Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Apr 2016
Randomized Controlled Trial Comparative StudyA Prospective, Randomized, Controlled Trial of Paravertebral Block versus General Anesthesia Alone for Prosthetic Breast Reconstruction.
Paravertebral blocks have gained popularity because of ease of implementation and a shift toward ambulatory breast surgery procedures. Previous retrospective studies have reported potential benefits of paravertebral blocks, including decreased narcotic and antiemetic use. ⋯ Therapeutic, II.
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Plast. Reconstr. Surg. · Apr 2016
Comparative Study Clinical TrialEvaluation of Cutaneous Spatial Resolution and Pressure Threshold Secondary to Digital Nerve Repair.
As the sophistication of functional reconstruction procedures continues to increase, so does the need for valid, precise, and reliable instruments to assess their clinical results. The authors compare two tests for spatial resolution and two for cutaneous pressure threshold in an adult patient cohort having undergone microsurgical digital nerve repair after traumatic transection. ⋯ Diagnostic, III.
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Plast. Reconstr. Surg. · Apr 2016
Away Rotations and Matching in Integrated Plastic Surgery Residency: Applicant and Program Director Perspectives.
Although nearly all medical students pursuing integrated plastic surgery residency participate in elective rotations away from their home medical school, the value and costs of these "away" rotations have not been well studied. ⋯ Away rotations appear to be mutually beneficial for applicants and programs in helping to establish a good fit between students and training programs through an extended interaction with the students, residents, and faculty. In addition, making a good impression on a senior elective rotation (home or away) may improve an applicant's chance of matching to a residency program.
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Plast. Reconstr. Surg. · Apr 2016
Comparative StudyWhat Is the Best Way to Measure Surgical Quality? Comparing the American College of Surgeons National Surgical Quality Improvement Program versus Traditional Morbidity and Mortality Conferences.
Morbidity and mortality conferences have played a traditional role in tracking complications. Recently, the American College of Surgeons National Surgical Quality Improvement Program Pediatrics (ACS NSQIP-P) has gained popularity as a risk-adjusted means of addressing quality assurance. The purpose of this article is to report an analysis of the two methodologies used within pediatric plastic surgery to determine the best way to manage quality. ⋯ The ACS NSQIP-P database is able to accurately track complication rates similarly to morbidity and mortality conferences, although it samples only half of all procedures. Although both systems offer value, limitations exist, such as differences in definitions and purpose. Because of the rigor of the ACS NSQIP-P, we recommend that it be expanded to include currently excluded cases and an extension of the study interval.
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Plast. Reconstr. Surg. · Apr 2016
The Economic Impact of Closed-Incision Negative-Pressure Therapy in High-Risk Abdominal Incisions: A Cost-Utility Analysis.
Complex abdominal wall reconstruction is beset by postoperative complications. A recent meta-analysis comparing the use of closed-incision negative-pressure therapy to standard dressings found a statistically significant reduction in surgical-site infection. The use of closed-incision negative-pressure therapy is gaining acceptance in this population; however, the economic impact of this innovative dressing remains unknown. In this study, a cost-utility analysis was performed assessing closed-incision negative-pressure therapy and standard dressings following closure of abdominal incisions in high-risk patients. ⋯ The use of closed-incision negative-pressure therapy is cost-saving following closure of abdominal incisions in high-risk patients.