Justin K Yeung, Leslie Tze Fung Leung, Anthony Papp
Objective: To summarize current Canadian practice patterns in the diagnosis of and interventions for inhalation injuries (INHI).
Methods: A 10-question survey regarding the diagnosis of and interventions for INHI was sent to the medical directors of all 16 burn centres across Canada.
Results: The response rate to the survey was 50%. Fibreoptic bronchoscopy is required for the diagnosis of INHI in only four centres (50%). The departments of intensive care, plastic surgery, otolaryngology and respirology are involved in performing fibreoptic bronchoscopy in 87.5%, 37.5%, 12.5% and 12.5% of Canadian burn centres, respectively. Intubation for INHI is most often based on physical examination results (87.5%) and clinical history (75%). The most common physical features believed to be most consistent with INHI are dyspnea (87.5%) and hoarseness (87.5%). Common treatments include intubation (87.5%), routine ventilatory support (87.5%) and chest physiotherapy (75%). None of the centres used nebulized heparin. A total of five centres (62.5%) routinely changed the fluid resuscitation protocol when INHI was diagnosed. Only two centres (25%) routinely used prophylactic antibiotics for INHI.
Conclusion: Prospective, multicentre trials are needed to generate evidence-based consensus in the areas of diagnosis, grading and treatment for INHI in Canada.
{"title":"A survey of current practices in the diagnosis of and interventions for inhalational injuries in Canadian burn centres.","authors":"Justin K Yeung, Leslie Tze Fung Leung, Anthony Papp","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To summarize current Canadian practice patterns in the diagnosis of and interventions for inhalation injuries (INHI).</p><p><strong>Methods: </strong>A 10-question survey regarding the diagnosis of and interventions for INHI was sent to the medical directors of all 16 burn centres across Canada.</p><p><strong>Results: </strong>The response rate to the survey was 50%. Fibreoptic bronchoscopy is required for the diagnosis of INHI in only four centres (50%). The departments of intensive care, plastic surgery, otolaryngology and respirology are involved in performing fibreoptic bronchoscopy in 87.5%, 37.5%, 12.5% and 12.5% of Canadian burn centres, respectively. Intubation for INHI is most often based on physical examination results (87.5%) and clinical history (75%). The most common physical features believed to be most consistent with INHI are dyspnea (87.5%) and hoarseness (87.5%). Common treatments include intubation (87.5%), routine ventilatory support (87.5%) and chest physiotherapy (75%). None of the centres used nebulized heparin. A total of five centres (62.5%) routinely changed the fluid resuscitation protocol when INHI was diagnosed. Only two centres (25%) routinely used prophylactic antibiotics for INHI.</p><p><strong>Conclusion: </strong>Prospective, multicentre trials are needed to generate evidence-based consensus in the areas of diagnosis, grading and treatment for INHI in Canada.</p>","PeriodicalId":50714,"journal":{"name":"Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3910522/pdf/cjps21221.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32090338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica T Goodwin, Chantelle Decroff, Emilia Dauway, Amelia Sybenga, Raman C Mahabir
Reduction mammoplasty is one of the most commonly performed procedures in plastic surgery. Occasionally, there are findings reported by pathologists that are unfamiliar to the treating surgeon. The aim of the present study was to determine the types of pathologies encountered in reduction mammoplasty specimens. From this list of diagnoses, a best practice guideline for management will be organized to better assist plastic surgeons in the management of patients with incidental findings on pathology reports. A total of 441 pathology reports from patients who underwent bilateral or unilateral reduction mammoplasty in the past three years were identified. A list of 21 different pathologies was generated from the pathology reports, along with supplemental data from recent texts and articles. Occult carcinomas were encountered in two cases (0.45%) and high-risk lesions were found in three cases (0.68%) at the authors' institution. An algorithm was then constructed to organize the pathologies according to risk of malignancy and assign them to a management guideline. There are many different lesions encountered incidentally in reduction mammoplasty specimens that may or may not confer some cancer risk. It is important for plastic surgeons to know which lesions need closer follow-up to provide the best care for their patients.
