Pub Date : 2024-04-29DOI: 10.1177/22925503241249586
{"title":"Canadian Society of Plastic Surgeons / Société Canadienne Des Chirurgiens Plasticiens77th Annual Meeting / 77e Réunion annuelleJune 18-22 juin 2024Halifax, NS/N-É","authors":"","doi":"10.1177/22925503241249586","DOIUrl":"https://doi.org/10.1177/22925503241249586","url":null,"abstract":"","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140832771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-29DOI: 10.1177/22925503241249755
Lauren Wong, Zina Sabir, Patrick Sachsalber, Yvonne Ying, Claudia Malic, Kevin Cheung
Background: Hand injuries are common in children. Most simple pediatric hand fractures do not require surgery and can be treated with protective immobilization, yielding good outcomes. A recent institutional audit revealed significant practice variation in managing these children with many being overtreated with unnecessary follow-up visits. The objective of this study was to implement and assess a streamlined care pathway to manage “simple” pediatric hand injuries and minimize healthcare utilization. Methods: A single institution prospective study of the streamlined care pathway was conducted. Simple hand injuries included volar plate injuries, phalangeal Salter-Harris type 2 fractures, metacarpal neck fractures, unicortical and buckle fractures, proximal interphalangeal dislocations, and thumb ligamentous injuries. Patients were treated with either thermoplastic splinting or buddy taping. Standardized verbal and written instruction were provided. No routine follow-up was arranged. Participants were contacted by telephone 6 weeks post-injury to identify any concerns or need for follow-up. Results: A total of 101 children with simple hand injuries were included. Sixty-one participants completed the telephone survey. About 90% had no problems during healing and 85% resumed all activities. Ten participants requested follow-up; however, 4 cancelled and the remaining 6 required reassurance with no additional treatment. Conclusions: Most simple pediatric hand injuries heal well with buddy taping or splint immobilization. The described streamlined hand pathway can avoid unnecessary follow-ups for simple pediatric hand trauma, reducing the burden on both families and the healthcare system.
{"title":"Streamlining the Management of Children With Simple Hand Injuries","authors":"Lauren Wong, Zina Sabir, Patrick Sachsalber, Yvonne Ying, Claudia Malic, Kevin Cheung","doi":"10.1177/22925503241249755","DOIUrl":"https://doi.org/10.1177/22925503241249755","url":null,"abstract":"Background: Hand injuries are common in children. Most simple pediatric hand fractures do not require surgery and can be treated with protective immobilization, yielding good outcomes. A recent institutional audit revealed significant practice variation in managing these children with many being overtreated with unnecessary follow-up visits. The objective of this study was to implement and assess a streamlined care pathway to manage “simple” pediatric hand injuries and minimize healthcare utilization. Methods: A single institution prospective study of the streamlined care pathway was conducted. Simple hand injuries included volar plate injuries, phalangeal Salter-Harris type 2 fractures, metacarpal neck fractures, unicortical and buckle fractures, proximal interphalangeal dislocations, and thumb ligamentous injuries. Patients were treated with either thermoplastic splinting or buddy taping. Standardized verbal and written instruction were provided. No routine follow-up was arranged. Participants were contacted by telephone 6 weeks post-injury to identify any concerns or need for follow-up. Results: A total of 101 children with simple hand injuries were included. Sixty-one participants completed the telephone survey. About 90% had no problems during healing and 85% resumed all activities. Ten participants requested follow-up; however, 4 cancelled and the remaining 6 required reassurance with no additional treatment. Conclusions: Most simple pediatric hand injuries heal well with buddy taping or splint immobilization. The described streamlined hand pathway can avoid unnecessary follow-ups for simple pediatric hand trauma, reducing the burden on both families and the healthcare system.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140832763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-29DOI: 10.1177/22925503241249758
Reshma Sirajee, Altay Baykan, Frankie O. G. Fraulin, Thomas Cawthorn, Kimberly Sass, Alan Robertson Harrop, Rebecca L. Hartley, Donald Ford McPhalen
Background: Minor burn injuries in children affecting less than 10% of total body surface area (TBSA) are often successfully managed in the outpatient setting, however it is important to recognize they can be associated with serious sequelae such as toxic shock syndrome (TSS). Methods: We conducted a retrospective chart review at a tertiary-level pediatric hospital between May 2012 and May 2022 to identify pediatric patients diagnosed with TSS following minor burn injuries. Data collected included: patient demographics, burn characteristics, TSS symptoms, and management. Data was analyzed using descriptive statistics. Results: During the study period, 3706 patients with minor burns were treated as outpatients, of which 6 patients developed TSS. Ages ranged from 12 to 36 months, and half were male. Most injuries were scalds (n = 4) or contact injuries (n = 2), involving 1% to 3% TBSA partial-thickness burns. Early symptoms of TSS included vomiting (n = 6) and fever (n = 5), and later, hypotension (n = 5). Hospital admission for TSS occurred 1 to 6 days post-injury. Four of the 6 patients required ICU care, with 2 of them requiring fluid resuscitation and 2 receiving IVIg. The clinical course of 2 patients was complicated by deep vein thrombosis, with 1 patient developing a septic ileus as a secondary infection. All patients recovered and were discharged home after 3 to 9 days. Conclusion: We highlight the rare complication of TSS following minor burns in children. Providers should be vigilant for early symptoms of TSS like fever, vomiting, and hypotension. Further research to identify at-risk patients and preventative treatment would be beneficial.
