-
Medicina (Kaunas, Lithuania) Apr 2021Integrative medicine focuses on the human being as a whole-on the body, mind, and spirit-to achieve optimal health and healing. As a synthesis of conventional and...
BACKGROUND
Integrative medicine focuses on the human being as a whole-on the body, mind, and spirit-to achieve optimal health and healing. As a synthesis of conventional and complementary treatment options, integrative medicine combines the pathological with the salutogenetic approach of therapy. The aim is to create a holistic system of medicine for the individual. So far, little is known about its role in plastic surgery.
HYPOTHESIS
We hypothesize that integrative medicine based on a conventional therapy with additional anthroposophic therapies is very potent and beneficial for plastic surgery patients. Evaluation and consequence of the hypothesis: Additional anthroposophic pharmacological and non-pharmacological treatments are promising for all areas of plastic surgery. We are convinced that our specific approach will induce further clinical trials to underline its therapeutic potential.
Topics: Humans; Integrative Medicine; Plastic Surgery Procedures; Surgery, Plastic
PubMed: 33915729
DOI: 10.3390/medicina57040326 -
JPRAS Open Sep 2021Plastic surgery is a dynamic and evolving field but remains poorly understood due to lack of knowledge, media misconceptions and recent changes to medical undergraduate...
INTRODUCTION
Plastic surgery is a dynamic and evolving field but remains poorly understood due to lack of knowledge, media misconceptions and recent changes to medical undergraduate curricula. To address issues around student interest and recruitment into the speciality, it is imperative to understand the factors influencing medical students and future clinicians.
AIMS
To examine influences, interest and perceptions of plastic surgery amongst Scottish medical students and explore methods to increase undergraduate engagement.
METHOD
Cross-sectional survey distributed online via Scottish undergraduate medical school offices comprising 6 domains: demographics; career interest; perceptions, interests and influences in plastic surgery; curriculum and trainer views; understanding the role of a plastic surgeon; and undergraduate engagement.
RESULTS
A total of 193 students responded with no statistically significant relationship between year group, gender, and interest in plastic surgery. Phrases most strongly identified with plastic surgery included private practice, reconstruction and cosmetics. Placements, teaching staff and workshops/courses were found to influence perception of plastic surgery. Fortunately, only 6% of students encountered antagonism towards plastic surgery encompassing themes of negative stereotypes of surgeons and connotations surrounding cosmetic surgery. Importantly, many students were largely unaware of the range of common procedures undertaken by plastic surgeons. To overcome this lack of awareness and generate greater interest, students suggested greater plastics exposure, consultant-led teaching and workshops showcasing the specialty.
CONCLUSION
Medical students want varied, stimulating and flexible careers - something which plastic surgery can provide. However it seems the understanding of the scope of plastic surgery is poorly understood amongs future trainees. To increase uptake and interest, negative perceptions need to be addressed and greater engagement is required from medical school upwards.
PubMed: 34258366
DOI: 10.1016/j.jpra.2021.04.009 -
Cirugia Y Cirujanos 2022This study was developed to determine the incidence and outcome of thromboembolic events in a plastic surgery infirmary.
INTRODUCTION
This study was developed to determine the incidence and outcome of thromboembolic events in a plastic surgery infirmary.
METHODS
In a retrospective study, using the hospital's software of statistics and database, we selected the patients admitted to the plastic surgery infirmary of Hospital São João, Porto- Portugal, from 2006 to the end of 2015. Using software diagnosis codification that is the same as the International Classification of Diseases, Ninth Revision (ICD-9), we selected patients that suffered a deep venous thrombosis or pulmonary embolism and reviewed their medical records - collected the number of patients submitted to abdominoplasty, head and neck cancer patients, and breast cancer patients.
RESULTS
Of the 10,473 patients of the data set, nine patients were diagnosed with a venous thromboembolism (VTE) event, leading to a rate of 0.09% over the 10 years. During that period, 1728 abdominoplasties were performed, and there were three cases of VTE (0.17%); 338 head and neck cancer patients, three VTE events (0.9%), and one VTE (0.2%) in 506 breast cancer patients.
CONCLUSION
This study suggests that in plastic surgery, VTE risk assessment and corresponding prophylaxis cannot be neglected.
Topics: Humans; Female; Venous Thromboembolism; Incidence; Retrospective Studies; Surgery, Plastic; Pulmonary Embolism; Hospitals; Breast Neoplasms; Risk Factors
PubMed: 36327487
DOI: 10.24875/CIRU.22000076 -
Plastic and Reconstructive Surgery.... Feb 2022Randomized controlled trials, though considered the gold standard in clinical research, are often not feasible in plastic surgery research. Instead, researchers rely...