{"title":"The management of incidental findings of reduction mammoplasty specimens.","authors":"Jessica T Goodwin, Chantelle Decroff, Emilia Dauway, Amelia Sybenga, Raman C Mahabir","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Reduction mammoplasty is one of the most commonly performed procedures in plastic surgery. Occasionally, there are findings reported by pathologists that are unfamiliar to the treating surgeon. The aim of the present study was to determine the types of pathologies encountered in reduction mammoplasty specimens. From this list of diagnoses, a best practice guideline for management will be organized to better assist plastic surgeons in the management of patients with incidental findings on pathology reports. A total of 441 pathology reports from patients who underwent bilateral or unilateral reduction mammoplasty in the past three years were identified. A list of 21 different pathologies was generated from the pathology reports, along with supplemental data from recent texts and articles. Occult carcinomas were encountered in two cases (0.45%) and high-risk lesions were found in three cases (0.68%) at the authors' institution. An algorithm was then constructed to organize the pathologies according to risk of malignancy and assign them to a management guideline. There are many different lesions encountered incidentally in reduction mammoplasty specimens that may or may not confer some cancer risk. It is important for plastic surgeons to know which lesions need closer follow-up to provide the best care for their patients. </p>","PeriodicalId":50714,"journal":{"name":"Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3910521/pdf/cjps21226.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32090339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zulqarnain Masoodi, Imran Ahmad, Fahud Khurram, Ansaul Haq
Background: Changes in sleep architecture are common phenomena observed in post-traumatic patients; such altered sleeping patterns have negative implications on various phases of rehabilitation. Sleep is an essential process, without which one cannot function effectively and, hence, any aberrations in the quality of sleep in such patients need to be critically analyzed.
Objective: To probe the quality of sleep in postburn patients at one year compared with a group of adequately matched controls.
Methods: Quality of sleep in postburn patients at one year was measured using the Pittsburg Sleep Quality Index questionnaire and compared with a group of adequately matched controls. Data were tabulated and subjected to statistical analysis using Pearson's χ(2) test.
Results: The relationship between the postburn state and sleep disturbances was found to be statistically significant. Other relevant parameters are also highlighted and discussed.
Discussion: Sleep is one of aspect of functioning that may be least taken into account by professionals during the phase of postburn rehabilitation because more obvious threats receive preferred treatment. Unless these problems are dealt with in the postburn period, rehabilitation can never be complete.
Conclusion: Postburn patients experience significant changes in sleep architecture, which need to be taken into account to enable complete rehabilitation of the patient.
{"title":"Changes in sleep architecture after burn injury: 'Waking up' to this unaddressed aspect of postburn rehabilitation in the developing world.","authors":"Zulqarnain Masoodi, Imran Ahmad, Fahud Khurram, Ansaul Haq","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Changes in sleep architecture are common phenomena observed in post-traumatic patients; such altered sleeping patterns have negative implications on various phases of rehabilitation. Sleep is an essential process, without which one cannot function effectively and, hence, any aberrations in the quality of sleep in such patients need to be critically analyzed.</p><p><strong>Objective: </strong>To probe the quality of sleep in postburn patients at one year compared with a group of adequately matched controls.</p><p><strong>Methods: </strong>Quality of sleep in postburn patients at one year was measured using the Pittsburg Sleep Quality Index questionnaire and compared with a group of adequately matched controls. Data were tabulated and subjected to statistical analysis using Pearson's χ(2) test.</p><p><strong>Results: </strong>The relationship between the postburn state and sleep disturbances was found to be statistically significant. Other relevant parameters are also highlighted and discussed.</p><p><strong>Discussion: </strong>Sleep is one of aspect of functioning that may be least taken into account by professionals during the phase of postburn rehabilitation because more obvious threats receive preferred treatment. Unless these problems are dealt with in the postburn period, rehabilitation can never be complete.</p><p><strong>Conclusion: </strong>Postburn patients experience significant changes in sleep architecture, which need to be taken into account to enable complete rehabilitation of the patient.</p>","PeriodicalId":50714,"journal":{"name":"Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3910526/pdf/cjps21234.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32090570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1177/229255031302100309
Edward W Buchel, Kimberly R Dalke, Thomas Ej Hayakawa
The transverse upper gracilis free flap is a well-described option for breast reconstruction. The technique is a secondary choice for autologous breast reconstruction because the abdomen remains the primary donor site for breast reconstruction. However, in appropriately selected patients, the authors believe that the transverse upper gracilis flap remains a reliable flap for breast reconstruction. Its consistent anatomy, potentially reasonable donor site scar, limited functional morbidity and simultaneous two-team surgical approach make this flap a viable option for many patients. The technique, however, is not without drawbacks - known numbness of the medial thigh and the potential for chronic lymphedema of the lower leg, contour deformities of the medial thigh, and widening of the medial thigh scar need to be considered. The current article presents a harvest technique that is reliable, rapid and addresses each of the above-mentioned limitations with specific changes in the traditional technique. The article provides video documentation of the modified harvest technique using only monopolar cautery for the dissection.