{"title":"Toxic Shock Syndrome as an Unexpected Complication in Outpatient Pediatric Burn Treatment: A Chart Review","authors":"Reshma Sirajee, Altay Baykan, Frankie O. G. Fraulin, Thomas Cawthorn, Kimberly Sass, Alan Robertson Harrop, Rebecca L. Hartley, Donald Ford McPhalen","doi":"10.1177/22925503241249758","DOIUrl":"https://doi.org/10.1177/22925503241249758","url":null,"abstract":"Background: Minor burn injuries in children affecting less than 10% of total body surface area (TBSA) are often successfully managed in the outpatient setting, however it is important to recognize they can be associated with serious sequelae such as toxic shock syndrome (TSS). Methods: We conducted a retrospective chart review at a tertiary-level pediatric hospital between May 2012 and May 2022 to identify pediatric patients diagnosed with TSS following minor burn injuries. Data collected included: patient demographics, burn characteristics, TSS symptoms, and management. Data was analyzed using descriptive statistics. Results: During the study period, 3706 patients with minor burns were treated as outpatients, of which 6 patients developed TSS. Ages ranged from 12 to 36 months, and half were male. Most injuries were scalds (n = 4) or contact injuries (n = 2), involving 1% to 3% TBSA partial-thickness burns. Early symptoms of TSS included vomiting (n = 6) and fever (n = 5), and later, hypotension (n = 5). Hospital admission for TSS occurred 1 to 6 days post-injury. Four of the 6 patients required ICU care, with 2 of them requiring fluid resuscitation and 2 receiving IVIg. The clinical course of 2 patients was complicated by deep vein thrombosis, with 1 patient developing a septic ileus as a secondary infection. All patients recovered and were discharged home after 3 to 9 days. Conclusion: We highlight the rare complication of TSS following minor burns in children. Providers should be vigilant for early symptoms of TSS like fever, vomiting, and hypotension. Further research to identify at-risk patients and preventative treatment would be beneficial.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140832761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-29DOI: 10.1177/22925503241249760
Patrick Jinhyung Kim, Lucas Gallo, Jeffrey Chen, Morgan Yuan, Matteo Gallo, Cheryl Main, Christopher Coroneos
Introduction: Burn wound infection can progress to sepsis and is a significant source of morbidity and mortality. Prevalence of multidrug-resistant organisms are high in burn patients; these organisms can be transmitted between patients leading to poor outcomes. Objectives: To characterize patient-to-patient transmission of pathogens causing burn wound colonization at a single tertiary hospital burn center in Hamilton, Canada from 2011 to 2020. Methods: Retrospective chart review of patients admitted to the burn trauma unit at Hamilton General Hospital between 2011 and 2020. Antibiotic susceptibility panels of pathogens cultured from burn patients’ wound swab/tissue cultures were compared against pathogens cultured from other burn/nonburn patients with overlapping admission dates. Pathogens were categorized into likely, possible, or unlikely transmission, or normal skin flora on a case-by-case basis. Results: There were 173 burn patients with positive wound culture and 613 nonburn patients included in the study. Included burn patients had median age 52 years, mostly male (73%) with flame injury (65%), and median total body surface area 18%. There were 18 patients (10%) with likely transmission and 54 patients (31%) with possible transmission. Most frequently implicated pathogens for likely patient-to-patient transmission were methicillin-resistant Staphylococcus aureus (MRSA) (7 patients) and methicillin-resistant coagulase-negative Staphylococci (4 patients). Both burn and nonburn patients were implicated. Conclusion: The burden of patient-to-patient transmission in culture-positive burn wounds was estimated to be between 10% and 41%. Greater care should be taken to avoid patient-to-patient transmission of pathogens to minimize burn infection morbidity and mortality. Prospective studies should be conducted with genomic sequencing and correlation with clinical outcomes.
