Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Jan 2020
Genital Gender-Affirming Surgery in Transgender Men in The Netherlands from 1989 to 2018: The Evolution of Surgical Care.
The number of individuals with gender identity incongruence seeking treatment, including genital gender-affirming surgery, has increased over the past decade. Surgical techniques for genital gender-affirming surgery in transgender men have evolved considerably. The aim of this study was to present an overview of the evolution of genital gender-affirming surgery for transgender men in a single, high-volume center. ⋯ Genital gender-affirming surgery has developed over time in line with reconstructive surgical innovations. Despite technical advancements, there is no one ideal technique, and every technique has specific advantages and disadvantages. With the increase in surgical options, shared decision-making and a shift from surgeon-centered toward more patient-centered care are required.
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Plast. Reconstr. Surg. · Jan 2020
Discrepancies between Registered and Published Primary and Secondary Outcomes in Randomized Controlled Trials within the Plastic Surgery Literature: A Systematic Review.
Recent studies have identified a high incidence of discrepancy between registered and published outcomes in registered medical and surgical randomized controlled trials. This has not yet been studied in the plastic surgery literature. ⋯ The plastic surgery literature has high rates of discrepancies between registered and published trial outcomes. Outcome reporting discrepancy is even more problematic for secondary outcomes, an area of analysis that has previously been poorly studied. The high rate of discrepancy change favoring a statistically significant outcome and more patient-relevant outcomes may indicate the pressure to demonstrate significant results to be accepted for publication in high-impact journals.
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Plast. Reconstr. Surg. · Dec 2019
Multicenter StudyRasch Analysis of the Patient and Observer Scar Assessment Scale in Linear Scars: Suggestions for a Patient and Observer Scar Assessment Scale v2.1.
The Patient and Observer Scar Assessment Scale (POSAS) v2.0 is a widely used instrument to evaluate postsurgical scars. Its two subscales respectively investigate the patient's and clinician's opinion on the scar quality. However, psychometric studies of the POSAS have indicated that its metric performance is suboptimal, and structural adjustments may be appropriate. The authors aimed to verify through Rasch analysis the measurement properties of the POSAS v2.0, and propose eventual structural refinements for an easier and more confident use of the scale in clinical practice and research. ⋯ This study demonstrates the good psychometric properties of a simplified Rasch-based version of the Patient and Observer Scar Assessment Scale with five response options (POSAS v2.1) in patients with postsurgical linear scars, and provides insights for future refinement of the tool.
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Plast. Reconstr. Surg. · Dec 2019
The Cutting Edge of Headache Surgery: A Systematic Review on the Value of Extracranial Surgery in the Treatment of Chronic Headache.
Migraine is a debilitating neurologic condition, with a large socioeconomic impact. There is a subgroup of patients that does not adequately respond to pharmacologic management and may have underlying neuralgia. Surgical decompression of extracranial sensory nerves has been proposed as an alternative therapy. The aim of this article is to review the evidence for the surgical treatment of neuralgias. ⋯ Nerve decompression surgery is an effective way of treating headaches in a specific population of patients with neuralgia. Although a meta-analysis of the current data was not possible, the extracranial decompression of peripheral head and neck sensory nerves has a high success rate.
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Plast. Reconstr. Surg. · Nov 2019
The Fragility of Statistically Significant Randomized Controlled Trials in Plastic Surgery.
The fragility index has been proposed as a metric to evaluate the robustness of statistically significant findings in randomized controlled trials. It measures the number of events that a trial result relies on to maintain statistical significance. This study examines the robustness of statistically significant results from randomized controlled trials in the plastic surgery literature. ⋯ The results of randomized controlled trials in plastic surgery demonstrate substantial fragility, as statistically significant results were found to hinge on a small number of events. The fragility index offers an intuitive and simple metric to complement the p value and determine the confidence in the results of randomized controlled trials.