Randomized controlled trials, though considered the gold standard in clinical research, are often not feasible in plastic surgery research. Instead, researchers rely heavily on observational studies, leading to potential issues with confounding and selection bias. Propensity scoring-a statistical technique that estimates a patient's likelihood of having received the exposure of interest-can improve the comparability of study groups by either guiding the selection of study participants or generating a covariate that can be adjusted for in multivariate analyses. In this study, we conducted a comprehensive review of research articles published in three major plastic surgery journals (, , and ) to determine the utilization of propensity scoring methods in plastic surgery research from August 2018 to August 2020. We found that propensity scoring was used in only eight (0.8%) of 971 research articles, none of which fully reported all components of their propensity scoring methodology. We provide a brief overview of propensity score techniques and recommend guidelines for accurate reporting of propensity scoring methods for plastic surgery research. Improved understanding of propensity scoring may encourage plastic surgery researchers to incorporate the method in their own work and improve plastic surgeons' ability to understand and analyze future research studies that utilize propensity score methods.
PubMed: 35169516
DOI: 10.1097/GOX.0000000000004003 -
Physiological Research Dec 2022Despite significant advances in medical research, plastic surgeons still face a shortage of suitable patient tissues, and soft tissue reconstruction is no exception. In...
Despite significant advances in medical research, plastic surgeons still face a shortage of suitable patient tissues, and soft tissue reconstruction is no exception. In recent years, there has been a rapid boom in the use of acellular dermal matrix (ADM) in reconstructive and aesthetic surgery. ADM is incorporated into the surrounding tissue and gradually replaced by the host's collagen, thus promoting and supporting the healing process and reducing the formation of scar tissue. The main goal of this article is to provide a brief review of the current literature assessing the clinical applications of ADM across a broad spectrum of applications in plastic and reconstructive surgery.
Topics: Humans; Acellular Dermis; Surgery, Plastic; Wound Healing
PubMed: 36592440
DOI: 10.33549/physiolres.935045 -
Seminars in Plastic Surgery Aug 2019As reconstructive needs often extend past the soft tissue alone, a plastic surgeon must also be well versed in the methods of bony reconstruction. Understanding of the... (Review)
Review
As reconstructive needs often extend past the soft tissue alone, a plastic surgeon must also be well versed in the methods of bony reconstruction. Understanding of the basic science of fracture healing and the biochemical mechanisms of the different bone grafts, bone substitutes, and orthobiologics is essential to selecting among the many different options available to the modern plastic surgeon. This review provides a broad overview of these different options and the specific applications for plastic surgeons based on anatomic location.
PubMed: 31384235
DOI: 10.1055/s-0039-1693020 -
Plastic and Reconstructive Surgery.... Jun 2023Ethnic, racial, and sex disparities continue to persist in medicine despite efforts to diversify the profession. In competitive surgical specialties such as plastic...
UNLABELLED
Ethnic, racial, and sex disparities continue to persist in medicine despite efforts to diversify the profession. In competitive surgical specialties such as plastic surgery, those disparities are particularly pronounced. This study aims to evaluate racial, ethnic, and sex diversity in academic plastic surgery.
METHODS
We compiled a list of major plastic surgery professional societies, plastic surgery journal editorial boards, and plastic surgery accreditation boards to evaluate ethnic and sex diversity in society, research, and accreditation domains, respectively. Demographic data were collected and analyzed using the Mann-Whitney test and the Kruskal-Wallis test.
RESULTS
White individuals are significantly overrepresented across the professional and research domains, and Asian individuals are overrepresented in the professional domain when compared to non-white races. White individuals make up a total of 74% of the society domain, 67% of the research domain, and 86% of the accreditation domain when compared to all non-white surgeons. Male surgeons made up 79% of the society domain, 83% of the research domain, and 77% of the accreditation domain when compared to all non-male surgeons.
CONCLUSIONS
Ethnic, racial, and sex disparities persist in academic plastic surgery. This study, which looked at societies, editorial boards, and accreditation boards, demonstrated a persistent ethnic, racial, and sex homogeneity among leadership. Changes are required to continue to diversify the field and provide women and underrepresented minorities the tools needed to succeed.
PubMed: 37396840
DOI: 10.1097/GOX.0000000000004991 -
JPRAS Open Mar 2022The COVID-19 pandemic has compounded existing training issues for plastic surgeons. The issues that exist result from a complex interplay of system, generational and...
BACKGROUND
The COVID-19 pandemic has compounded existing training issues for plastic surgeons. The issues that exist result from a complex interplay of system, generational and individual factors, and can be hard to tease out by quantitative means. This pilot study aimed to investigate the perceptions of trainees and trainers of plastic surgical training in the UK.
