 20 to skin; and finally 20 involving overlapping general topics in 3D printing and PRS.
CONCLUSIONS
The 3D printing provides the ability to construct complex individualized implants that not only improve patient outcomes but also increase economic feasibility. The technology offers a potential level of accessibility that is paramount for remote and resource-limited locations where health care is most often limited. The 3D printing-based technologies will have an immense impact on the reconstruction of traumatic injuries, facial and limb prosthetic development, as well as advancements in biologic and synthetic implants.
Topics: Humans; Models, Anatomic; Preoperative Care; Printing, Three-Dimensional; Prostheses and Implants; Plastic Surgery Procedures; Tissue Scaffolds
PubMed: 26678104
DOI: 10.1097/SAP.0000000000000671