Experience In Reconstructive Surgery Research Articles

The Impact of Language-Discordant Care Upon the Patient Family Experience in Pediatric Plastic Surgery

Background: Patient satisfaction surveys usually overlook differences in patient family experience (PFE) for families whose spoken language is different from that of the treating physician. This study examines the relationship between language-discordant care and patient experience. Methods: A retrospective review of deidentified pediatric plastic surgery PFE survey responses from 2018 to 2021 was performed with permission from Lurie Children’s Hospital’s PFE Team. Results: A total of 443 pediatric plastic surgery patients were included. The race breakdown was White (49%), Other (23.9%), Black (8.8%), and Asian (5.9%). Ethnic distribution included “Not Hispanic/Latino” (58.2%) and “Hispanic/Latino” (31.4%). Languages spoken were English (80.4%), Spanish (18.1%), and Other (2.3%). Eighty-seven (19.64%) patients were language-discordant with their providers; out of this group, 68 (78.2%) preferred interpreter services. Methods of interpreter services included in-person (54.4%), over-the-phone (27.9%), video (1.5%), and no services (16.2%). The language-discordant group was less likely to give the highest ranking to “provider courtesy and respect” [odds ratio (OR)=0.200, P<0.001], “provider listened carefully” (OR=0.202, P<0.001), and “knowing what to do with subsequent questions following visit” (OR=0.435, P<0.01). No differences in PFE ratings existed for: “enough information provided,” overall provider rating, and whether they would recommend the facility. There were no significant differences in provider ratings by interpreter service method. Conclusions: Patient/provider language discordance results in significantly lower PFE ratings in areas involving patient teaching and perceptions of provider respect, courtesy, and careful listening. This underscores the importance of providers better accommodating families with limited English proficiency.

20. Establishing a Virtual Clinical Research Laboratory: the Consortium for Advancement Through Research and Education in Plastic Surgery (CARE) Experience

20. Establishing a Virtual Clinical Research Laboratory: the Consortium for Advancement Through Research and Education in Plastic Surgery (CARE) Experience

16. The Operation Diversify Plastic Surgery Experience: Pioneering Diversity, Equity, and Inclusion Initiatives

16. The Operation Diversify Plastic Surgery Experience: Pioneering Diversity, Equity, and Inclusion Initiatives

Surgical or Nonsurgical Facial Rejuvenation: The Patients' Choice.

Patients seeking a pan-facial rejuvenation may not receive appropriate medical advice on surgical versus nonsurgical treatments, resulting in those who are best-suited for surgery receiving nonsurgical options, and vice versa. Patients who requested total-face, nonsurgical revitalization were surveyed to understand the factors influencing this decision-making. Patients consulting for total facial rejuvenation were surveyed on their reasons for seeking nonsurgical versus surgical interventions by an investigator with 30 years of plastic surgery experience, practicing in a nonsurgical clinic alongside a dermatologist and aesthetic physician. Of the 92 patients surveyed, 78% completed the survey, 47% of whom had considered facelift surgery, and 14% of whom proceeded to inquiries or consultations with a plastic surgeon about facelift surgery. All respondents were women, and age was not an exclusion factor. Forty-four percent would still consider facelifts in later life. Among the most common reasons for choosing nonsurgical approaches were a desire for natural and subtle results, cost, having flexibility in treatment choice, concerns about surgical and anesthesia risks, downtime, the ability to distribute treatments over time, and scarring. Many patients book nonsurgical treatments without prior professional advice, and consider these as a temporary solution, but may desire surgery later in life. Before conducting nonsurgical treatments, doctors should identify this group and avoid interventions that may interfere with optimal surgical outcomes later. Also, some patients desire surgical outcomes when surgery is not a feasible option, and thus seek nonsurgical alternatives. For this group, realistic goals must be set before treatment to avoid disappointment.

