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Canadian Journal of Surgery. Journal... Jun 2021Surgery has become increasingly recognized as an important component of health care in low and middle income countries (LMICs). Many surgeons from high income countries...
Surgery has become increasingly recognized as an important component of health care in low and middle income countries (LMICs). Many surgeons from high income countries (HICs) are interested in working on improving access to surgery in LMICs. We sought to evaluate the involvement and potential barriers of Canadian plastic surgeons and plastic surgery residents in international work with an online survey. The survey indicated that plastic surgery residents have a high interest and involvement in international electives, with 45% of graduating residents previously involved. About 40% of respondents were involved in international projects, and academic plastic surgeons were more frequently involved than community surgeons. Taking time off work and personal/family commitments were cited as the greatest obstacles for those who are currently involved, whereas finding opportunities was the biggest challenge for those who would like to participate in the future.
Topics: Canada; Humans; International Cooperation; Internship and Residency; Medical Missions; Surgeons; Surgery, Plastic; Surveys and Questionnaires
PubMed: 34105931
DOI: 10.1503/cjs.008720 -
Tidsskrift For Den Norske Laegeforening... Oct 2021Surgical procedures in the perineum can cause major soft-tissue defects that require reconstruction with plastic surgery. In this article we present plastic surgery...
Surgical procedures in the perineum can cause major soft-tissue defects that require reconstruction with plastic surgery. In this article we present plastic surgery principles for the reconstruction of wound defects and common methods used to reconstruct wound defects in the perineum.
Topics: Humans; Perineum; Plastic Surgery Procedures; Surgery, Plastic
PubMed: 34726052
DOI: 10.4045/tidsskr.21.0161 -
Tidsskrift For Den Norske Laegeforening... Apr 2019
Topics: Burns; History, 20th Century; Humans; Pilots; Plastic Surgery Procedures; Rehabilitation; Surgery, Plastic; United Kingdom; World War II
PubMed: 30969060
DOI: 10.4045/tidsskr.18.0743 -
Aesthetic Plastic Surgery Dec 2023The COVID-19 pandemic has upended graduate medical education globally. We investigated the COVID-19 impact on learning inputs and expected learning outputs of plastic... (Review)
Review
BACKGROUND
The COVID-19 pandemic has upended graduate medical education globally. We investigated the COVID-19 impact on learning inputs and expected learning outputs of plastic surgery residents across the world.
METHODS
We administered an online survey capturing training inputs before and during the pandemic and retrieved residents' expected learning outputs compared with residents who completed their training before COVID. The questionnaire reached residents across the world through the mobilization of national and international societies of plastic surgeons.
RESULTS
The analysis included 412 plastic surgery residents from 47 countries. The results revealed a 44% decline (ranging from - 79 to 10% across countries) and an 18% decline (ranging from - 76 to across 151% countries) in surgeries and seminars, respectively, per week. Moreover, 74% (ranging from 0 to 100% across countries) and 43% (ranging from 0 to 100% across countries) of residents expected a negative COVID-19 impact on their surgical skill and scientific knowledge, respectively. We found strong correlations only between corresponding input and output: surgeries scrubbed in with surgical skill (ρ = -0.511 with p < 0.001) and seminars attended with scientific knowledge (ρ = - 0.274 with p = 0.006).
CONCLUSIONS
Our ranking of countries based on their COVID-19 impacts provides benchmarks for national strategies of learning recovery. Remedial measures that target surgical skill may be more needed than those targeting scientific knowledge. Our finding of limited substitutability of inputs in training suggests that it may be challenging to make up for lost operating room time with more seminars. Our results support the need for flexible training models and competency-based advancement.
LEVEL OF EVIDENCE V
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .
Topics: Humans; COVID-19; Surgery, Plastic; Pandemics; Education, Medical, Graduate; Internship and Residency
PubMed: 37253842
DOI: 10.1007/s00266-023-03389-w -
Revista Do Colegio Brasileiro de... 2023obesity is one of the most common diseases worldwide, and the most effective treatment to it is the bariatric surgery. One of the negative impacts of this procedure is...
INTRODUCTION
obesity is one of the most common diseases worldwide, and the most effective treatment to it is the bariatric surgery. One of the negative impacts of this procedure is the body dysmorphia caused by overhanging skin. In Brazil, the national health system - Sistema Único de Sáude (SUS) - provide body contouring surgery to treat post-bariatric patients, since 2007. This article aims to describe the Brazilian public health approach to post bariatric patients and perform an analyze in the Brazilian health care database.
METHODS
in Brazilian Health System database, a search for the post-bariatric procedures performed between 2007 to 2021 was done. The variables analyzed were geographic location, year, mean days of hospitalization, death, and mortality rate. Also, we evaluated the number of bariatric procedures done in the same period. Statistical analysis was performed using the Student-t and the chi-square tests and p-value <0.5 was considered significant.