{"title":"The transverse upper gracilis flap: Efficiencies and design tips.","authors":"Edward W Buchel, Kimberly R Dalke, Thomas Ej Hayakawa","doi":"10.1177/229255031302100309","DOIUrl":"https://doi.org/10.1177/229255031302100309","url":null,"abstract":"<p><p>The transverse upper gracilis free flap is a well-described option for breast reconstruction. The technique is a secondary choice for autologous breast reconstruction because the abdomen remains the primary donor site for breast reconstruction. However, in appropriately selected patients, the authors believe that the transverse upper gracilis flap remains a reliable flap for breast reconstruction. Its consistent anatomy, potentially reasonable donor site scar, limited functional morbidity and simultaneous two-team surgical approach make this flap a viable option for many patients. The technique, however, is not without drawbacks - known numbness of the medial thigh and the potential for chronic lymphedema of the lower leg, contour deformities of the medial thigh, and widening of the medial thigh scar need to be considered. The current article presents a harvest technique that is reliable, rapid and addresses each of the above-mentioned limitations with specific changes in the traditional technique. The article provides video documentation of the modified harvest technique using only monopolar cautery for the dissection. </p>","PeriodicalId":50714,"journal":{"name":"Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/229255031302100309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32026762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the editor.","authors":"Nasim Huq","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50714,"journal":{"name":"Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905995/pdf/cjps21255.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32090576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1177/229255031302100114
Remi Goulart, Daniele Detanico, Roberta Pires Vasconcellos, Gustavo Ricardo Schütz, Saray Giovana Dos Santos
Women with hypertrophic breasts often experience body pain and posture problems, which tend to be reduced or even eliminated after reduction mammoplasty. The present study aimed to analyze the effects of reduction mammoplasty on anthropometric variables, body posture and pain in women with breast hypertrophy. Eleven women (mean [± SD] age 31.3±10.4 years) participated in the present study. Anthropometric variables, body posture and pain perception were evaluated pretest, and 60 (post60) and 90 (post90) days after reduction mammoplasty. Commercially available posture analysis software was used to analyze the following variables: acromial horizontal alignment (AHA), angle between acromial and anterior superior iliac spines (A-AAIS), vertical alignment of right (R) and left (L) trunk (VAT), vertical alignment of R and L body (VAB) and horizontal alignment of R and L pelvis (HAP). Descriptive statistics and ANOVA for repeated measures were used, and effect sizes (ES) were measured; the level of significance was set at P<0.05. There were no significant differences in anthropometric variables among the assessments. Only HAP-R showed a significant decrease; however, when analyzed, ES, VAT- L and HAP- L in post60, and VAT-R, VAT-L, HAP-R, HAP-L and VAB-L in post90 showed large ES after mammoplasty (ES>0.70). There were significant reductions in pain at post60 and post90 in the neck, cervical spine, back, shoulder and arm (P<0.05). Following mammoplasty, an improvement in body posture, primarily in the alignment of shoulders, trunk and pelvis, and a decrease in pain in the upper limbs and spine, were observed.