Health Literacy among General and Plastic and Reconstructive Interest Population

PURPOSE: The United States population has varying levels of health literacy (HL), which impacts patient care and clinical outcomes. However, little is known regarding the levels of HL among plastic and reconstructive surgery (PRS) patients compared to the general population. Therefore, this study aims to characterize HL of PRS patients and those interested in PRS. Moreover, this study aims to assess potential risk factors for low levels of HL among this population. METHODS: Amazon’s Mechanical Turk (MTurk) platform was used through October 2021 in an IRB-approved cross-sectional study to survey adults aged 18 or older residing in the U.S. Respondents self-reported their experience or interests in PRS, and their HL was assessed using the validated Chew’s Brief Health Literacy Screener. The cohort was broadly divided into two groups: (1) a no-PRS group containing participants with no background nor interest in PRS; and (2) a PRS group containing participants interested in or who previously had any PRS. Two subgroups were created with interest or experience in: (1) cosmetic surgery or (2) reconstructive surgery, and two additional subgroups with no interest or experience in: (3) cosmetic surgery, and (4) reconstructive surgery. Differences were evaluated using unpaired t-test and Fisher’s Exact tests for continuous and categorical variables, respectively. A multivariable logistic regression model was constructed to assess associations between levels of HL and socio-demographic characteristics. RESULTS: A total of 510 responses were included and analyzed in this study. 159 (69%) participants pertain to the PRS group and 351 (31%) to the non-PRS group. The mean age was 38.3 SD 13.0 and 39.0 SD 11.9 for the PRS and non-PRS groups, respectively. The non-PRS group had more males (60%) compared to the PRS group (43%). Most of the cohort self-identified as white (83% in the PRS group vs. 84% in the non-PRS group), and non-Hispanics (80% in the PRS group and 79% in the PRS group). Gender (<0.001) and ethnicity (p 0.048) showed a statistically significant difference between groups. Low levels of HL in the non-PRS and PRS groups showed no statistically significant difference (p 0.718). Notably, a statistically significant difference in HL levels was evidenced between non-reconstructive vs. reconstructive groups [0.29 OR, 95% CI (0.15 – 0.58), p <0.001), not seen between the non-cosmetic and cosmetic groups. Age [1.03 OR, 95% CI (1.01 – 1.04), p <0.001) and being non-Hispanic (0.60 OR, 95% CI (0.37 – 0.94, p 0.028) were significant. CONCLUSION: PRS patients’ HL is representative the U.S. population, with almost half of the participants having low HL. This highlights the importance of adequately assessing HL levels among PRS patients in both clinics and the hospital setting. Reconstructive patients had notably higher levels of HL than patients who had not undergone any reconstructive procedures, potentially indicating that experience in reconstructive surgery can improve HL. This could also partly be attributed to the inherent complexity of reconstruction necessitating increased patient education for informed consent. Our study encourages providers to assess patient HL with evidence-based techniques, such as the teach-back method, to provide appropriate level patient counseling.

Buccal ureteroplasty options, techniques, long-term results

Purpose of the study. Surgical treatment of extended strictures and obliterations of the ureter is still a complicated problem of modern urology. The aim of the study was to analyze our own experience of ureteral replacement plastic surgery with buccal graft, i.e buccal ureteroplasty (BU) with its extended strictures/obliterations.Patients and methods. We’ve observed 25 patients who underwent BU. The lower third of the ureter was affected in 3 (12.0 %) cases, the lower third and the mouth of the ureter was affected in 7 people (28.0 %), the middle third in 2 (8.0 %), the upper third in 5 patients (20.0 %), the combined lesion of the upper third of the ureter and the pelvic‑ureteral segment (PUS) was in 8 (32.0 %) patients. All patients underwent repeated operations on a ureter, all revealed a significant comorbid background. The surgery was performed with a tubularized buccal graft in 13 (52.0 %), the onlay technique was applied in 12 (48.0 %). Laparoscopic surgery was performed in 10 (40.0 %) patients, surgical aid was carried out in an open way in 15 (60 %).Results. Severe complications according to the Clavien‑Dindo classification, requiring hospitalization of patients in the intensive care unit with organ dysfunction, as well as lethal outcomes were absent. The follow‑up period of patients ranged from 1 to 57 months (an average of 14.7 months). One patient after laparoscopic BU with a tubular graft had a short (1 mm) stenosis in the anastomosis area for 6 months of follow‑up, which was successfully eliminated by laser endoureterotomy. During the entire follow‑up period, residual hydronephrosis was recorded in 4 patients (16.0 %) against the background of complete patency of the anastomosis. A control flexible ureteroscopy performed in 16 (64.0 %) patients did not reveal rejection of the buccal graft. There are still 20 patients under our supervision.Conclusion. Our experience shows that the implementation of BU is possible on any part of the VMP using various techniques. This operation can be regarded as the "second" line of surgical treatment of strictures and obliterations of the ureter, especially after unsuccessful attempts of other reconstructions in a group of patients with severe concomitant pathology.

