Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Jan 2014
Multicenter Study Clinical TrialMeasuring outcomes that matter to face-lift patients: development and validation of FACE-Q appearance appraisal scales and adverse effects checklist for the lower face and neck.
The FACE-Q is a new patient-reported outcome instrument to evaluate a range of outcomes for patients undergoing any type of facial cosmetic operation, minimally invasive cosmetic procedure, or facial injectable. This article describes the development and validation of FACE-Q scales relevant to face-lift patients. ⋯ The five FACE-Q appearance appraisal scales were found to be clinically meaningful, reliable, valid, and responsive to clinical change. These findings were supported by Rasch measurement theory analysis (e.g., overall chi-square values of p ≥ 0.18; Person Separation Index ≥ 0.88). Responsiveness analyses showed that patient scores for facial appearance improved significantly after treatment (p < 0.001); changes in scores were associated with moderate effect sizes (range effect size, 0.40 to 0.79; range standardized response mean, 0.37 to 0.69). Traditional psychometric statistics provided further support (e.g., Cronbach's alpha values ≥ 0.94) CONCLUSIONS:: The FACE-Q appearance appraisal scales are scientifically sound and clinically meaningful and can be used with the adverse effects checklist to measure patient-reported outcomes following a face lift.
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Plast. Reconstr. Surg. · Jan 2014
ReviewComplex ventral hernia repair using components separation with or without synthetic mesh: a cost-utility analysis.
Components separation provides a useful option among closure choices for complex ventral hernia repairs. The use of synthetic mesh in addition to performing a components separation is controversial. The authors' goal was to perform the first cost-utility analysis on the use of synthetic mesh in addition to performing components separation when performing a complex ventral hernia repair in a noncontaminated field. ⋯ The addition of synthetic mesh when performing components separation in repairing complex ventral hernias is cost-effective when using average retail prices. Physicians and hospitals should use synthetic mesh in patients with noncontaminated wounds.
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Hospital readmissions have become a topic of focus for quality care measures and cost-reduction efforts. However, no comparative multi-institutional data on plastic surgery outpatient readmission rates currently exist. The authors endeavored to investigate hospital readmission rates and predictors of readmission following outpatient plastic surgery. ⋯ Unplanned readmission after outpatient plastic surgery is infrequent and compares favorably to rates of readmission among other specialties. Obesity, wound infection within 30 days of the index operation, and American Society of Anesthesiologists class 3 or 4 physical status are independent predictors of readmission. As procedures continue to transition into outpatient settings and the drive to improve patient care persists, these findings will serve to optimize outpatient surgery use.
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Plast. Reconstr. Surg. · Jan 2014
Anatomic sites of origin of the suprascapular and lateral pectoral nerves within the brachial plexus.
The goal of this study was to clarify the anatomical origins of the suprascapular and lateral pectoral nerves from the brachial plexus as an aid to surgical exploration. ⋯ The suprascapular nerve most frequently originates from the posterior division of the upper trunk, and the lateral pectoral nerve from the anterior divisions of the upper and middle trunks. This information can be used to guide the surgeon in identifying the key landmarks of the supraclavicular brachial plexus at surgical exploration.