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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 -
Plastic and Reconstructive Surgery.... Aug 2023This study explores factors that encourage residents to apply to independent plastic surgery residencies to gain insight into whether they faced bias as a result of this...
BACKGROUND
This study explores factors that encourage residents to apply to independent plastic surgery residencies to gain insight into whether they faced bias as a result of this decision.
METHODS
Resident applicants who applied to two academic independent plastic surgery residencies in 2021 and 2022 were emailed a survey consisting of 25 questions. Responses were collected anonymously and analyzed. Descriptive statistics were performed, and subgroup analyses were conducted with Fisher exact and Pearson testing.
RESULTS
Thirty-nine complete responses were included for analysis (response rate 22.7%). Participants were asked what encouraged them to go into plastic surgery during residency. The most common reasons were scrubbing in on plastic surgery cases and interactions with plastic surgery faculty/residents, with each reason cited by 30 respondents (76.8%). Further, 20.5% of residents agreed or strongly agreed that they felt unsupported by their program director in their decision to apply into plastic surgery. Likewise, 64.1% of respondents agreed or strongly agreed to having experienced demeaning comments or jokes by faculty about their choice of plastic surgery. Consequently, 17.9% agreed or strongly agreed that they developed stress or anxiety due to how co-residents and/or faculty treated them regarding their decision to pursue plastic surgery.
CONCLUSIONS
General surgery residents planning to apply to independent plastic surgery residency may experience workplace biases related to their career decision. An important opportunity exists to support independent applicants and to provide mentorship.
PubMed: 37744674
DOI: 10.1097/GOX.0000000000005220 -
Revista Da Associacao Medica Brasileira... Jul 2021This study aimed to compare the publications authored by plastic surgeons with those from other specialties' surgeons on patient-reported outcomes of oncoplastic surgery. (Review)
Review
OBJECTIVE
This study aimed to compare the publications authored by plastic surgeons with those from other specialties' surgeons on patient-reported outcomes of oncoplastic surgery.
METHODS
A review was carried out on the Medline database, emcompassing five years (2015-2020). Studies about partial breast reconstruction after conservative treatment, immediate or delayed, by any technique, which presented patient-reported outcomes, were included.
RESULTS
We found 292 articles, from which 142 met the eligibility criteria. Publications were stratified into groups 1 (plastic surgeons) and 2 (other surgical specialties), and also into groups A (only plastic surgeons), B (only other specialties) and C (both), and compared statistically. Most publications (60.6%) were attributed to specialties other than plastic surgery. Nineteen percent had only plastic surgeons as authors, 50% only other specialties' surgeons, and 31% had both. There was no difference between groups regarding the impact factor of the journals in any of the stratifications, and the majority was published in journals with impact factor ≤2. CONCLUSION: In the last years, surgeons from specialties other than plastic surgery published more about the results of the oncoplastic surgery reported by the patients. There was no statistical difference between the groups regarding the impact factor of the journals.
Topics: Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Patient Reported Outcome Measures; Surgeons; Surgery, Plastic
PubMed: 34817528
DOI: 10.1590/1806-9282.20210186 -
Aesthetic Plastic Surgery Aug 2022Political contributions from healthcare providers are essential to shaping healthcare policy and allow physicians to expand their influence on a national level....
BACKGROUND
Political contributions from healthcare providers are essential to shaping healthcare policy and allow physicians to expand their influence on a national level. Political Action Committees in particular provide a useful avenue for unifying contributions for the interest of a specific community. This study examined the geographical distribution, temporal pattern, and overall nature of the political contributions made by plastic surgeons.
METHODS
The Federal Election Commission was analyzed for political contributions made by plastic surgeons from 2003 to 2021 using the search terms "plastic surgeon," "microsurgeon," and "craniofacial" as well as physician contributions to PlastyPAC. Contributions were categorized based on political parties (Democratic, Republican, and independent parties), and further analyzed based on state distribution and year of contribution. Spatial distribution data were then visualized using heatmaps for each state.
RESULTS
The total sum of contributions between 2003 and 2021 from plastic surgeons was $5,306,605, with $1,737,178.51 for the Republican party, $962,773.26 for the Democratic party, and $2,604,149.86 for independent parties. Political funding of PlastyPAC consisted of 47.3% of the overall political contributions. There was no significant trend through the years in the overall contribution amount. The states with the most political contributions were California, New York, Florida, and Texas.