Body Image and Acceptance of Plastic Surgery Among College Students in South Korea

Abstract. Studied more extensively in Western societies, body image in other cultures is less researched. South Korea provides a unique context to examine body image given its flourishing plastic surgery industry, which is indicative of negative body image and plastic surgery acceptance. The current study examined whether relevant sociocultural factors in South Korea (i.e., fear of negative evaluation [FNE] and filial piety [FP]) play a role in the association between body image and acceptance of plastic surgery. College students in South Korea ( n = 227) completed self-report measures of body image, FNE, FP, and acceptance of plastic surgery. Students with plastic surgery experience reported greater FNE and acceptance of plastic surgery than those without. Significant negative indirect effects of body image on acceptance of plastic surgery through FNE were found in the full sample. FP was found to moderate the body image-acceptance of plastic surgery link such that for individuals low in FP, lower body areas satisfaction was associated with greater acceptance of plastic surgery. The findings highlight the importance of understanding body image within a cultural context and provide implications for body image concerns in South Korean individuals.

Four years of experience in plastic surgery of anterior abdominal wall hernias with mesh implants made of titanium thread

To evaluate the results of using titanium thread mesh implants in the treatment of anterior abdominal wall hernias. This article evaluates the titanium thread mesh implant used by us in the treatment of 240 patients with anterior abdominal wall hernias; describes the features of this type of implants and the technical features of various types of operations using them. The overall rate of postoperative complications was 2.9%. Hernia recurrence was observed in 2.4% of patients after laparoscopic transabdominal preperitoneal hernioplasty. The use of a mesh implant made of titanium thread did not reveal any specific complications for this implant. At the stage of gaining experience with a mesh implant made of titanium thread, technical difficulties may occur when placing and fixing it, which increases the duration of surgery.

An experience of reconstructive surgery for lower gingival carcinoma in a patient with von Willebrand disease

An experience of reconstructive surgery for lower gingival carcinoma in a patient with von Willebrand disease

ПРОБЛЕМЫ, ВОЗНИКАЮЩИЕ ПРИ ОПЕРАТИВНОМ ЛЕЧЕНИИ ДИАФРАГМАЛЬНЫХ ГРЫЖ

A review of the literature on prospective randomized studies of the treatment of hiatal hernias, as well as an assessment of the results of our own experience of plastic surgery for large and giant hiatal hernias, was carried out.

Forward Triage in the COVID-19 Era: The Plastic Surgery Experience.