METHODS
Ten semi-structured interviews were performed using purposive sampling in a central London plastic surgical unit. These were coded into and discussed in four themes: Medical directives and service demands; Sociocultural norms within plastic surgical training; Equity and access; and Plastic surgery training methods.
RESULTS
This study showed that current plastic surgery training is not optimised for learning or well-being, and that inequities are fostered, to the detriment of the specialty. Investment and planning are required to support our trainers and protect the diversity of our trainee group, with efficient and monitored learning essential to maintain our breadth and competence of practice.
CONCLUSION
Expanding this work through a broader study could provide valuable information to contribute to the development of future training schemes and curricula within British plastic surgery.
PubMed: 34917732
DOI: 10.1016/j.jpra.2021.10.003 -
JAMA Otolaryngology-- Head & Neck... Jun 2023Research in facial plastic and reconstructive surgery (FPRS) in the global health setting, especially in low- and middle-income countries (LMICs), is increasing year by... (Review)
Review
IMPORTANCE
Research in facial plastic and reconstructive surgery (FPRS) in the global health setting, especially in low- and middle-income countries (LMICs), is increasing year by year. As this work progresses, it will be crucial to include voices and perspectives of individuals living in the LMICs being studied.
OBJECTIVE
To characterize and understand international collaborations in published literature on FPRS care in a global health setting and report patterns in whether these articles included authors from the LMICs in which the studies took place.
EVIDENCE REVIEW
A systematic bibliometric scoping review of articles in Scopus from 1971 to 2022 was performed using a set list of search terms; studies were included using predetermined inclusion and exclusion criteria. Studies met criteria for inclusion if the abstract or text contained information regarding surgeons from a different country performing surgery or conducting research in an LMIC within the domain of FPRS. Exclusion criteria were studies that did not mention a facial plastic or reconstructive surgery and studies where both an HIC and LMIC were not mentioned.
FINDINGS
A total of 286 studies met criteria for inclusion. The highest percentage of studies (n = 72, 25.2%) were conducted across multiple countries. A total of 120 studies (41.9%) discussed cleft lip/palate. Overall, 141 studies (49.5%) included at least 1 author from the host LMIC; 89 (31.1%) had first authors from LMICs, and 72 (25.2%) had senior authors from LMICs. A total of 79 studies (27.6%) described humanitarian clinical service trips without mentioning research or education in the text. The remaining studies described research, education projects, or a combination. The published literature on humanitarian service trips had the lowest rate of inclusion of a first or senior author from the host LMICs.
CONCLUSIONS AND RELEVANCE
In this systematic bibliometric scoping review, findings showed a general trend of increased international work in the field of FPRS. However, there continues to be a paucity of inclusive authorship trends, with the majority of studies not including first or senior authors from LMICs. The findings presented here encourage new collaborations worldwide, as well as the improvement of existing efforts.
Topics: Humans; Developing Countries; Cleft Lip; Surgery, Plastic; Cleft Palate; Bibliometrics
PubMed: 37103939
DOI: 10.1001/jamaoto.2023.0372 -
Plastic and Reconstructive Surgery.... Oct 2023ChatGPT-4 (Chat Generative Pre-Trained Transformer) has demonstrated remarkable capabilities in natural language processing and understanding, making it a promising tool...
BACKGROUND
ChatGPT-4 (Chat Generative Pre-Trained Transformer) has demonstrated remarkable capabilities in natural language processing and understanding, making it a promising tool for various medical domains. This article presents a comprehensive overview of the potential applications of ChatGPT-4, a cutting-edge language model developed by OpenAI, in the field of plastic and reconstructive surgery.
METHODS
After conducting a thorough literature review, we discovered pertinent articles that explore the application of ChatGPT-4 in plastic surgery. By examining these findings and integrating the information with our personal experience using ChatGPT-4 in the field of plastic surgery, we have produced an all-encompassing narrative review.
RESULTS
The narrative review focuses on three main areas: clinical applications, research applications, and medical education. In the clinical realm, ChatGPT-4 has the potential to streamline documentation processes, improve communication, and enhance personalized patient care. It can assist in generating accurate and comprehensive progress notes, operative notes, surgical consent forms, on-call schedules, and consultation reports. However, it is important to note that ChatGPT-4 should be used as a supportive tool and should not replace human doctors.
CONCLUSIONS
The potential applications of ChatGPT-4 in plastic and reconstructive surgery are vast and promising. This technology has the potential to revolutionize documentation, research, and medical education in the field. However, it is crucial to integrate this tool responsibly, considering its limitations and ensuring that human expertise remains paramount.
PubMed: 37900984
DOI: 10.1097/GOX.0000000000005305