Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Dec 2009
Comparative StudyA cost-utility analysis of amputation versus salvage for Gustilo type IIIB and IIIC open tibial fractures.
Lower extremity trauma is common. Despite an abundance of literature on severe injuries that can be treated with salvage or amputation, the appropriate management of these injuries remains uncertain. In this situation, a cost-utility analysis is an important tool in providing an evidence-based practice approach to guide treatment decisions. ⋯ Unless the injury is so severe that salvage is not a possibility, based on this economic model, surgeons should consider limb salvage, which will yield lower costs and higher utility when compared with amputation.
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Plast. Reconstr. Surg. · Dec 2009
Career plans of graduating plastic surgery trainees in 2009: the impact of an uncertain economic climate.
Trainees in plastic surgery graduating in the midst of the current economic recession face unique financial challenges. These issues have the potential to affect future training and practice plans. ⋯ The majority of graduating trainees enter private practice without additional subspecialty fellowship training. Neither exceptional debt nor concern about the current economic recession was the primary determinant of future career plans, whereas trainees in a traditional model of plastic surgery and trainees with dependents were more likely to enter practice without further fellowship training.
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Existing scar evaluation tools are based on verbal descriptions and used primarily for burn scar assessment. To evaluate linear scars, the authors developed a new tool called the visual assessment of linear scars. This study was designed to determine whether patients and surgeons rated scars similarly and to test the intrarater and interrater reliability of the surgeons' ratings. ⋯ The visual assessment of linear scars tool was developed to create a simple, straightforward method of assessing the overall appearance of the postsurgical linear scar, keeping in mind that the patient's perspective might differ from that of a surgeon or researcher. Both patients and surgeons found the ratings easy to perform, and the results showed that patients might rate their scars' appearance more favorably than the surgeons. The visual assessment of linear scars is a reliable tool with two plastic surgeons' rating of repeated photographs.