RESULTS
a total of 12,717 plastic surgery procedures in post bariatric patients were done, with a national prevalence of 13.8%. Dermolipectomy was the most performed procedure, with 6,719. The years of 2020 and 2021 suffered a decreased of 64.3% and 70.9% in the number of surgeries (p<0,001). Bariatric Procedures had a high rate and a higher percentage of growth comparing to post bariatric surgery (p<0,001), totalizing 93,589 surgeries.
CONCLUSIONS
Brazil had a significant number of body contouring surgery, however with a low prevalence. Dermoliepctomy was the most common procedure performed. We could notice a significant impact of COVID pandemic in those procedures .
Topics: Humans; Surgery, Plastic; COVID-19; Plastic Surgery Procedures; Bariatric Surgery; Obesity; Obesity, Morbid
PubMed: 37531503
DOI: 10.1590/0100-6991e-20233520-en -
Aesthetic Plastic Surgery Oct 2023Historically, men have been shamed if they cared seemingly too much about their appearance and especially, if they pursued aesthetic surgery. However, due to the...
BACKGROUND
Historically, men have been shamed if they cared seemingly too much about their appearance and especially, if they pursued aesthetic surgery. However, due to the changing landscape of the culture, this stigma has seemed to decrease. Men have diverse and quickly changing interests in particular procedures that have not been readily explored in the currently available reports. To examine this, we analyzed interest in specific plastic surgery procedures in men over the last two decades using the Google Trends tool.
METHODS
The most common cosmetic procedures were chosen from the American Society of Plastic Surgeons website and served as the search terms for the Google Trends tool from 2004 to 2021. All 19 procedures were examined for overall trends and for changes in the last decade through comparing the data in bisected time periods.
RESULTS
Interest in all plastic surgery procedures in men increased since 2004 except for breast reduction. Most notably, jawline filler, Botox, microneedling, lip filler, chemical peel, CoolSculpting, and butt lift had the largest trend increases. In the last decade, all procedures showed a significant increase in interest.
CONCLUSIONS
While surgical volume data are valuable, our study shows that Google Trends is a beneficial tool to predict quickly changing and specific trends, especially as the patient population of plastic surgery grows with increased diversity and generational changes. Our study shows that there is an increase in male-centered plastic surgery procedures, especially nonsurgical facial procedures. Male interest in plastic surgery will continue to increase with time.
LEVEL OF EVIDENCE IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Topics: Humans; Male; United States; Surgery, Plastic; Plastic Surgery Procedures; Mammaplasty; Esthetics; Face
PubMed: 37193887
DOI: 10.1007/s00266-023-03344-9 -
Journal of Korean Medical Science Nov 2014Regenerative medicine using stem cells has progressed significantly over the last decade. Plastic surgeons historically have used tissues of human being to restore... (Review)
Review
Regenerative medicine using stem cells has progressed significantly over the last decade. Plastic surgeons historically have used tissues of human being to restore various defect sites and utilized a single cell lines for the tissue regeneration. The cell sources (autologous or allogeneic), cell types (embryonic stem cell or adult stem cell), and source of tissues (bone marrow, muscle, adipose, cartilage, or blood) are very important for stem cell-based tissue coverage. Embryonic stem cells are pluripotent precursors obtained from the inner cell mass of the blastocyst and reported to be used for preventing muscle atrophy after peripheral nerve injury. Multipotent adult stem cells are easily accessed for plastic surgeons during many routine procedures. This article briefly review the current state of overall stem cell research and clinical applications in the plastic surgical field.
Topics: Embryonic Stem Cells; Graft Rejection; Humans; Induced Pluripotent Stem Cells; Plastic Surgery Procedures; Regenerative Medicine; Surgery, Plastic; Tissue Engineering; Wound Healing
PubMed: 25473205
DOI: 10.3346/jkms.2014.29.S3.S167 -
BMJ Open Quality Dec 2023The aim of this quality improvement was to develop a sustainable nurse-led 'See and Treat' service in a regional plastic surgery unit in England for patients requiring...
