Comparing Different Pathways in Medical Education and Surgical Training: A Global Survey of Surgeons.

Background: Currently, interest in surgical careers is declining globally, whereas aging populations are contributing to a rising demand for surgical procedures. Surgeons who conduct scientific investigations and share clinical advances internationally pay little attention to comparing differences in ways nations attract, educate, and train their surgeons. This study compares international pathways toward surgeon development with the aim of seeking best practices and improving the outlook of surgery as an attractive career.

Colposcopy and Loop Electrosurgical Excision Procedure: A Simulated Exercise.

Introduction: Cervical intraepithelial neoplasia 3 is associated with a high degree of progression to cervical cancer. Its risk is markedly reduced after excisional treatment. Hence, it is critical that providers accurately diagnose and treat this condition.

Testing for Implicit Gender Bias among Plastic Surgeons.

Unlabelled: The aim of this study was to examine for the presence of implicit bias within the field of plastic surgery using a gender-specific Implicit Association Test (IAT), specifically looking at gender and career stereotypes.

Methods: A Gender-Career/Family Implicit Association Test was developed and distributed to the international plastic surgery community. Mean scores were calculated.

Hospital volume is associated with cost and outcomes variation in 2,942 pelvic reconstructions.

Background: Complex pelvic reconstruction is challenging for plastic and reconstructive surgeons following surgical resection of the lower gastrointestinal or genitourinary tract. Complication rates and hospital costs are variable and may be linked to the hospital case volume of pelvic reconstructions performed. A comprehensive examination of these factors has yet to be performed.

A paintable phosphorescent bandage for postoperative tissue oxygen assessment in DIEP flap reconstruction.

Flaps are common in plastic surgery to reconstruct large tissue defects in cases such as trauma or cancer. However, most tissue oximeters used for monitoring ischemia in postoperative flaps are bulky, wired devices, which hinder direct flap observation. Here, we present the results of a clinical trial using a previously untried paintable transparent phosphorescent bandage to assess the tissue's partial pressure of oxygen (pO).

Regional incidence of and reconstructive management patterns in melanoma and nonmelanoma skin cancer of the head and neck: A 3-year analysis in the inpatient setting.

Introduction: Currently, there is limited literature on reconstructive trends for inpatient head and neck skin cancer. Rather, studies have focused primarily on patients treated on an outpatient basis. To gain a better understanding of the effect that reconstructive correction of complex skin cancer defects has on the healthcare system, we examined the existing incidence and reconstructive trends of head and neck melanoma and nonmelanoma skin cancer (NMSC) in the inpatient setting.

International and Geographic Trends in Gender Authorship within Plastic Surgery.

Background: Professional advancement in academic plastic surgery may depend on scholarly activity. The authors evaluate gender-based publishing characteristics in three international plastic surgery journals.

Methods: A retrospective review of all articles published in 2016 in the following journals was undertaken: Plastic and Reconstructive Surgery, Journal of Plastic, Reconstructive and Aesthetic Surgery, European Journal of Plastic Surgery, Annals of Surgery, and New England Journal of Medicine.

Social Media: Is the Message Reaching the Plastic Surgery Audience?

Background: The aim of this study was to assess readability of articles shared on Twitter and analyze differences between them to determine whether messages and written posts are at reading levels comprehended by the general public.

Methods: Top-rated #PlasticSurgery tweets (per Twitter algorithm) in January of 2017 were reviewed retrospectively. Text from tweeted links to full, open-access, and society/institutional patient information articles were extracted.

Socioeconomic Disparities in Brachial Plexus Surgery: A National Database Analysis.

Background: Brachial plexus injuries have devastating effects on upper extremity function, with significant pain, psychosocial stress, and reduced quality of life. The aim of this study is to identify socioeconomic disparities in the receipt of brachial plexus repair in the emergent versus elective setting, and in the use of supported services on discharge.

Methods: Analysis of the Healthcare Cost and Utilization Project National Inpatient Sample Database was performed for the years 2009-2014.

Reconstruction of Mohs Defects Located in the Head and Neck.

Background: Defects following Mohs micrographic surgery (MMS) can range in size from small defects requiring linear closure to large defects needing flap coverage. Reconstruction is dependent on defect size and facial aesthetic unit involvement. The aim of this study was to review the types of facial reconstruction per aesthetic unit involvement and describe their outcomes.

Facial Reconstruction After Mohs Surgery: A Critical Review of Defects Involving the Cheek, Forehead, and Perioral Region.

Facial defects following Mohs surgery can cause significant functional, cosmetic, and psychologic sequelae. Various techniques for nasal reconstruction after Mohs surgery have been analyzed in the medical literature, yet there has been less attention given to procedures for other crucial facial aesthetic regions. A literature search using PubMed, EMBASE, and ISI Web of Science for studies assessing reconstructive techniques of the forehead, cheek, and perioral regions after Mohs surgery was performed.

Institutional Collaboration in Plastic Surgery Research: A Solution to Resource Limitations.

Background: The current climate of health care reform and research funding restrictions presents new challenges for academic plastic surgery. Collaboration with private enterprise has been associated with greater research productivity in the general biomedical literature. This study seeks to analyze publication trends in (PRS) to evaluate any changes in institutional collaboration over time.

Crowdsourcing Public Perceptions of Plastic Surgeons: Is There a Gender Bias?

Background: Implicit gender bias may result in lower wages for women, fewer leadership positions, and lower perceived competence. Understanding public and patient gender preferences for plastic surgeons may enable opportunities to address public perceptions. This investigation evaluates public preferences for a plastic surgeon's gender or demeanor.

Evaluating the Impact of Resident Participation and the July Effect on Outcomes in Autologous Breast Reconstruction.

