Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Nov 2009
Toward outcomes-based plastic surgery training: a needs assessment of recent graduates.
The Accreditation Council for Graduate Medical Education Outcomes Project mandates data-driven improvements to training programs. Few outcomes measures exist in plastic surgery. The purpose of this study was to determine how well we presently train plastic surgery residents within the context of the council's competencies and how well those competencies are practiced after residency. ⋯ Recent graduates view plastic surgery training as excellent. The competency domain in greatest need of attention is systems-based practice. We must broaden our use of assessment instruments for more valid results and investigate gender differences in our training programs. These results describe the outcomes of current plastic surgery training and serve as a needs assessment for improvement and as a baseline for future comparison.
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Plast. Reconstr. Surg. · Nov 2009
The impact of breast reduction surgery on low-back compressive forces and function in individuals with macromastia.
Macromastia can be a morbid condition causing affected women to endure shoulder pain, back pain, intertrigo, and shoulder grooving from the bra straps. Subjective symptoms are effectively relieved by reduction mammaplasty surgery. Reliable objective evidence is limited in evaluating benefits for this patient population. ⋯ Reduction mammaplasty surgery produced objective improvement in low-back compressive forces and patients' reported level of functional disability.
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Plast. Reconstr. Surg. · Nov 2009
Reconstruction of extensive composite posterolateral mandibular defects using nonosseous free tissue transfer.
The management of composite oromandibular defects involving the posterolateral mandible and surrounding soft tissue remains a reconstructive challenge. Although bony reconstitution restores continuity of the mandible, osteocutaneous flaps sometimes do not provide adequate soft-tissue coverage of these postablative defects. The purpose of this study was to evaluate the use of soft-tissue flaps for extensive posterolateral oromandibular defects. ⋯ Extensive composite defects of the posterolateral mandibular can be repaired effectively using soft-tissue flaps alone. When reconstructing a defect involving (1) the posterolateral mandible, overlying soft-tissues, and external skin and/or (2) the posterolateral mandible and two or more adjacent soft-tissue zones, the use of a soft-tissue flap alone can maximize success.
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Plast. Reconstr. Surg. · Oct 2009
ReviewEvidence-based patient safety advisory: patient assessment and prevention of pulmonary side effects in surgery. Part 1. Obstructive sleep apnea and obstructive lung disease.
Obstructive sleep apnea and obstructive lung disease may increase a patient's risk of perioperative pulmonary complications. This practice advisory provides an overview of the preoperative steps that should be performed to ensure appropriate patient selection and the safety of patients with these conditions. Also discussed are recommendations for perioperative management and strategies for minimizing complications.
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Plast. Reconstr. Surg. · Oct 2009
ReviewEvidence-based patient safety advisory: patient selection and procedures in ambulatory surgery.
Despite the many benefits of ambulatory surgery, there remain inherent risks associated with any surgical care environment that have the potential to jeopardize patient safety. This practice advisory provides an overview of the preoperative steps that should be completed to ensure appropriate patient selection for ambulatory surgery settings. In conjunction, this advisory identifies several physiologic stresses commonly associated with surgical procedures, in addition to potential postoperative recovery problems, and provides recommendations for how best to minimize these complications.