Immediately after the COVID-19 outbreak was declared a pandemic by the World Health Organization,1 an administrative decision was made in our department to minimize unnecessary exposure of patients and staff while ensuring the continued standard medical care. We began by allocating the patients scheduled for the general plastic surgery clinic during the following weeks into separate groups according to their main reason for attendance. The indications for patients’ arrival to the scheduled clinic visit are summarized in Table 1. Biopsy-proven lesions requiring excision or wide excision, or those with positive margins, were automatically scheduled for surgery. Table 1. - Indications to Arrive to the Scheduled Clinic Appointment First postoperative visit following procedures under general anesthesia Signs of infection Signs of delayed wound healing Lesion suspicious of malignancy (e.g., malignant melanoma, SCC, BCC) Active burn/wound care Biopsy-proven lesion requiring wide excision SCC, squamous cell carcinoma; BCC, basal cell carcinoma. The results of our triage are summarized in Table 2. Our study period included the first 3 weeks of the COVID-19 pandemic, in which we had two planned clinics per week for a total of six clinics. Two hundred thirteen patients were contacted by telephone by the residents. Twenty-one patients did not respond to the phone call. Of a total of 213 patients, 28 (13 percent) met the indication to arrive, and 26 (12.2 percent) eventually arrived. Six patients did not show up despite existent indication and four insisted on attending contrary to medical recommendation. Most appointments were rescheduled for either future visit or telemedicine video appointment, and cancellation was done only in cases of complete healing and benign pathology report. Table 2. - Outcome of Forward Triage of the Patients Scheduled for the General Plastic Surgery Clinic during the First 3 Weeks of the COVID-19 Pandemic Reason for Clinic Visit No. of Patients No. of Patients with Indication to Arrive (%) No. of Patients Who Arrived (%) Immediately postoperatively after general anesthesia 10 7 (70) 5 (50) Immediately postoperatively after local anesthesia 63 5 (7.9) 7 (11.1) Late postoperatively after general anesthesia 30 2 (6.6) 3 (10) Late postoperatively after local anesthesia 28 1 (3.6) 0 (0) Scar follow-up 17 0 (0) 0 (0) Burn follow-up 8 1 (12.5) 1 (12.5) Wound follow-up 19 8 (42.1) 7 (36.8) Skin lesion follow-up 23 3 (13) 2 (8.7) First time visit 15 1 (6.6) 1 (6.6) Total 213 28 (13) 26 (12.2) In general, we managed to reduce visits to our general plastic surgery clinic by 87.8 percent during the first 3 weeks of the COVID-19 pandemic. None of the patients who rescheduled or cancelled visits attended the emergency room during this period and 1 week after. A main strategy for health care surge control is “forward triage”—the sorting of patients before they arrive in the emergency department. Direct-to-consumer (on demand) telemedicine, a twenty-first–century approach to forward triage that allows patients to be efficiently screened, is both patient-centered and conducive to self-quarantine, and protecting patients, clinicians, and the community from exposure.2 The concept of forward triage has been drawn to our field as a bridge to a fully implemented telemedicine system ready to be operated by the plastic surgery staff. A systematic review found 23 articles focused on telemedicine in plastic surgery, specifically, in wound management, free flap care, and cleft lip/palate repair. The benefits include reductions in the number of unnecessary clinic visits and improvement in triage decisions.3 However, we also recognize the fear “that the implementation of telemedicine may introduce organizational changes and have a negative impact on quality of care” as expressed by Gignon.4 We believe that forward triage, deferring or reducing surveillance visits, must be considered as a means to minimize exposure. Rescheduled visits must be tracked to avoid patients being lost to follow-up. For further aspects of telemedicine in plastic surgery, we recommend following the “12 important considerations for plastic surgeons regarding the use of electronic communication” proposed by Eberlin et al. in 2018.5 Our purpose was to share our experience regarding the first step to telemedicine, forward triage, in the time of the current COVID-19 pandemic. DISCLOSURE No funding was provided for this article. Dr. Barnea is a speaker for Johnson Medical. None of the other authors has a financial interest or personal relationship to declare in relation to the content of this article.

Giant Buschke-Löwenstein Tumor: a Successful Challenging Radical Surgery

Buschke-Lowenstein tumor (BLT) is a rare sexually transmitted disease and is commonly discovered in advanced stage where the surgical excision leaves large skin defect. We report herein the case of a 29-year-old man presenting with locally advanced giant BLT after 6 years of neglect, involving the proximal two-thirds of the penis in addition to the suprapubic region. The mass was radically excised in one fragment. The suprapubic defect was closed by using bilateral parallel relaxing incisions, and the degloved penis defect was closed by tension free simple interrupted suture. The patient declares having erections with no deviation or pain 3 months after surgery. Urologists should have plastic surgery experience so they can ensure excellent cosmetic and functional outcomes as demonstrated in our patient.

JIPMER Protocol for Teleconsultation during COVID-19- Plastic Surgery Experience

JIPMER Protocol for Teleconsultation during COVID-19- Plastic Surgery Experience

A 10-year experience of facial plastic surgery with one full thickness skin autograft

A 10-year experience of facial plastic surgery with one full thickness skin autograft

The Role of Learning Style in the Changing Landscape of Medical Education: The Canadian Plastic Surgery Experience

Objectives: The transition to competency-based education and restraints on trainee work hours necessitates re-evaluation of resident education. The role of learning style in plastic surgery residency training has not been investigated. The objective of this study was to identify the learning styles of plastic surgeons and trainees in Canadian Plastic Surgery programs.&#x0D; Methods: A cross-sectional electronic survey was distributed to all members of the Canadian Society of Plastic Surgeons and through program directors at Canadian training programs. Basic demographics were captured. The Kolb Learning Style Inventory was used to identify each individual’s learning style (converging, accommodative, assimilative, or divergent). &#x0D; Results: There were a total of 98 respondents (15% response rate), including 62 staff plastic surgeons (63%) and 36 trainees (37%). All regions of Canada and age categories were well represented. The most dominant learning styles were convergent (47%) and accommodative (29%). No significant difference in dominant learning styles existed between age groups; while males were more commonly convergent learners, females were accommodative learners. &#x0D; Conclusions: The majority of plastic surgery trainees and staff have learning styles that rely heavily on practical application and experiential learning. Accounting for this propensity towards convergent and accommodative learning styles should be incorporated into training programs to maximize efficacy of learning.

