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Handchirurgie, Mikrochirurgie,... Aug 2022Specialty training in plastic, reconstructive and aesthetic surgery is a prerequisite for safe and effective provision of care. The aim of this study was to assess and...
BACKGROUND
Specialty training in plastic, reconstructive and aesthetic surgery is a prerequisite for safe and effective provision of care. The aim of this study was to assess and portray similarities and differences in the continuing education and specialization in plastic surgery in Europe.
MATERIAL AND METHODS
A detailed questionnaire was designed and distributed utilizing an online survey administration software. Questions addressed core items regarding continuing education and specialization in plastic surgery in Europe. Participants were addressed directly via the European Leadership Forum (ELF) of the European Society of Plastic, Reconstructive and Aesthetic Surgery (ESPRAS). All participants had detailed knowledge of the organization and management of plastic surgical training in their respective country.
RESULTS
The survey was completed by 29 participants from 23 European countries. During specialization, plastic surgeons in Europe are trained in advanced tissue transfer and repair and aesthetic principles in all parts of the human body and within several subspecialties. Moreover, rotations in intensive as well as emergency care are compulsory in most European countries. Board certification is only provided for surgeons who have had multiple years of training regulated by a national board, who provide evidence of individually performed operative procedures in several anatomical regions and subspecialties, and who pass a final oral and/or written examination.
CONCLUSION
Board certified plastic surgeons meet the highest degree of qualification, are trained in all parts of the body and in the management of complications. The standard of continuing education and qualification of European plastic surgeons is high, providing an excellent level of plastic surgical care throughout Europe.
HINTERGRUND
Die Facharzt-Weiterbildung für Plastische und Ästhetische Chirurgie ist eine Grundvoraussetzung für sichere und effektive Patientenversorgung. Ziel der vorliegenden Studie war die Darstellung von Gemeinsamkeiten und Unterschieden in der Weiterbildung für Plastische Chirurgie innerhalb von Europa.
MATERIALIEN UND METHODEN
Ein internetbasierter Fragebogen wurde mit Hilfe eines kostenlosen Formularerstellungstools erstellt und verteilt. Die Fragen betrafen Kernpunkte der Weiterbildung für Plastische Chirurgie in Europa. Die Teilnehmer wurden direkt über das European Leadership Forum (ELF) der European Society of Plastic, Reconstructive and Aesthetic Surgery (ESPRAS) kontaktiert. Alle Teilnehmer hatten weitreichende Kenntnisse über die Organisation und Struktur der plastisch-chirurgischen Weiterbildung in ihrem jeweiligen Land.
ERGEBNISSE
29 Teilnehmer*innen aus 23 europäischen Ländern nahmen an der Umfrage teil. Die Weiterbildung für Plastische Chirurgie beinhaltet grundlegende Prinzipien und Techniken zur Wiederherstellung von Form und Funktion innerhalb der verschiedenen Säulen der Plastischen Chirurgie, sowie in allen Körperregionen. In den meisten europäischen Ländern ist eine Rotation in der Intensiv- und Notfallmedizin und die Behandlung kritisch kranker Patienten obligatorisch. Voraussetzung für die Facharztbezeichnung ist die mehrjährige, national organisierte Weiterbildung, der Nachweis einer festgelegten Anzahl selbstständig durchgeführter Operationen, sowie die mündliche und/oder schriftliche Abschlussprüfung.
SCHLUSSFOLGERUNG
Fachärzte für Plastische und Ästhetische Chirurgie sind hochqualifiziert und auch im Umgang mit Komplikationen geschult. Der Standard der Weiterbildung der europäischen Plastischen Chirurgen ist hoch, so dass innerhalb Europas eine hohe Qualität plastisch-chirurgischer Versorgung gewährleistet ist.
Topics: Education, Continuing; Esthetics; Europe; Humans; Surgery, Plastic; Surveys and Questionnaires
PubMed: 35944539
DOI: 10.1055/a-1894-7436 -
Plastic and Reconstructive Surgery.... Nov 2021The goal of this study was to characterize the references provided as supporting evidence of the Plastic Surgery In-service Training Examination (PSITE) syllabi,...
UNLABELLED
The goal of this study was to characterize the references provided as supporting evidence of the Plastic Surgery In-service Training Examination (PSITE) syllabi, including those on the novel "core surgical principles" section.
METHODS
We analyzed the references from five consecutive PSITE Examination syllabi (2016-2020). We collected the following information from each question: question section, total number of references, and source of publication of each reference.
RESULTS
We analyzed 1250 questions and 3436 references. was overall the most frequently referenced journal followed by ) and The most commonly referenced textbooks were (by Neligan), and Regarding the "core surgical principles" section, remained the most frequently cited journal, followed by the and . "Core surgical principles" contained the largest number of unique journals (n = 209) among all test sections. Within the "core" section, was the most frequently referenced textbook followed by
CONCLUSIONS
The main plastic surgery texts and literature were used to support approximately half of the answers within the "core surgical principles" section. The references within this section originated from the largest number of different journals, thus highlighting the breadth and variety of this content and the challenges in preparing for this section.