{"title":"A 10-year Retrospective Review of Patient-to-Patient Transmitted Pathogens in Culture-Positive Burn Wounds at a Tertiary Burn Center","authors":"Patrick Jinhyung Kim, Lucas Gallo, Jeffrey Chen, Morgan Yuan, Matteo Gallo, Cheryl Main, Christopher Coroneos","doi":"10.1177/22925503241249760","DOIUrl":"https://doi.org/10.1177/22925503241249760","url":null,"abstract":"Introduction: Burn wound infection can progress to sepsis and is a significant source of morbidity and mortality. Prevalence of multidrug-resistant organisms are high in burn patients; these organisms can be transmitted between patients leading to poor outcomes. Objectives: To characterize patient-to-patient transmission of pathogens causing burn wound colonization at a single tertiary hospital burn center in Hamilton, Canada from 2011 to 2020. Methods: Retrospective chart review of patients admitted to the burn trauma unit at Hamilton General Hospital between 2011 and 2020. Antibiotic susceptibility panels of pathogens cultured from burn patients’ wound swab/tissue cultures were compared against pathogens cultured from other burn/nonburn patients with overlapping admission dates. Pathogens were categorized into likely, possible, or unlikely transmission, or normal skin flora on a case-by-case basis. Results: There were 173 burn patients with positive wound culture and 613 nonburn patients included in the study. Included burn patients had median age 52 years, mostly male (73%) with flame injury (65%), and median total body surface area 18%. There were 18 patients (10%) with likely transmission and 54 patients (31%) with possible transmission. Most frequently implicated pathogens for likely patient-to-patient transmission were methicillin-resistant Staphylococcus aureus (MRSA) (7 patients) and methicillin-resistant coagulase-negative Staphylococci (4 patients). Both burn and nonburn patients were implicated. Conclusion: The burden of patient-to-patient transmission in culture-positive burn wounds was estimated to be between 10% and 41%. Greater care should be taken to avoid patient-to-patient transmission of pathogens to minimize burn infection morbidity and mortality. Prospective studies should be conducted with genomic sequencing and correlation with clinical outcomes.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140832770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-02DOI: 10.1177/22925503241234936
Anais Di Via Ioschpe, Nikita Roy, Justin James, Malory Alexis, Esther Kim, Olachi O. Oleru, Nargiz Seyidova, Peter W. Henderson
Introduction: Popular video-sharing platforms YouTube and TikTok offer a plethora of information on the topic of breast implant illness (BII). As a largely patient-driven phenomenon, it is important to understand the influence of social media on patient knowledge regarding BII. This study sought to evaluate the quality, reliability, visibility, and popularity of YouTube and TikTok videos about BII. Methods: Two validated tools for health information, DISCERN and the Patient Education Materials Assessment Tool (PEMAT), were utilized to evaluate the quality of information regarding the topic of BII on YouTube and TikTok. High DISCERN score indicates content of superior quality and reliability, while elevated PEMAT scores signify content that is easily understandable and actionable for viewers. The search phrase “breast implant illness” was used to screen videos, which were sorted based on relevance and view count. The first 100 videos that fulfilled inclusion criteria were independently graded by three reviewers. Results: TikTok videos of longer duration, a higher number of shares, and in the patient education category were all significantly associated with a higher total DISCERN score ( P < 0.05). YouTube videos that included a provider or a patient were significantly more likely to have a higher total DISCERN and PEMAT understandability score (all P < 0.05). Discussion of physician education, operation details, and patient experience was significantly associated with higher total DISCERN and PEMAT understandability scores (all P < 0.05). Conclusions: Total DISCERN and PEMAT scores for videos regarding BII on two popular social media platforms are low. Video length, patient experience categorization, and the presence of a provider are worth considering when developing high-quality online content for breast reconstruction and augmentation patients.
