Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Nov 2014
Lessons learned from the American College of Surgeons National Surgical Quality Improvement Program Database: has centralized data collection improved immediate breast reconstruction outcomes and safety?
The American College of Surgeons National Surgical Quality Improvement Program database was implemented to longitudinally track surgical 30-day surgical outcomes and complications. The authors analyze the program-reported outcomes for immediate breast reconstruction from 2007 to 2011, to assess whether longitudinal data collection has improved national outcomes and to highlight areas in need of continued improvement. ⋯ Therapeutic, III.
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Plast. Reconstr. Surg. · Nov 2014
Bibliometric indices and academic promotion within plastic surgery.
Bibliometric indices are proposed measures to quantitatively and qualitatively evaluate scholarly output within academic medicine. The authors sought to validate bibliometric indices as an indicator of academic productivity within plastic surgery and their association with promotion of faculty surgeons in academic practice. ⋯ Bibliometric indices predict promotion in academic surgery and provide a useful metric for surgeons embarking on a career in academia.
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Plast. Reconstr. Surg. · Oct 2014
Preemptive, preventive, multimodal analgesia: what do they really mean?
To improve postoperative pain management, several concepts have been developed, including preemptive analgesia, preventive analgesia, and multimodal analgesia. This article will discuss the role of these concepts in improving perioperative pain management. Preemptive analgesia refers to the administration of an analgesic treatment before the surgical insult or tissue injury. ⋯ These drugs may be administered via the same route or by different routes. Thus, the aim of multimodal analgesia is to improve pain relief while reducing opioid requirements and opioid-related adverse effects. Analgesic modalities currently available for postoperative pain control include opioids, local anesthetic techniques [local anesthetic infiltration, peripheral nerve blocks, and neuraxial blocks (epidural and paravertebral)], acetaminophen, nonsteroidal anti-inflammatory drugs, and cyclooxygenase-2-specific inhibitors as well as analgesic adjuncts such as steroids, ketamine, α-2 agonists, and anticonvulsants.
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Plast. Reconstr. Surg. · Oct 2014
Randomized Controlled TrialPreemptive analgesia with bupivacaine in reduction mammaplasty: a prospective, randomized, double-blind, placebo-controlled trial.
Preincisional analgesia is an antinociceptive treatment that prevents altered central excitability from high-intensity noxious stimuli. To determine the analgesic efficacy of preoperative infiltration with bupivacaine for reduction mammaplasty, a randomized, double-blind, placebo-controlled trial was designed. ⋯ Therapeutic, I.