Tilapia Skin for Neovaginoplasty after Sex Reassignment Surgery

To describe a new technique of neovaginoplasty after a female sex reassignment surgery using a tilapia skin as a graft. Stepwise demonstration of a new technique with narrated video of a single case report. The patient provided oral and written informed consent. Moreover, this video report is part of a multicenter, Investigational Review Board-approved study. Women's university hospital in Campinas, Brazil. Neovaginoplasty technique using tilapia skin with the following key strategies: (1) corpus cavernosum removal, (2) vagina tunnel creation, (3) mold coating with tilapia skin, (4) mold fixation, and (5) postoperative care. The patient remained with the mold coated with tilapia skin for 5 days; after this time, the mold was removed, and the tissue graft was adhered and incorporated in the new vaginal canal. After 2 months, the tissue resembled a vaginal mucosa, and the vaginal length was 8 cm. The patient has not had intercourse yet. We introduce an alternative for low-morbidity neovaginoplasty based on the experience of plastic surgery in burned grafts. The procedure described offers an alternative option to develop an anatomic neovagina with tissue similar to mucosa tissue by a simple, low-morbidity minimally invasive procedure.

Surgical Procedures Performed by Emergency Medical Teams in Sudden-Onset Disasters: A Systematic Review

Aim:To describe the types of surgical procedures performed by emergency medical teams (EMTs) with general surgical capability in the aftermath of sudden-onset disasters (SODs) in low- and middle-income countries (LMICs).Methods:A search of electronic databases (PubMed, MEDLINE, and EMBASE) was carried out to identify articles published between 1990 and 2018 that describe the type of surgical procedures performed by EMTs in the impact and post-impact phases a SOD. Further relevant articles were obtained by hand-searching reference lists.Results:16 articles met the inclusion criteria. Articles reporting on EMTs from a number of different countries and responding to a variety of disasters were included. There was a high prevalence of procedures for extremity soft tissue injuries (46.8%) and fractures (28.3%). However, a significant number of genitourinary/obstetric procedures were also reported.Discussion:Knowledge of the types of surgical procedures most frequently performed by EMTs may help further determine the necessary prerequisite surgical skills required for the recruitment of surgeons for EMTs. Experience in basic plastic, orthopedic, urological, and obstetric surgery would seem desirable for surgeons and surgical teams wishing to participate in an EMT.

The Boston Marathon Bombings: The Early Plastic Surgery Experience of One Boston Hospital: Correction.

The Boston Marathon Bombings: The Early Plastic Surgery Experience of One Boston Hospital: Correction.

Patients Body Modeling: A Practical Theoretical Experience in Plastic Surgery

This research is an active pedagogical experience with surgeons who are specialized in reconstructive plastic surgery and nursing. The guiding questions were the statements of each Surgeon’s clients and what they think about them. Modeling the imaginary bodies of the patients and identify what they built in their minds, highlighting topics and the discussion about the practice made in clay modeling. Eight bodies were modeled, with six bodies with all the senses and two incomplete bodies with only the regions of the breasts and buttocks. It was concluded that there are diverse issues emerging such as gender, ethics, care, spirituality and dream as the fulfillment of the wishes of the patients. Where in the body can these surgeons act to improve the patients’ physical and quality of life? There is an important theme when we are generally welcoming women into an anamnesis that considers their body as a whole, but what is their expectation for each patient? This paper showed the importance of the preoperative evaluation of this whole, for the indication of repairs or contraindications of procedures that aim to improve the physical of the patients, with possible bodily surgical modifications as a form of modeling through liposuction, grafting or excision with lipectomy and withdrawal of excess skin to mitigate the effects of the transformations that deform the physical and end up harming the human relationship, especially women. This is a qualitative method showing the meanings of the bodies of the women represented in the modeling by the Surgeons. However, some surgeons stand out by the look of their practice, as greater sensitivity looking at the body as a whole, spiritual and emotional. They need to use their skills as surgical art and gift, to try to achieve a means, but not an end.

미용성형 수술 경험이 의료기관 선택 속성에 미치는 영향

미용성형 수술 경험이 의료기관 선택 속성에 미치는 영향