PubMed: 34765388
DOI: 10.1097/GOX.0000000000003639 -
International Journal of Molecular... Jul 2022Tissue adhesives have been successfully used in various kind of surgeries such as oral and maxillofacial surgery for some time. They serve as a substitute for suturing... (Review)
Review
Tissue adhesives have been successfully used in various kind of surgeries such as oral and maxillofacial surgery for some time. They serve as a substitute for suturing of tissues and shorten treatment time. Besides synthetic-based adhesives, a number of biological-based formulations are finding their way into research and clinical application. In natural adhesives, proteins play a crucial role, mediating adhesion and cohesion at the same time. Silk fibroin, as a natural biomaterial, represents an interesting alternative to conventional medical adhesives. Here, the most commonly used bioadhesives as well as the potential of silk fibroin as natural adhesives will be discussed.
Topics: Biocompatible Materials; Fibroins; Silk; Surgery, Plastic; Tissue Adhesives; Tissue Engineering; Tissue Scaffolds
PubMed: 35887050
DOI: 10.3390/ijms23147687 -
Journal of Plastic, Reconstructive &... Jun 2023To explore the possibilities of artificial intelligence (AI) text-to-picture system, DALL·E 2 was used to generated clinical photographs for medical and plastic surgery...
To explore the possibilities of artificial intelligence (AI) text-to-picture system, DALL·E 2 was used to generated clinical photographs for medical and plastic surgery education. Generic English text was used to guide AI in three categories: subcutaneous tumor, wound and skin tumor. The most clinically accurate images were chosen for the article or for further editing. AI-generated images with variating clinical accuracy in different categories. The most accurate images were the soft-tissue tumors and the least accurate wounds. This study showed that AI text-to-picture system might be worthy tool for medical education.
Topics: Humans; Artificial Intelligence; Surgery, Plastic; Plastic Surgery Procedures; Skin Neoplasms; Soft Tissue Neoplasms
PubMed: 37137194
DOI: 10.1016/j.bjps.2023.04.055 -
Plastic and Reconstructive Surgery.... Jan 2021Plastic surgery requires extensive wide-ranging surgical knowledge, special technical dexterity, and personal skills in order to achieve improved quality of life and...
Plastic surgery requires extensive wide-ranging surgical knowledge, special technical dexterity, and personal skills in order to achieve improved quality of life and satisfying outcomes for patients. For decades, international plastic surgery fellowship programs have offered opportunities to enhance the subspecialty training of young plastic surgeons abroad and promote international exchange of information in the field of plastic surgery. However, concerns around enrolling in a nontraditional educational strategy at the postgraduate level have restricted young plastic surgery residents from pursuing comprehensive training opportunities overseas. Therefore, we present a personal experience of a distinct established international fellowship program in plastic, reconstructive, and aesthetic surgery at Nippon Medical School Hospital, Japan, as an example. This institution has adopted the use of highly skilled surgical techniques, providing basic research education along with the teaching of essential personal skills needed in modern plastic surgery. As a mean to promote international educational collaboration in plastic surgery, we discussed the modern plastic surgery educational strategies worldwide that participate in developing a successful plastic surgeon's career.
PubMed: 33564590
DOI: 10.1097/GOX.0000000000003367 -
Plastic and Reconstructive Surgery Apr 2021Opioid prescribing practices contribute to opioid misuse, dependency, and diversion. There are currently no comprehensive and quantitative evidence-based guidelines that...
BACKGROUND
Opioid prescribing practices contribute to opioid misuse, dependency, and diversion. There are currently no comprehensive and quantitative evidence-based guidelines that give procedure-specific recommendations regarding opioid prescribing in plastic surgery.
METHODS
A retrospective review of 479 plastic surgery patients encompassing 23 different plastic surgery procedure categories was performed. Opioid prescribing patterns and patient-reported opioid use at 1 and 3 months postoperatively are reported.
RESULTS
Opioid overprescribing was common, averaging an excess of 13 pills per patient across all procedure categories (prescribed versus consumed, 25.4 ± 23.1 versus 12.1 ± 19.7; p = 3.0 × 10-19), with a total excess of 5895 pills (30,967 oral morphine equivalents) for the study's sample. Fifty-two percent of all opioid pills prescribed went unused. Opioid consumption ranged between four and 37 pills across procedure categories. A greater proportion of patients who reported a history of preoperative opioid use were still using opioids at the time of their 1-month and 3-month follow-up appointments (62 percent versus 9 percent at 1 month, and 31 percent versus 1 percent at 3 months). Most patients (83 percent) did not store opioids in a locked location, and 64 percent did not dispose of opioids at 1 month.
CONCLUSIONS
Opioids are commonly overprescribed by plastic surgery providers. This study determined procedure-specific opioid consumption patterns, which can help providers reduce opioid waste. In addition, patients do not properly store or dispose of opioids, demonstrating the need for better patient education.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Analgesics, Opioid; Female; Humans; Inappropriate Prescribing; Male; Middle Aged; Practice Patterns, Physicians'; Plastic Surgery Procedures; Retrospective Studies; Surgery, Plastic; Young Adult
PubMed: 33761520
DOI: 10.1097/PRS.0000000000007782 -
Journal of Plastic, Reconstructive &... Jan 2022Despite government restrictions during the coronavirus (COVID-19) pandemic, cosmetic tourism continued to occur. The authors present the impact of cosmetic tourism on...
