Annals of plastic surgery
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Annals of plastic surgery · May 2016
Randomized Controlled TrialEffects of A Novel Decision Aid for Breast Reconstruction: A Randomized Prospective Trial.
The choice to undergo mastectomy and breast reconstruction is a highly personal decision with profound psychosocial effects, and ultimately, the decision between implant- and autologous tissue-based reconstruction should be made based on a combination of factual information and the patient's personal values and preferences. Unfortunately, patients undergoing breast reconstruction surgery may experience decision regret. Decision aids promote patient involvement in decision making by not only providing standard information about options, but also emphasizing comparative risks, benefits, and alternatives, and most importantly by providing clarification exercises regarding personal values to guide patients toward an individualized decision. ⋯ The use of decision aids in breast reconstruction surgery may help decrease decisional conflict and regret through promoting improved information sharing and shared decision making, which are highly important in this particular setting, patient population, and in our move toward greater patient-centered care.
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The h-index is a measure designed to assess the quantity and significance of an individual's academic contributions. The objective of this study was to determine whether the h-index of plastic surgeons correlates with academic rank and whether there is a difference based on academic rank, residency training model, sex, geographic region, faculty size, and departmental status. ⋯ The h-index of plastic surgeons seems to correlate with academic rank and has potential as a tool to measure academic productivity within plastic surgery. Plastic surgeons on faculty in integrated plastic surgery programs, those at larger programs, and male plastic surgeons tend to have higher h-indices. The difference between sexes seems to be, at least in part, due to the higher number of men in high academic positions. There does not seem to be a regional difference with regard to h-indices or a difference with regard to departmental status.
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Annals of plastic surgery · May 2016
Comparative StudyComparison of Extension Orthosis Versus Percutaneous Pinning of the Distal Interphalangeal Joint for Closed Mallet Injuries.
We compared a static extension orthosis with percutaneous pinning of the distal interphalangeal joint (DIPJ) for treatment of closed mallet injuries. After receiving counsel about treatment options, 44 patients (25 women and 19 men; mean age, 57 years) freely chose orthosis and 18 patients (5 women and 13 men; mean age, 51 years) chose pinning. Both the extension orthosis and the pin remained in place for 6 weeks; the pin then was removed, and the care in both groups was transitioned to nighttime orthosis use for an additional 6 weeks. ⋯ The techniques produce satisfactory correction of extensor lag and have high patient satisfaction. Pinning allows better correction of DIPJ extensor lag and results in a smaller degree of final extensor lag. Pinning is more expensive and may result in more DIPJ stiffness (ie, loss of active flexion), but it may be justified in certain patients (eg, medical professionals, food service workers) who would have difficulty working with an orthosis.