Plastic and reconstructive surgery
-
Plast. Reconstr. Surg. · Sep 2014
Bioburden after Staphylococcus aureus inoculation in type 1 diabetic rats undergoing internal fixation.
Fracture stabilization in the diabetic patient is associated with higher complication rates, particularly infection and impaired wound healing, which can lead to major tissue damage, osteomyelitis, and higher amputation rates. With an increasing prevalence of diabetes and an aging population, the risks of infection of internal fixation devices are expected to grow. Although numerous retrospective clinical studies have identified a relationship between diabetes and infection, currently there are few animal models that have been used to investigate postoperative surgical-site infections associated with internal fixator implantation and diabetes. ⋯ Using an initial series of streptozotocin doses, followed by optional additional doses to reach a target blood glucose range of 300 to 600 mg/dl, the authors reliably induced diabetes in 100 percent of the rats (n = 16), in which a narrow hyperglycemic range was maintained 14 days after onset of diabetes (mean ± SEM, 466 ± 16 mg/dl; coefficient of variation, 0.15). With respect to their primary endpoint, the authors quantified a significantly higher infectious burden in inoculated diabetic animals (median, 3.2 × 10 colony-forming units/mg dry tissue) compared with inoculated nondiabetic animals (7.2 × 10 colony-forming units/mg dry tissue). These data support the authors' hypothesis that uncontrolled diabetes adversely affects the immune system's ability to clear Staphylococcus aureus associated with internal hardware.
-
Plast. Reconstr. Surg. · Sep 2014
Diminishing relative contraindications for immediate breast reconstruction.
The rise in U.S. immediate breast reconstruction over the past decade may reflect greater patient awareness or expanding use in women not previously offered reconstruction. The purpose of the current study was to determine whether reconstruction in high-risk surgical and oncologic patients was a factor contributing to increased reconstruction rates, specifically using prosthetic techniques. ⋯ Risk, IV.
-
Plast. Reconstr. Surg. · Sep 2014
Variation in hospital-based acute care within 30 days of outpatient plastic surgery.
When complications arise following outpatient plastic surgery, patients may require hospital-based acute care after discharge. The extent to which these events vary across centers may reflect the quality of care provided. The authors conducted this study to describe the frequency and variation of hospital-based acute care rates across ambulatory surgery centers. ⋯ The overall rate of hospital-based acute care after common outpatient plastic surgery procedures is low but measurable. However, the frequency of these events varies across centers and may reflect the quality of care provided.
-
Plast. Reconstr. Surg. · Sep 2014
Influence of training institution on academic affiliation and productivity among plastic surgery faculty in the United States.
Educational processes that encourage a career in academic plastic surgery remain unclear. The authors' study aim was to examine the impact of training institution on the pursuit of a career in academic plastic surgery. ⋯ Identification of educational processes that encourage a career in academic practice may improve resident mentorship and resident interest in academic plastic surgery.
-
Plast. Reconstr. Surg. · Sep 2014
Online patient resources for breast reconstruction: an analysis of readability.
Online resources for health information are commonly used by many patients. The discrepancy between functional health literacy and available patient information is recognized as an important contributor to health disparities. To provide understandable patient information, the National Institutes of Health and the American Medical Association have advised that health literature for patients be written at a sixth-grade reading level. This study identifies the most popular, online, patient-targeted resources for breast reconstruction information, and evaluates readability of these sites in the context of literacy in the United States. ⋯ Online patient resources for breast reconstruction exceed recommended reading levels and are too difficult to be understood by a large portion of the population. Significant variability between sites provides an opportunity to direct patients to appropriate websites for their level of health literacy.