{"title":"Reduction mammoplasty improves body posture and decreases the perception of pain.","authors":"Remi Goulart, Daniele Detanico, Roberta Pires Vasconcellos, Gustavo Ricardo Schütz, Saray Giovana Dos Santos","doi":"10.1177/229255031302100114","DOIUrl":"https://doi.org/10.1177/229255031302100114","url":null,"abstract":"<p><p>Women with hypertrophic breasts often experience body pain and posture problems, which tend to be reduced or even eliminated after reduction mammoplasty. The present study aimed to analyze the effects of reduction mammoplasty on anthropometric variables, body posture and pain in women with breast hypertrophy. Eleven women (mean [± SD] age 31.3±10.4 years) participated in the present study. Anthropometric variables, body posture and pain perception were evaluated pretest, and 60 (post60) and 90 (post90) days after reduction mammoplasty. Commercially available posture analysis software was used to analyze the following variables: acromial horizontal alignment (AHA), angle between acromial and anterior superior iliac spines (A-AAIS), vertical alignment of right (R) and left (L) trunk (VAT), vertical alignment of R and L body (VAB) and horizontal alignment of R and L pelvis (HAP). Descriptive statistics and ANOVA for repeated measures were used, and effect sizes (ES) were measured; the level of significance was set at P<0.05. There were no significant differences in anthropometric variables among the assessments. Only HAP-R showed a significant decrease; however, when analyzed, ES, VAT- L and HAP- L in post60, and VAT-R, VAT-L, HAP-R, HAP-L and VAB-L in post90 showed large ES after mammoplasty (ES>0.70). There were significant reductions in pain at post60 and post90 in the neck, cervical spine, back, shoulder and arm (P<0.05). Following mammoplasty, an improvement in body posture, primarily in the alignment of shoulders, trunk and pelvis, and a decrease in pain in the upper limbs and spine, were observed. </p>","PeriodicalId":50714,"journal":{"name":"Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/229255031302100114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32036035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1177/229255031302100110
Emilie Godbout, Lucie Farmer, Patricia Bortoluzzi, Louise Caouette Laberge
Background/objective: Few options, apart from the buttock area, are available for autologous breast reconstruction in thin teenagers. The aim of the present study was to objectively evaluate and compare donor-site morbidity of the inferior gluteal artery perforator (IGAP) flap with that of the previously described inferior gluteal musculocutaneous flap.
Method: A retrospective review of all IGAP flaps for breast reconstruction performed in teenagers between June 2006 and April 2011 at the Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, was performed. Patients were invited to undergo a specific physical evaluation and complete a questionnaire on aesthetic and functional outcomes.
Results: Thirteen records and 11 photographic charts were reviewed. Lateral buttock flattening was noticeable in nine of 11 cases. Three patients experienced some degree of inferior displacement of the gluteal crease. All six patients available for the appointment presented with a zone of dysesthesia or hypoesthesia in the territory of the operated buttock and/or posterior thigh. No motor impairment was found. The questionnaire, completed by eight patients, revealed that six were satisfied or very satisfied with the surgery. Appearance of the operated buttock was rated 3.4 on a scale from 1 to 5 (5 = normal) compared with the normal side.
Conclusions: The IGAP flap remains a suitable option for breast reconstruction in slim teenagers. Similar to the myocutaneous flap, the major donor-site morbidity of the IGAP flap remains sensory impairment involving the posterior femoral cutaneous nerve. There is, however, less visible lateral depression when it is harvested as a perforator flap.
