Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Jan 2020
Prospective Study of Doppler Ultrasound Surveillance for Deep Venous Thromboses in 1000 Plastic Surgery Outpatients.
Current guidelines recommend individual risk stratification, chemoprophylaxis, and risk mitigation to prevent venous thromboembolism. However, the evidence for efficacy is lacking in plastic surgery outpatients. Anticoagulation can cause bleeding. Ultrasound technology offers a highly accurate screening method. ⋯ Diagnostic, IV.
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Plast. Reconstr. Surg. · Jan 2020
Comparative StudyMatched Comparison of Microsurgical Anastomoses Performed with Loupe Magnification versus Operating Microscope in Traumatic Lower Extremity Reconstruction.
Although the surgical microscope remains the most common tool used for visual magnification for microsurgical anastomoses in free tissue transfer, loupe-only magnification for free flap breast reconstruction has been demonstrated to be safe and effective. To evaluate the loupe-only technique in lower extremity free flap reconstruction, the authors compared perioperative outcomes between microsurgical anastomoses performed with loupe magnification versus a surgical microscope. ⋯ Therapeutic, III.
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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.