The aim of this quality improvement was to develop a sustainable nurse-led 'See and Treat' service in a regional plastic surgery unit in England for patients requiring plastic surgery under local anaesthetic following traumatic injury.Trauma-related injuries are a substantial part of the workload in the plastic surgery department in question; with people with the most minor injuries requiring surgery under local anaesthetic accounting for 17%. COVID-19 threatened the continuation of any minor surgery service, but the initial crisis-driven response to the pandemic provided the opportunity to develop a new, more effective, nurse-led service for this patient group.The Model for Improvement was used and four 'Plan, Do, Study, Act' cycles deployed over an 8-week period, involving 102 patients. Routine quantitative and qualitative data in the form of a semistructured patient feedback proforma were used to guide the improvement process, optimising the new service design and delivery.The results demonstrated that 98% (n=100) of patients received same-day surgery via the new 'See and Treat' service. Staff and patient satisfaction remained high throughout; all patients preferred same-day surgery. No negative unintended consequences, for example, postoperative infections, were identified. One positive unintended consequence was the reduction in carbon footprint achieved by decreasing clinical waste and patient travel.Improvement methodology was successfully used by a nurse-led team to enable the continuation and enhancement of surgical services for trauma patients during COVID-19-driven service disruption. This service transformation has resulted in the retention of the revised service delivery model as the 'new normal' approximately 2 years later. The COVID-19 pandemic challenged the resilience of the trauma surgery service but led to a positive long-term legacy that sustainably improved waiting times and patient experience while maintaining safety.
Topics: Humans; COVID-19; Surgery, Plastic; Anesthetics, Local; Pandemics; Nurse's Role
PubMed: 38114249
DOI: 10.1136/bmjoq-2023-002280 -
Medicine Jun 2021Rhinoplasty in children has raised concerns about its safety in the pediatric population. There is scarcity of evidence describing outcomes and surgical techniques... (Comparative Study)
Comparative Study
Comparing plastic surgery and otolaryngology surgical outcomes and cartilage graft preferences in pediatric rhinoplasty: A retrospective cohort study analyzing 1839 patients.
Rhinoplasty in children has raised concerns about its safety in the pediatric population. There is scarcity of evidence describing outcomes and surgical techniques performed in pediatric rhinoplasty. We analyzed post-operative complications and cartilage preferences between plastic surgeons and otolaryngologists.Data was collected through the Pediatric National Surgical Improvement Program from 2012 to 2017. Current Procedure Terminology codes were used for data extraction. Patients were grouped according to type of rhinoplasty procedures (primary, secondary, and cleft rhinoplasty). A comparison between plastic surgeons and otolaryngologists was made in each group in terms of postoperative complications. Additionally, a sub-group analysis based on cartilage graft preferences was performed.During the study period, a total of 1839 patients underwent rhinoplasty procedures; plastic surgeons performed 1438 (78.2%) cases and otolaryngologists performed 401 (21.8%) cases. After analyzing each group, no significant differences were noted in terms of wound dehiscence, surgical site infection, readmission, or reoperation. Subgroup analysis revealed that plastic surgeons prefer using rib and ear cartilage, while otolaryngologists prefer septal and ear cartilage.The analysis of 1839 pediatric patients undergoing three types of rhinoplasty procedures showed similar postoperative outcomes, but different cartilage graft utilization between plastic surgeons and otolaryngologists.
Topics: Adolescent; Child; Child, Preschool; Costal Cartilage; Ear Cartilage; Female; Humans; Infant; Male; Nasal Cartilages; Otolaryngologists; Otolaryngology; Patient Readmission; Reoperation; Retrospective Studies; Rhinoplasty; Surgeons; Surgery, Plastic; Surgical Wound Dehiscence; Surgical Wound Infection; Treatment Outcome
PubMed: 34160421
DOI: 10.1097/MD.0000000000026393 -
Journal of Plastic, Reconstructive &... Dec 2023Harold Gillies, plastic surgeon, and Donald Morton, surgical oncologist, were iconic pioneers in their respective fields. Both of them made their mark by identifying... (Review)
Review
Harold Gillies, plastic surgeon, and Donald Morton, surgical oncologist, were iconic pioneers in their respective fields. Both of them made their mark by identifying crucial practical problems and finding innovative ways of solving them. Gillies grappled with the challenge of restoring form and function to British military personnel injured in World War I, and he set up a dedicated facility for performing this work. He introduced many new reconstructive techniques that became the foundation of the modern specialty of plastic and reconstructive surgery, which he established and nurtured. Morton, in the United States, applied his problem-solving skills to the long-debated question of the best way to manage regional lymph nodes in patients with melanoma. He developed the innovative technique of sentinel lymph node biopsy and initiated large-scale international clinical trials to establish its validity and clinical value. This and other important contributions to the emerging field of surgical oncology earned Morton his reputation as a pioneer and leader of that specialty. The problems that confronted Gillies and Morton were completely different, but both demonstrated remarkable skills as master problem-solvers in their respective fields and made extraordinary contributions to the body of knowledge and welfare of patients. All surgeons must be problem-solvers because every patient who presents for surgical management represents a new problem (or set of problems) to be addressed. As surgeons, we would do well to consider individuals such as Gillies and Morton as role models for our own problem-solving activities in day-to-day clinical practice.
Topics: Male; Humans; Surgery, Plastic; Surgical Oncology; Plastic Surgery Procedures; Sentinel Lymph Node Biopsy; Melanoma
PubMed: 37804644
DOI: 10.1016/j.bjps.2023.09.047