{"title":"Donor-site morbidity of the inferior gluteal artery perforator flap for breast reconstruction in teenagers.","authors":"Emilie Godbout, Lucie Farmer, Patricia Bortoluzzi, Louise Caouette Laberge","doi":"10.1177/229255031302100110","DOIUrl":"https://doi.org/10.1177/229255031302100110","url":null,"abstract":"<p><strong>Background/objective: </strong>Few options, apart from the buttock area, are available for autologous breast reconstruction in thin teenagers. The aim of the present study was to objectively evaluate and compare donor-site morbidity of the inferior gluteal artery perforator (IGAP) flap with that of the previously described inferior gluteal musculocutaneous flap.</p><p><strong>Method: </strong>A retrospective review of all IGAP flaps for breast reconstruction performed in teenagers between June 2006 and April 2011 at the Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, was performed. Patients were invited to undergo a specific physical evaluation and complete a questionnaire on aesthetic and functional outcomes.</p><p><strong>Results: </strong>Thirteen records and 11 photographic charts were reviewed. Lateral buttock flattening was noticeable in nine of 11 cases. Three patients experienced some degree of inferior displacement of the gluteal crease. All six patients available for the appointment presented with a zone of dysesthesia or hypoesthesia in the territory of the operated buttock and/or posterior thigh. No motor impairment was found. The questionnaire, completed by eight patients, revealed that six were satisfied or very satisfied with the surgery. Appearance of the operated buttock was rated 3.4 on a scale from 1 to 5 (5 = normal) compared with the normal side.</p><p><strong>Conclusions: </strong>The IGAP flap remains a suitable option for breast reconstruction in slim teenagers. Similar to the myocutaneous flap, the major donor-site morbidity of the IGAP flap remains sensory impairment involving the posterior femoral cutaneous nerve. There is, however, less visible lateral depression when it is harvested as a perforator flap.</p>","PeriodicalId":50714,"journal":{"name":"Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/229255031302100110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32036676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Creation of an aesthetically pleasing nipple plays a significant role in breast reconstruction as a determining factor in patient satisfaction. The goals for nipple reconstruction include minimal donor site morbidity and appropriate, long-lasting projection. Currently, the most popular techniques used are associated with a significant loss of projection postoperatively. Accordingly, the authors introduce the angel flap, which is designed to achieve nipple projection with lasting results. The lateral edges of the flap and the area surrounding the top of the nipple are de-epithelialized and the flaps are wrapped to create a nipple mound composed primarily of dermis. Decreasing the amount of fat within core of the nipple and enhancing dermal content promotes long-lasting projection. Furthermore, the incision pattern fits within a desired areolar size, preventing unnecessary superfluous extension of the incisions. Thus, the technique described herein achieves the goals of nipple reconstruction, including adequate and long-lasting projection, without extension of the lateral limb scars.
{"title":"The angel flap for nipple reconstruction.","authors":"Wendy W Wong, Matthew A Hiersche, Mark C Martin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Creation of an aesthetically pleasing nipple plays a significant role in breast reconstruction as a determining factor in patient satisfaction. The goals for nipple reconstruction include minimal donor site morbidity and appropriate, long-lasting projection. Currently, the most popular techniques used are associated with a significant loss of projection postoperatively. Accordingly, the authors introduce the angel flap, which is designed to achieve nipple projection with lasting results. The lateral edges of the flap and the area surrounding the top of the nipple are de-epithelialized and the flaps are wrapped to create a nipple mound composed primarily of dermis. Decreasing the amount of fat within core of the nipple and enhancing dermal content promotes long-lasting projection. Furthermore, the incision pattern fits within a desired areolar size, preventing unnecessary superfluous extension of the incisions. Thus, the technique described herein achieves the goals of nipple reconstruction, including adequate and long-lasting projection, without extension of the lateral limb scars. </p>","PeriodicalId":50714,"journal":{"name":"Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3891113/pdf/cjps21e001.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32037040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-08-01DOI: 10.1177/229255031202000310
Background In up to 2% of all pregnancies, the need for general anesthesia in a nonobstetrical surgery arises. Surgery on a pregnant woman may have significant implications for the fetus, patient, physician and hospital. On review of the plastic surgery literature, the authors were unable to find current guidelines or recommendations for preoperative pregnancy testing in the plastic surgery patient population. Methods Literature regarding maternal and fetal risk during anesthesia and surgery, as well as preoperative pregnancy testing was identified by performing a PubMed, OVID and MEDLINE key word search. The current literature was subsequently reviewed and summarized. Results A report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation allows physicians and hospitals to implement their own policies and practices with regard to preoperative pregnancy testing. The overall frequency of an incidentally found positive preoperative pregnancy test ranges from 0.34% to 2.4%. Discussion Various studies have reported increased rates of spontaneous abortions, congenital anomalies, such as neural tube defects, and low and very low birth weight infants born to mothers exposed to anesthesia and surgery during pregnancy. Because the accepted practice is to postpone elective surgery during pregnancy, identifying these patients before surgery is critical. Conclusions Based on the current evidence, the authors' best practice recommendation for preoperative pregnancy testing is provided.