{"title":"Scrolling for Answers About Breast Implant Illness: Application of Validated Tools to Assess the Quality of Content on YouTube and TikTok","authors":"Anais Di Via Ioschpe, Nikita Roy, Justin James, Malory Alexis, Esther Kim, Olachi O. Oleru, Nargiz Seyidova, Peter W. Henderson","doi":"10.1177/22925503241234936","DOIUrl":"https://doi.org/10.1177/22925503241234936","url":null,"abstract":"Introduction: Popular video-sharing platforms YouTube and TikTok offer a plethora of information on the topic of breast implant illness (BII). As a largely patient-driven phenomenon, it is important to understand the influence of social media on patient knowledge regarding BII. This study sought to evaluate the quality, reliability, visibility, and popularity of YouTube and TikTok videos about BII. Methods: Two validated tools for health information, DISCERN and the Patient Education Materials Assessment Tool (PEMAT), were utilized to evaluate the quality of information regarding the topic of BII on YouTube and TikTok. High DISCERN score indicates content of superior quality and reliability, while elevated PEMAT scores signify content that is easily understandable and actionable for viewers. The search phrase “breast implant illness” was used to screen videos, which were sorted based on relevance and view count. The first 100 videos that fulfilled inclusion criteria were independently graded by three reviewers. Results: TikTok videos of longer duration, a higher number of shares, and in the patient education category were all significantly associated with a higher total DISCERN score ( P < 0.05). YouTube videos that included a provider or a patient were significantly more likely to have a higher total DISCERN and PEMAT understandability score (all P < 0.05). Discussion of physician education, operation details, and patient experience was significantly associated with higher total DISCERN and PEMAT understandability scores (all P < 0.05). Conclusions: Total DISCERN and PEMAT scores for videos regarding BII on two popular social media platforms are low. Video length, patient experience categorization, and the presence of a provider are worth considering when developing high-quality online content for breast reconstruction and augmentation patients.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140587504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-02DOI: 10.1177/22925503241241088
Haley Shade, A. Robertson Harrop, Donald McPhalen, Pamela Roach
Purpose: Our small-scale qualitative study sought to explore the experiences of Indigenous patients receiving care for cleft lip and/or palate at a multidisciplinary clinic. There currently are no published studies that demonstrate the experiences of cleft lip and/or palate patients receiving care in multidisciplinary clinics in Canada. This work is foundational to informing future care in a way that is reflective and cognizant of Indigenous ways of life and lived experiences. Method: Participants were recruited via purposive and snowball sampling through community networks and public advertising in relevant healthcare spaces. Semi-structured interviews were completed; transcribed verbatim and descriptive codes were generated using Indigenist research methodologies through the Blackfoot medicine wheel. Results: Five participants that included patients, parents of patients with cleft lip and/or palate, and Indigenous health liasions were interviewed. Participants indicated a lack of spiritual health, the physical demands of having a cleft lip and/or palate on a patient and their families, the fear and unknown associated with a new cleft lip and/or palate diagnosis, and lack of cultural support, awareness and racism may negatively impact mental health. Conclusion: Indigenous patients must receive cleft lip and/or palate care that is cognizant of both their cultural needs identified in our study but also reflective of the ways in which health may be conceptualized for Indigenous patients. The following models of care suggested in our study must also seek to address historic mandates that include UNDRIP and the Truth and Reconciliation Commission's Calls to Action.
{"title":"First Nations Patients’ Experience Receiving Care for Cleft Lip and Palate in a Multidisciplinary Clinic Setting","authors":"Haley Shade, A. Robertson Harrop, Donald McPhalen, Pamela Roach","doi":"10.1177/22925503241241088","DOIUrl":"https://doi.org/10.1177/22925503241241088","url":null,"abstract":"Purpose: Our small-scale qualitative study sought to explore the experiences of Indigenous patients receiving care for cleft lip and/or palate at a multidisciplinary clinic. There currently are no published studies that demonstrate the experiences of cleft lip and/or palate patients receiving care in multidisciplinary clinics in Canada. This work is foundational to informing future care in a way that is reflective and cognizant of Indigenous ways of life and lived experiences. Method: Participants were recruited via purposive and snowball sampling through community networks and public advertising in relevant healthcare spaces. Semi-structured interviews were completed; transcribed verbatim and descriptive codes were generated using Indigenist research methodologies through the Blackfoot medicine wheel. Results: Five participants that included patients, parents of patients with cleft lip and/or palate, and Indigenous health liasions were interviewed. Participants indicated a lack of spiritual health, the physical demands of having a cleft lip and/or palate on a patient and their families, the fear and unknown associated with a new cleft lip and/or palate diagnosis, and lack of cultural support, awareness and racism may negatively impact mental health. Conclusion: Indigenous patients must receive cleft lip and/or palate care that is cognizant of both their cultural needs identified in our study but also reflective of the ways in which health may be conceptualized for Indigenous patients. The following models of care suggested in our study must also seek to address historic mandates that include UNDRIP and the Truth and Reconciliation Commission's Calls to Action.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140587189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-02DOI: 10.1177/22925503241242800