CONCLUSIONS
The temporal stagnation of total political contributions and decline in recent PlastyPAC funding from plastic surgeons support an increased political awareness for new plastic surgeons.
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 www.springer.com/00266 .
Topics: Florida; Humans; Surgeons; Surgery, Plastic
PubMed: 34859276
DOI: 10.1007/s00266-021-02686-6 -
Ear, Nose, & Throat Journal Feb 2022To test the applicability of a fresh tissue model for teaching facial plastic techniques and approaches to the eyelids and orbit. (Observational Study)
Observational Study
OBJECTIVE
To test the applicability of a fresh tissue model for teaching facial plastic techniques and approaches to the eyelids and orbit.
DESIGN
Observational animal experiments.
SUBJECTS
Ten prepubescent sheep heads harvested following humane euthanasia at the completion of unrelated live animal research.
METHODS
Young sheep were saline perfused at the end of an in vivo protocol. Head and neck tissues were harvested and refrigerated for 3-7 days. An experienced oculoplastic surgeon and an otolaryngologist explored the feasibility of common oculoplastic procedures in the ovine model.
RESULTS
The model has potential for teaching basic principles in eyelid surgery including upper lid blepharoplasty, aponeurotic ptosis repair, upper lid gold weight lid loading for facial paralysis, lateral canthotomy and inferior limb cantholysis, lower lid tightening, and transconjunctival approach to the orbital floor. Eye muscle advancement, optic nerve sheath fenestration, and enucleation also accurately simulated human surgery. Anatomic variations limit the sheep model for orbital floor reconstruction and lacrimal drainage procedures.
CONCLUSIONS
The sheep head and neck provide an inexpensive, safe model for developing skills in several oculoplastic procedures. Formal simulation testing is needed to confirm these expert opinions.
Topics: Animals; Eyelids; Oculomotor Muscles; Orbit; Plastic Surgery Procedures; Sheep; Surgery, Plastic
PubMed: 34551606
DOI: 10.1177/01455613211047036 -
Journal of Plastic Surgery and Hand... 2023Tissue expansion can be used to overcome challenges due to tissue deficiency in plastic and reconstructive surgery; however, the long expansion process is often... (Meta-Analysis)
Meta-Analysis
Tissue expansion can be used to overcome challenges due to tissue deficiency in plastic and reconstructive surgery; however, the long expansion process is often accompanied by numerous complications. This meta-analysis aimed to determine whether endoscopy-assisted expander placement could decrease complications and shorten treatment time. This study followed the principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in PROSPERO (CRD42021226116). A literature search was performed in eight databases from their inception dates up to 25 August 2021, to identify clinical studies on endoscopy-assisted and/or open tissue expander placement in plastic and reconstructive surgery. Seven studies met the inclusion criteria. In seven studies, 194 underwent endoscopy-assisted expander placement, and 565 underwent open expander placement. The overall complication rate in the endoscopy-assisted group was significantly lower than that in the open group (risk difference (RD) -0.28, 95% confidence interval (CI), -0.38, -0.18, < .001). Subgroup analysis showed significantly lower incidence rates of hematoma, infection and dehiscence in the endoscopy-assisted group. The complication rate in the head/neck was lower with low heterogeneity (RD, -0.18; 95% CI, -0.26 to -0.09, < .001; = 0%). The endoscopy-assisted group had shorter surgery time, hospital stay and time to full expansion (weighted mean difference (WMD), -13.97 min, -16.88 h, -27.54 days; 95% CI, -15.85, -12.08 min, -24.36, -9.40 h, -38.85, -16.24 days; both < .001, respectively). Endoscopy-assisted expander placement may help lower the risk of complications, especially in the head/neck, and reduce surgery time, hospital stay, and time to full expansion. CI: confidence interval; CNKI: China National Knowledge Infrastructure Database; CSTJ, China Science and Technology Journal Database; NOS: the Newcastle-Ottawa Scale; PRISMA: preferred reporting items for systematic reviews and meta-analyses; RCT: randomized controlled trial; RoB: the cochrane risk-of-bias; RD: risk difference; WMD: weighted mean difference; SE: standard error; SND: standard normal deviate.
Topics: Humans; Tissue Expansion Devices; Surgery, Plastic; Endoscopy; Plastic Surgery Procedures; Tissue Expansion
PubMed: 35195054
DOI: 10.1080/2000656X.2022.2032106 -
Annals of African Medicine 2020The delivery of education and training in plastic surgery in Sub-Saharan Africa face increasing challenges. These include endemic shortages of plastic surgeons within... (Review)
Review
The millennial generation plastic surgery trainees in sub-Saharan Africa and social media: A review of the application of blogs, podcasts, and twitter as web-based learning tools.
