Annals of plastic surgery
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Annals of plastic surgery · May 2017
We Are Going to Name Names and Call You Out! Improving the Team in the Academic Operating Room Environment.
Communication failures between multidisciplinary teams can impact efficiency, performance, and morale. Academic operating rooms (ORs) often have surgical, anesthesia, and nursing teams, each teaching multiple trainees. Incorrectly identifying name and "rank" (postgraduate year [PGY]) of resident trainees can disrupt performance evaluations and team morale and even potentially impair delivery of quality care when miscommunication errors proliferate. ⋯ Many fail to know the names and ranks of contributors among members of different OR teams. Even our most reliable nursing team was inconsistent at identification information from collaborating practitioners. Despite universally acknowledged benefits, participants rarely learned basic background identification data beyond their own team. Those surveyed all desired improving identifications with suggestions including sterile name and rank tags and proper notification of entry and exit from the OR. Because successful collaborations require appropriate level task delegations, participants believed knowing a resident's name and rank is important not only for team bonding but also for safety. Academia furthermore demands fair performance evaluations, and displaying them clearly improves recall. Refining our own identified gaps in OR communications may demonstrate improved teamwork and safer task delegations and perhaps even stimulate other performance benefits for academic ORs.
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Annals of plastic surgery · May 2017
Latissimus Dorsi Flap Breast Reconstruction-A Nationwide Inpatient Sample Review.
The latissimus dorsi (LD) myocutaneous flap has been a long term standard for breast reconstruction. The variable indications for the LD flap have not been statistically examined because of the relative infrequency of its use by any single surgeon or institution. ⋯ The LD is most commonly used for delayed or salvage breast reconstruction, with particular utility in irradiated patients. Younger patients tend to undergo more involved LD variants with bilateral reconstructions and expanders or implants. After adjusting for comorbidity, age and the use of bilateral latissimus flaps with implants or expanders have no adverse impact on LOS.
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Annals of plastic surgery · May 2017
The Teaching of Ethics and Professionalism in Plastic Surgery Residency: A Cross-Sectional Survey.
The ethical practice of medicine has always been of utmost importance, and plastic surgery is no exception. The literature is devoid of information on the teaching of ethics and professionalism in plastic surgery. In light of this, a survey was sent to ascertain the status of ethics training in plastic surgery residencies. ⋯ Despite the lack of information in the literature, formal ethics and professionalism training does exist in many plastic surgery residencies, although barriers to implementation do exist. Plastic surgery leadership should be involved in the development of standardized curricula to help overcome these barriers.
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Annals of plastic surgery · Apr 2017
Reconstruction of Moderate-Sized Hand Defects Using a Superficial Lateral Sural Artery Perforator Flap.
The skin on the lower leg has abundant perforators and, thus, is an excellent donor site for transplant tissue flaps. However, due to vascular variations and body positions, tissue flaps at the posterolateral proximal portion of the lower leg are rarely used for transplantation. This study reports our experience with the use of superficial lateral sural artery perforator (SLSAP) flaps in the repair of moderate-sized hand wounds. ⋯ Our experience showed that the SLSAP flap is suitable for reconstruction of moderate-sized hand defects.
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Annals of plastic surgery · Apr 2017
Heat-Shock Protein 70 Overexpression in Adipose-Derived Stem Cells Enhances Fat Graft Survival.
Autologous fat grafting is a prevalent technique used for soft-tissue augmentation; however, the poor survival rate of the grafted tissue remains a drawback of this method. Although adipose-derived stem cells (ASCs) are an attractive candidate for enhancing graft retention, the poor posttransplantation viability of these cells limits their application. Here we investigated whether overexpression of the antiapoptotic protein heat-shock protein 70 (Hsp70) could enhance ASCs' therapeutic potential for fat transplant survival. ⋯ Our data indicate that Hsp70 overexpression enhances the efficacy of ASC therapy by improving the survival and quality of the transplanted fat tissues.