Mitchell Brown
{"title":"Continuing Medical Education (CME) Is All Well and Good, What About Continuing Practice Education (CPE)?","authors":"Mitchell Brown","doi":"10.1177/22925503241242800","DOIUrl":"https://doi.org/10.1177/22925503241242800","url":null,"abstract":"","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140587110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-28DOI: 10.1177/22925503241241087
Sneha Subramaniam, Reid W. Smith, Neil Tanna, Mark L. Smith
Background: Frailty has been shown to have a strong association with adverse outcomes in several surgical specialties. Only recently, however, its relevance in plastic surgery has been examined, yielding inconsistent results. Our goal was to apply the five-factor modified frailty index (mFI-5) across multiple subcategories of plastic surgery procedures to identify potential areas where it might prove useful. Methods: NSQIP data from 2015 to 2019 were utilized. Plastic surgery CPT codes were placed into clinically relevant subcategories based on common procedure groupings as follows: superficial soft tissue procedures, head and neck reconstruction, hand surgery, breast reconstruction, gender surgery, esthetic surgery, and facial fractures. The mFI-5 score was calculated for each subcategory. C-statistics were used to determine predictive ability for 30-day morbidity. Multivariable logistic regressions were also calculated to assess for odds ratios (ORs) with regard to 30-day morbidity. Results: A total of 188,741 patients fit inclusion criteria. The mean frailty of plastic surgery patients was noted to be lower than in other surgical specialties. C-statistic models and ORs showed mFI-5 to have predictive ability for post-operative complication in superficial soft tissue procedures (C stat: 0.758), hand surgery (C-stat: 0.832), breast reconstruction (C-statistic: 0.718), head and neck reconstruction (C-statistic: 0.735), and gender surgery (C-statistic: 0.732). Conclusion: The mFI-5 is a clinical tool that can be selectively and cautiously used in plastic surgery, for specific subcategories of procedures including soft tissue procedures, hand surgery, head and neck reconstruction, and breast reconstruction.
{"title":"Assessing Frailty in Plastic Surgery: Analysis of the Five-factor Index","authors":"Sneha Subramaniam, Reid W. Smith, Neil Tanna, Mark L. Smith","doi":"10.1177/22925503241241087","DOIUrl":"https://doi.org/10.1177/22925503241241087","url":null,"abstract":"Background: Frailty has been shown to have a strong association with adverse outcomes in several surgical specialties. Only recently, however, its relevance in plastic surgery has been examined, yielding inconsistent results. Our goal was to apply the five-factor modified frailty index (mFI-5) across multiple subcategories of plastic surgery procedures to identify potential areas where it might prove useful. Methods: NSQIP data from 2015 to 2019 were utilized. Plastic surgery CPT codes were placed into clinically relevant subcategories based on common procedure groupings as follows: superficial soft tissue procedures, head and neck reconstruction, hand surgery, breast reconstruction, gender surgery, esthetic surgery, and facial fractures. The mFI-5 score was calculated for each subcategory. C-statistics were used to determine predictive ability for 30-day morbidity. Multivariable logistic regressions were also calculated to assess for odds ratios (ORs) with regard to 30-day morbidity. Results: A total of 188,741 patients fit inclusion criteria. The mean frailty of plastic surgery patients was noted to be lower than in other surgical specialties. C-statistic models and ORs showed mFI-5 to have predictive ability for post-operative complication in superficial soft tissue procedures (C stat: 0.758), hand surgery (C-stat: 0.832), breast reconstruction (C-statistic: 0.718), head and neck reconstruction (C-statistic: 0.735), and gender surgery (C-statistic: 0.732). Conclusion: The mFI-5 is a clinical tool that can be selectively and cautiously used in plastic surgery, for specific subcategories of procedures including soft tissue procedures, hand surgery, head and neck reconstruction, and breast reconstruction.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140325115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.1177/22925503241241343
Daniela Lee, Elizabeth Laikhter, Valeria P. Bustos, Eric Shiah, Carly D. Comer, Samuel M. Manstein, Samuel J. Lin, Ryan Cauley
{"title":"Why Has Rigid Primary Sternal Fixation Adoption Stalled?","authors":"Daniela Lee, Elizabeth Laikhter, Valeria P. Bustos, Eric Shiah, Carly D. Comer, Samuel M. Manstein, Samuel J. Lin, Ryan Cauley","doi":"10.1177/22925503241241343","DOIUrl":"https://doi.org/10.1177/22925503241241343","url":null,"abstract":"","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140316200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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