The delivery of education and training in plastic surgery in Sub-Saharan Africa face increasing challenges. These include endemic shortages of plastic surgeons within postgraduate medical school faculties, the erosion of financial and clinical resources for teaching, and more recently, the millennial generation paradigm shift. It is generally accepted that the millennial generation will be more discerning and comfortable in their requirements for web-based learning content to support their education and training in plastic surgery. We reviewed current literature including original and review articles obtained through a search of PubMed database, Medline, Google Scholar, and hand searching of bibliographies of published articles using the keywords: social media, Blogs, Twitter, plastic surgery, and millennial generation. This article defines and explores Blogs, Podcasts, and Twitter, as web-based learning tools, and discusses how to leverage social media to maximize their educational value and effectiveness.s.
Topics: Africa South of the Sahara; Education, Medical, Graduate; Humans; Internet; Social Media; Surgery, Plastic; Teaching; Webcasts as Topic
PubMed: 32499462
DOI: 10.4103/aam.aam_25_17 -
Plastic and Reconstructive Surgery Feb 2022
Topics: Armed Conflicts; COVID-19; Diffusion of Innovation; Disasters; Humans; Pandemics; Plastic Surgery Procedures; Surgery, Plastic; Telemedicine
PubMed: 34958650
DOI: 10.1097/PRS.0000000000008749 -
Journal of Public Health Research Mar 2021Misconceptions surrounding the discipline of plastic surgery are widespread among not only the public, but medical students and professionals, as well. The purpose of...
INTRODUCTION
Misconceptions surrounding the discipline of plastic surgery are widespread among not only the public, but medical students and professionals, as well. The purpose of this study was to explore how the inclusion of plastic surgery rotation into the medical curriculum affects medical students' knowledge, attitudes and preferences regarding plastic surgery specialization and referral. Design and Methods: A descriptive-correlational design was utilized to collect data from 200 medical students in the final two years of education from two separate six-year medical programs in Jordan. Data was collected using self-reported questionnaires regarding knowledge of surgical procedures allocation, attitude towards plastic surgery, preference of specialization, and benefits of plastic surgery to physicians and patients.
RESULTS
Analysis showed that medical students of plastic surgery integrate rotation (program A) had a higher average score of correct procedure-allocation (M = 12.57, SD = 3.14), compared to non-integrated plastic survey rotation program (program B) (M = 8.29, SD = 3.05) 8.29. About 83% of students in program A had their knowledge on plastic surgery from direct exposure to a plastic surgeon, compared to 43% of program B, and 24% of students in program A reported that their perception of plastic surgery influenced by media compared to 62% of those in program B.
CONCLUSIONS
medical students who have been exposed to plastic surgery education are more confident about procedures of plastic surgery specialty and had more reliable sources of knowledge about plastic surgery than those who were not exposed to plastic surgery rotation.
PubMed: 33759481
DOI: 10.4081/jphr.2021.1927 -
Current Opinion in Otolaryngology &... Aug 2020Leonardo Da Vinci possessed one of humanity's greatest minds, known for exploring the boundaries of art and science. The discipline of facial plastic surgery also relies...
PURPOSE OF REVIEW
Leonardo Da Vinci possessed one of humanity's greatest minds, known for exploring the boundaries of art and science. The discipline of facial plastic surgery also relies on art and science for its advancement. This review focuses on key elements of Leonardo Da Vinci's work, and how they relate to concepts within facial plastic surgery.
RECENT FINDINGS
Leonardo Da Vinci was a self-taught creative genius. Common themes that permeated his art were those of proportion, perspective, light and shadow, anatomy, and science. These principles are reflected in key aspects of facial plastic surgery, such as facial analysis, human gaze, facial subunits, surgery of the craniofacial skeleton, and evidence-based medicine.
SUMMARY
Leonardo Da Vinci's approach to scientific inquiry and artistic beauty strikes a balance from which facial plastic surgeons have much to learn. In depth study of how Leonardo Da Vinci viewed the world furthers the analytical and creative sides of a facial plastic surgeon as well as informs their personal development.
Topics: Anatomy, Artistic; Face; History, 15th Century; Humans; Medicine in the Arts; Science; Surgery, Plastic
PubMed: 32628412
DOI: 10.1097/MOO.0000000000000643