{"title":"Preoperative pregnancy testing","authors":"","doi":"10.1177/229255031202000310","DOIUrl":"https://doi.org/10.1177/229255031202000310","url":null,"abstract":"Background In up to 2% of all pregnancies, the need for general anesthesia in a nonobstetrical surgery arises. Surgery on a pregnant woman may have significant implications for the fetus, patient, physician and hospital. On review of the plastic surgery literature, the authors were unable to find current guidelines or recommendations for preoperative pregnancy testing in the plastic surgery patient population. Methods Literature regarding maternal and fetal risk during anesthesia and surgery, as well as preoperative pregnancy testing was identified by performing a PubMed, OVID and MEDLINE key word search. The current literature was subsequently reviewed and summarized. Results A report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation allows physicians and hospitals to implement their own policies and practices with regard to preoperative pregnancy testing. The overall frequency of an incidentally found positive preoperative pregnancy test ranges from 0.34% to 2.4%. Discussion Various studies have reported increased rates of spontaneous abortions, congenital anomalies, such as neural tube defects, and low and very low birth weight infants born to mothers exposed to anesthesia and surgery during pregnancy. Because the accepted practice is to postpone elective surgery during pregnancy, identifying these patients before surgery is critical. Conclusions Based on the current evidence, the authors' best practice recommendation for preoperative pregnancy testing is provided.","PeriodicalId":50714,"journal":{"name":"Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85751837","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 : 2012-08-01DOI: 10.4172/PLASTIC-SURGERY.1000766
H. Sinno, J. Lutfy, Youssef Tahiri, Omar Fouda Neel, M. Gilardino
Background With the associations between investigators and funding sources becoming increasingly complicated, conflicts of interest may arise that could potentially cause biases in the reporting of results. Objective To determine the number of published plastic surgery articles that lack reporting of disclosures. Methods An online review of four major North American plastic surgery journal publications from January 1, 2007 to December 31, 2007, was performed. For identification and to provide anonymity, journals were assigned a letter from A to D. Results Of the 1759 articles reviewed, 726 (41%) were included. Disclosure was not reported in 368 (51%) articles: Journal A (n=10, 3%), Journal B (n=153, 85%), Journal C (n=193, 93%) and Journal D (n=12, 32%). Journals differed significantly in their reporting of disclosure (P<0.01). Conclusion In the plastic surgery journals reviewed, the lack of documentation of disclosures was frequent. To ensure identification of bias in plastic surgery publications, a section dedicated to disclosure statements is recommended for each published article.
{"title":"Reporting disclosures to the reader in plastic surgery journal publications","authors":"H. Sinno, J. Lutfy, Youssef Tahiri, Omar Fouda Neel, M. Gilardino","doi":"10.4172/PLASTIC-SURGERY.1000766","DOIUrl":"https://doi.org/10.4172/PLASTIC-SURGERY.1000766","url":null,"abstract":"Background With the associations between investigators and funding sources becoming increasingly complicated, conflicts of interest may arise that could potentially cause biases in the reporting of results. Objective To determine the number of published plastic surgery articles that lack reporting of disclosures. Methods An online review of four major North American plastic surgery journal publications from January 1, 2007 to December 31, 2007, was performed. For identification and to provide anonymity, journals were assigned a letter from A to D. Results Of the 1759 articles reviewed, 726 (41%) were included. Disclosure was not reported in 368 (51%) articles: Journal A (n=10, 3%), Journal B (n=153, 85%), Journal C (n=193, 93%) and Journal D (n=12, 32%). Journals differed significantly in their reporting of disclosure (P<0.01). Conclusion In the plastic surgery journals reviewed, the lack of documentation of disclosures was frequent. To ensure identification of bias in plastic surgery publications, a section dedicated to disclosure statements is recommended for each published article.","PeriodicalId":50714,"journal":{"name":"Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77581279","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}