Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Jun 2008
ReviewOutcome-based residency education: teaching and evaluating the core competencies in plastic surgery.
Through its oversight of residency education in the United States, the Accreditation Council for Graduate Medical Education has mandated new structural changes in resident education with its newly created core competencies and an emphasis on outcomes-based education. These core competencies represent the central areas in which the Accreditation Council for Graduate Medical Education believes a plastic surgery resident should receive adequate and appropriate education and training. In addition, as part of this outcomes-based education, residents are to be evaluated on their level of mastery in these core competencies. ⋯ This shift in residency evaluation initiated by the Outcomes Project by the Accreditation Council for Graduate Medical Education will have a significant impact in how plastic surgery residents are taught and, as importantly, evaluated in the coming years. The objectives of this work were as follows: (1) to outline the different methods available to foster a core competency-based plastic surgery training curriculum and (2) to serve as a primer to help both full-time academic and clinical faculty to further develop their curriculum to successfully teach and constructively evaluate their residents in the core competencies in accordance with the Accreditation Council for Graduate Medical Education guidelines. At the conclusion of this review, the reader should have a better understanding of what is necessary to formulate and help foster a plastic surgery core competency curriculum, particularly with an emphasis on the contemporary methods used for outcomes evaluations.
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Plast. Reconstr. Surg. · Jun 2008
Vascularized fibula flap onlay for salvage of pathologic fracture of the long bones.
Long bone pathologic fractures, especially when radiation-induced, represent a significant and difficult-to-treat entity. The ultimate goal of treatment is limb salvage; however, there are no treatment methods that guarantee bony healing. The vascularized fibula flap has revolutionized bone reconstruction, including that of the long bones. The authors report the results of onlay vascularized fibula flaps for pathologic long bone fractures and the outcomes and complications of this reconstruction method. ⋯ Despite a high complication rate, this study demonstrates that pathologic long bone fracture salvage with an onlay fibula flap achieves relatively good clinical and functional outcomes. Limb salvage was made possible in a majority of patients, all of whom experienced a difficult problem in the form of long bone pathologic fractures.
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Plast. Reconstr. Surg. · Jun 2008
Histopathologic study of the neuroma-in-continuity in obstetric brachial plexus palsy.
Operative treatment of traction lesions in obstetric brachial plexus palsy is still controversial. The authors analyzed the histopathology of neuroma-in-continuity of the upper trunk by study of the resected neuroma. ⋯ The nerve structure of the neuroma-in-continuity is substantially damaged in obstetric brachial plexus palsy. Its resection followed by nerve reconstruction of the plexus is favored.
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Plast. Reconstr. Surg. · Jun 2008
Safety device use affects the incidence patterns of facial trauma in motor vehicle collisions: an analysis of the National Trauma Database from 2000 to 2004.
Airbags and seat belts are designed to decrease injuries sustained in motor vehicle collisions. The authors hypothesize that the use of these devices has an effect on the patterns of facial fractures and facial lacerations. ⋯ Based on the largest reported series on motor vehicle collision-associated facial fractures in the United States, the use of airbags and seat belts is associated with a significantly decreased incidence of facial fractures and lacerations. Given that fewer than half of these patients used a safety device and the high morbidity and costs associated with these injuries, plastic surgeons should advocate for the increased use of these safety devices.