Plastic and reconstructive surgery
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Existing scar evaluation tools are based on verbal descriptions and used primarily for burn scar assessment. To evaluate linear scars, the authors developed a new tool called the visual assessment of linear scars. This study was designed to determine whether patients and surgeons rated scars similarly and to test the intrarater and interrater reliability of the surgeons' ratings. ⋯ The visual assessment of linear scars tool was developed to create a simple, straightforward method of assessing the overall appearance of the postsurgical linear scar, keeping in mind that the patient's perspective might differ from that of a surgeon or researcher. Both patients and surgeons found the ratings easy to perform, and the results showed that patients might rate their scars' appearance more favorably than the surgeons. The visual assessment of linear scars is a reliable tool with two plastic surgeons' rating of repeated photographs.
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Plast. Reconstr. Surg. · Nov 2009
Toward outcomes-based plastic surgery training: a needs assessment of recent graduates.
The Accreditation Council for Graduate Medical Education Outcomes Project mandates data-driven improvements to training programs. Few outcomes measures exist in plastic surgery. The purpose of this study was to determine how well we presently train plastic surgery residents within the context of the council's competencies and how well those competencies are practiced after residency. ⋯ Recent graduates view plastic surgery training as excellent. The competency domain in greatest need of attention is systems-based practice. We must broaden our use of assessment instruments for more valid results and investigate gender differences in our training programs. These results describe the outcomes of current plastic surgery training and serve as a needs assessment for improvement and as a baseline for future comparison.
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Plast. Reconstr. Surg. · Nov 2009
The impact of breast reduction surgery on low-back compressive forces and function in individuals with macromastia.
Macromastia can be a morbid condition causing affected women to endure shoulder pain, back pain, intertrigo, and shoulder grooving from the bra straps. Subjective symptoms are effectively relieved by reduction mammaplasty surgery. Reliable objective evidence is limited in evaluating benefits for this patient population. ⋯ Reduction mammaplasty surgery produced objective improvement in low-back compressive forces and patients' reported level of functional disability.
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Plast. Reconstr. Surg. · Nov 2009
Reconstruction of extensive composite posterolateral mandibular defects using nonosseous free tissue transfer.
The management of composite oromandibular defects involving the posterolateral mandible and surrounding soft tissue remains a reconstructive challenge. Although bony reconstitution restores continuity of the mandible, osteocutaneous flaps sometimes do not provide adequate soft-tissue coverage of these postablative defects. The purpose of this study was to evaluate the use of soft-tissue flaps for extensive posterolateral oromandibular defects. ⋯ Extensive composite defects of the posterolateral mandibular can be repaired effectively using soft-tissue flaps alone. When reconstructing a defect involving (1) the posterolateral mandible, overlying soft-tissues, and external skin and/or (2) the posterolateral mandible and two or more adjacent soft-tissue zones, the use of a soft-tissue flap alone can maximize success.