BACKGROUND
Despite government restrictions during the coronavirus (COVID-19) pandemic, cosmetic tourism continued to occur. The authors present the impact of cosmetic tourism on their plastic surgery unit.
METHODS
Retrospective case note review of two cohorts was performed: COVID-19 (March 2020-April 2021) and a pre COVID-19 comparator (January 2019-February 2020). Patients presenting with complications from cosmetic tourism were included and their hospital notes were reviewed.
RESULTS
Seven patients were identified in the COVID-19 cohort compared with four patients in the comparator. In the COVID-19 patient group, six underwent their procedure overseas. The final patient was operated on in the UK by a visiting surgeon. Cases consisted of two abdominoplasties, two breast augmentations, two gluteal augmentations, and the final patient had a hernia repair. The most common presenting complaint in the COVID-19 cohort was a post-operative wound infection (n = 5), of which two had deeper associated collections, with two further wound dehiscences. In the pre-pandemic group, four patients underwent their procedure overseas. Cases consisted of an abdominoplasty, a blepharoplasty, a breast augmentation and a gluteal augmentation. Two patients presented with a wound infection, and two with simple wound dehiscence.
CONCLUSION
Cosmetic surgery tourism is a growing industry with an increasing number of patients presenting with complications to NHS services. These patients are a potentially vulnerable group who exhibit risk-taking behaviours, such as going abroad amidst a pandemic and acceptance of not having appropriate follow up care.
Topics: COVID-19; Humans; Medical Tourism; Pandemics; Postoperative Complications; Retrospective Studies; SARS-CoV-2; Surgery, Plastic
PubMed: 34838496
DOI: 10.1016/j.bjps.2021.11.013 -
Facial Plastic Surgery : FPS Oct 2023From virtual chat assistants to self-driving cars, artificial intelligence (AI) is often heralded as the technology that has and will continue to transform this... (Review)
Review
From virtual chat assistants to self-driving cars, artificial intelligence (AI) is often heralded as the technology that has and will continue to transform this generation. Among widely adopted applications in other industries, its potential use in medicine is being increasingly explored, where the vast amounts of data present in electronic health records and need for continuous improvements in patient care and workflow efficiency present many opportunities for AI implementation. Indeed, AI has already demonstrated capabilities for assisting in tasks such as documentation, image classification, and surgical outcome prediction. More specifically, this technology can be harnessed in facial plastic surgery, where the unique characteristics of the field lends itself well to specific applications. AI is not without its limitations, however, and the further adoption of AI in medicine and facial plastic surgery must necessarily be accompanied by discussion on the ethical implications and proper usage of AI in healthcare. In this article, we review current and potential uses of AI in facial plastic surgery, as well as its ethical ramifications.
Topics: Humans; Artificial Intelligence; Surgery, Plastic; Plastic Surgery Procedures; Forecasting
PubMed: 37353051
DOI: 10.1055/s-0043-1770160 -
Journal of Plastic, Reconstructive &... May 2022The COVID-19 pandemic has disrupted the functioning of global society and healthcare systems, including surgical departments. We aimed to assess alterations in plastic...
BACKGROUND
The COVID-19 pandemic has disrupted the functioning of global society and healthcare systems, including surgical departments. We aimed to assess alterations in plastic surgery training in Europe during the COVID-19 pandemic.
METHODS
A 34-question survey was emailed in January and February 2021 to 54 National Associations of Plastic, Reconstructive, and Aesthetic Surgeons throughout European countries. The questions concerned the general profile of plastic surgery trainees, plastic surgery department, and training organization during the COVID-19 pandemic and its influence on respondents' health. The acquisition of responses was finalized at the end of February 2021.
RESULTS
All 71 of the respondents reported alterations in planned courses, workshops, and conferences. Organizational changes included team rotation 62%, followed by redeployment to another department 45.1%. Reduction in admissions to the plastic surgery departments was more significant during the 1st wave than the 2nd wave of COVID-19 pandemics. During the interim period, admission restrictions were proportional to the infection number. The most frequently reported surgical procedures performed were skin cancer surgeries, trauma, and burns (79%, 77%, and 77%). The majority, 62% of the respondents, noticed the negative impact of pandemics on training; 53.5% think their manual skills and clinical knowledge may deteriorate because of the pandemic. Respondents noticed that their mental (50.7%) and physical (32%) health worsened, along with feeling more stressed in general (57%).
CONCLUSION
The COVID-19 pandemic limited plastic surgery departments' activities and implementation of the plastic surgery training program in all European countries involved in our study.
Topics: COVID-19; Europe; Humans; Pandemics; SARS-CoV-2; Surgery, Plastic
PubMed: 34973932
DOI: 10.1016/j.bjps.2021.11.090 -
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