Objective: Although resident involvement in surgical procedures is critical for training, it may be associated with increased morbidity, particularly early in the academic year-a concept dubbed the "July effect." Assessments of such phenomena within the field of plastic surgery have been both limited and inconclusive. We sought to investigate the impact of resident participation and academic quarter on outcomes for autologous breast reconstruction.

Gender Inequality for Women in Plastic Surgery: A Systematic Scoping Review.

Background: Previous research has highlighted the gender-based disparities present throughout the field of surgery. This study aims to evaluate the breadth of the issues facing women in plastic surgery, worldwide.

Methods: A systematic scoping review was undertaken from October of 2016 to January of 2017, with no restrictions on date or language.

Treatment of Craniosynostosis: The Impact of Hospital Surgical Volume on Cost, Resource Utilization, and Outcomes.

The authors aim to quantify the impact of hospital volume of craniosynostosis surgery on inpatient complications and resource utilization using national data. Children <12 months with nonsyndromic craniosynostosis who underwent surgery in 2012 at academic hospitals in the United States were identified from the Kids' Inpatient Database (KID) developed by the Healthcare Cost and Utilization Project (HCUP). Hospital craniosynostosis surgery volume was stratified into tertiles based on total annual hospital cases: low volume (LV, 1-13), intermediate volume (IV, 14-34), and high volume (HV, ≥35).

The National Surgical Quality Improvement Program 30-Day Challenge: Microsurgical Breast Reconstruction Outcomes Reporting Reliability.

Background: The aim was to assess reliability of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) 30-day perioperative outcomes and complications for immediate, free-tissue transfer breast reconstruction by direct comparisons with our 30-day and overall institutional data, and assessing those that occur after 30 days.

Methods: Data were retrieved for consecutive immediate, free-tissue transfer breast reconstruction patients from a single-institution database (2010-2015) and the ACS-NSQIP (2011-2014). Multiple logistic regressions were performed to compare adjusted outcomes between the 2 datasets.

The Impact of Surgical Volume on Outcomes and Cost in Cleft Repair: A Kids' Inpatient Database Analysis.

Background: Centralization of specialist services, including cleft service delivery, is occurring worldwide with the aim of improving the outcomes. This study examines the relationship between hospital surgical volume in cleft palate repair and outcomes.

Methods: A retrospective analysis of the Kids' Inpatient Database was undertaken.

National Mortality Rates after Outpatient Cosmetic Surgery and Low Rates of Perioperative Deep Vein Thrombosis Screening and Prophylaxis.

Background: Concerns have arisen over reports of deaths occurring after certain outpatient plastic surgery procedures. Here, the authors present a national analysis, reporting on deaths occurring after outpatient cosmetic surgical procedures and venous thromboembolism screening.

Methods: A retrospective analysis of the American Association for Accreditation of Ambulatory Surgical Facilities database was performed for the years 2012 to 2017.

The Influence of Connective Tissue Disease in Breast Reconstruction: A National Database Analysis.

Background: Patients with connective tissue diseases (CTD), or collagen vascular diseases, are at risk of potentially higher morbidity after surgical procedures. We aimed to investigate the complication profile in CTD versus non-CTD patients who underwent breast reconstruction on a national scale.

Methods: A retrospective analysis of the Healthcare Cost and Utilization Project NIS Database between 2010 and 2014 was conducted for patients 18 years or older admitted for immediate autologous or implant breast reconstruction.

Surgical site infection in immediate breast reconstruction: Does chemotherapy timing make a difference?

Background And Objectives: We aim to analyze the impact of chemotherapy timing on surgical site infections (SSI) after immediate breast reconstruction (IBR).

Methods: A retrospective review of patients undergoing IBR between 2010 and 2015 was performed. Patients were divided into four groups: those with neoadjuvant chemotherapy only, adjuvant chemotherapy only, both adjuvant and neoadjuvant, and those with no chemotherapy.

Does industry funding mean more publications for subspecialty academic plastic surgeons?

Background: Conflict of interest among physicians in the context of private industry funding led to the introduction of the Physician Payments Sunshine Act in 2010. This study examined whether private industry funding correlated with scholarly productivity in the respective subspecialties of plastic surgery and the wider academic plastic surgery community.

Materials And Methods: Full-time plastic surgeons and their academic attributes were identified via institutional websites.

Evaluation of Contralateral and Bilateral Prophylactic Mastectomy and Reconstruction Outcomes: Comparing Alloplastic and Autologous Reconstruction.

Background: Over the last decade, there has been a 12% increase in prophylactic mastectomy (PM) per year. The aim of the study was to analyze complication rates and associated risk factors in patients undergoing PM and reconstruction.

Methods: We reviewed patients undergoing PM (contralateral and bilateral) from 2010 to 2015 at a single academic institution.

Labiaplasty: Indications and Predictors of Postoperative Sequelae in 451 Consecutive Cases.

Background: The increasing demand for labiaplasty is well recognized; however, the procedure remains contentious.

Objectives: We aim to provide a large-scale, up-to-date analysis of labiaplasty outcomes and factors influencing postoperative sequelae (POS).

Methods: We analyzed a single-center, prospectively maintained database of females undergoing labiaplasty between 2002 and 2017.

Indocyanine Green Angiography Use in Breast Reconstruction: A National Analysis of Outcomes and Cost in 110,320 Patients.

Background: Indocyanine green angiography has gained popularity in breast reconstruction for its ability to assess mastectomy skin and tissue flap viability. The authors aim to analyze trends and outcomes associated with indocyanine green angiography use in breast reconstruction.

Methods: Using 2012 to 2014 data from the Healthcare Cost and Utilization Project National Inpatient Sample, Agency for Healthcare Research and Quality, the authors identified breast reconstructions performed with or without indocyanine green angiography use.