Annals of plastic surgery
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Annals of plastic surgery · Jun 2015
Clinical TrialPatient access in plastic surgery: an operational and financial analysis of service-based interventions to improve ambulatory throughput in an academic surgery practice.
Inefficient patient throughput in a surgery practice can result in extended new patient backlogs, excessively long cycle times in the outpatient clinics, poor patient satisfaction, decreased physician productivity, and loss of potential revenue. This project assesses the efficacy of multiple throughput interventions in an academic, plastic surgery practice at a public university. ⋯ Implementation of a PAcE initiative, focusing on outpatient clinic throughput, yields significant improvements in access to care, patient satisfaction as measured by complaints, physician productivity, and financial performance. An academic, university-based, plastic surgery practice can use throughput interventions to deliver timely care and to enhance financial viability.
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Annals of plastic surgery · Jun 2015
Patient perception of postoperative pain after administration of liposomal bupivacaine in plastic surgery.
Since obtaining FDA approval for postsurgical pain management in 2011, a number of well-designed studies have reported favorably on the safety and efficacy of liposomal bupivacaine (LB). However, the literature lacks adequate reports of patient perception of postoperative pain and subjective satisfaction. ⋯ Patient perception of efficacy after the injection of LB correlates with previous clinical findings. Our experience with LB injections for cosmetic and reconstructive breast procedures indicates that patients experienced low postoperative pain scores with high overall patient satisfaction. Additional studies comparing the use of LB to standard narcotic regimens and its use in multimodality pain management are warranted.
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Annals of plastic surgery · Jun 2015
Multicenter StudyCraniofacial fracture patterns in all terrain vehicle injuries.
A multicenter, retrospective study was conducted to determine the frequency and distribution of craniofacial fractures sustained from all terrain vehicle (ATV) accidents. ⋯ The most common craniofacial fractures experienced in ATV injuries are naso-orbital fractures. The correlation of nonuse of safety equipment and associated traumatic brain injuries displays the importance of using helmets when operating ATVs. Future studies can be conducted examining ATV-related upper extremity injuries, among others.
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Annals of plastic surgery · Jun 2015
Randomized Controlled TrialEvaluation of 2 novel devices for calculation of fluid requirements in pediatric burns.
The Parkland formula for maintenance and resuscitation fluid requirements in the first 24 hours after pediatric burns is widely used, but calculation errors frequently occur. Two different novel aids to calculation, a dedicated electronic device and a mechanical disc calculator, are described and compared with the conventional method of calculation (pen and paper, assisted by a general purpose calculator). ⋯ Both novel devices provide safer and faster alternatives to conventional methods for calculation of fluid requirements in pediatric burns.
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Annals of plastic surgery · Jun 2015
Comparative StudyEffects of immediate reconstruction on adjuvant chemotherapy in breast cancer patients.
Recent studies have shown that patients undergoing immediate breast reconstruction after mastectomy have a higher rate of complications relative to patients undergoing mastectomy alone. Conflicting data exist on how these complications impact adjuvant treatment. We sought to quantify the additional risk associated with immediate breast reconstruction after mastectomy and determine how these risks influence adjuvant chemotherapy. ⋯ Immediate reconstruction after mastectomy does not delay additional cancer treatment. Overall, when complications do occur, adjuvant therapy is significantly delayed, though the median delay was only 6 days.