Levels of Evidence in Plastic and Reconstructive Surgery Research: Have We Improved Over the Past 10 Years?

Levels of evidence (LOE) aid in the critical appraisal of evidence by ranking studies based on limitation of its design. Analyzing LOE provides insight into application of evidence-based medicine. The aim of this study is to determine if the quality of evidence in plastic surgery research has improved over the past 10 years.

Botulinum Toxin Treatment for Mild to Moderate Platysma Bands: A Systematic Review of Efficacy, Safety, and Injection Technique.

Background: Platysma bands are characteristic of an aging neck. Resection and plication of the platysma muscle is the basis of treatment. However, unfavorable surgical outcomes and improved understanding of platysma band etiology have shifted treatment towards nonsurgical rejuvenation.

Trapezius flaps for reconstruction of head and neck defects following oncological resection - A systematic review.

Objective: Head and neck (H&N) reconstruction after cancer resection is challenging. Myocutaneous trapezius flaps provide an alternative reconstruction for patients not suitable for microvascular free tissue transfer.

Methods: A systematic review was performed on studies involving trapezius flaps for H&N reconstruction post oncological resection between the years 1985-2015.

ASCOT: Autologous Bone Marrow Stem Cell Use for Osteoarthritis of the Thumb-First Carpometacarpal Joint.

Background: The first carpometacarpal joint (CMCJ) in the hand is a commonly affected joint by osteoarthritis. It causes significant thumb base pain, limiting functional capacity. Microfracturing and application of autologous stem cells has been performed on large joints such as the knee but has never been evaluated for use in the smaller joints in the hand.

Tumor Margin Assessment With Loupe Magnification Enables Greater Histological Clearance of Facial Basal Cell Carcinomas Compared With Clinical Examination Alone.

Background: Surgical excision of facial basal cell carcinomas (BCCs) is a balance between oncological clearance and conservation of cosmetic and functionally sensitive tissues.

Objective: To assess if loupe magnification (LM) can enhance the visual assessment of BCC tumor margins resulting in a greater histological clearance.

Materials And Methods: This prospective study randomized patients with primary facial BCCs into preoperative tumor margin assessment with LM (study group) or clinical examination alone (control group).

Trends in the Level of Evidence in Clinical Hand Surgery Research.

Background: The application of evidence-based medicine (EBM) to the practice of hand surgery has been limited. Production of high-quality research is an integral component of EBM. With considerable improvements in the quality evidence in both orthopedic and plastic and reconstructive surgery, it is imperative that hand surgery research emulates this trend.

Current practice patterns of drain usage amongst UK and Irish surgeons performing bilateral breast reductions: Evidence down the drain.

Introduction: Bilateral breast reduction (BBR) is one of the most frequently performed female breast operations. Despite no evidence supporting efficacy of drain usage in BBRs, postoperative insertion is common. Recent high quality evidence demonstrating potential harm from drain use has subsequently challenged this traditional practice.

Patient awareness and sun protection behaviour following excision of basal cell carcinoma.

Background: Limited information is available regarding disease awareness and sun protection behaviour in patients previously treated for non-melanoma skin cancer.

Methods: Using a telephone-administered questionnaire, we investigated these characteristics in 250 patients in the west of Ireland who had undergone excision of basal cell carcinomas between January 2011 and December 2012.

Results: Only 28.

Plastic surgery and the breast: a citation analysis of the literature.

Background: A large proportion of the plastic surgery literature is dedicated to the breast. It is one of the most common topics in our specialty, yet it is unclear which articles have been the most influential. The purpose of this study was to identify the top 100 most-cited articles on breast in the plastic surgery literature and examine the characteristics of each individual article.

A barbed suture repair for flexor tendons: a novel technique with no exposed barbs.

Background: Barbed suture technology has shown promise in flexor tendon repairs, as there is an even distribution of load and the need for a knot is eliminated. We propose that a quick and simple, novel, barbed technique without any exposed barbs on the tendon surface has comparable strength and a smaller cross-sectional area at the repair site than traditional methods of repair.

Methods: Forty porcine flexor tendons were randomized to polybutester 4-strand barbed repair or to 4-strand Adelaide monofilament repair.

An Analysis of the "Classic" Papers in Aesthetic Surgery.

Introduction: Over the past 50 years, there has been a significant increase in published articles in the medical literature. The aesthetic surgery literature is vast, consisting of a plethora of diverse articles written by a myriad of illustrious authors. Despite this considerable archive of published material, it remains nebulous as to which precise papers have had the greatest impact on our specialty.

100 citation classics in the melanoma literature: a bibliometric analysis.

Background: Modern immunologic therapies targeting genetic mutations have created a renewed interest in melanoma research, and this is reflected in the increasing number of published works.

Objective: The purpose of this study was to identify the top 100 most cited articles in melanoma and to examine the characteristics of each individual article.

Methods: Using an electronic database through the Web of Science, we were able to determine the 22 journals that contributed to the 100 most cited articles in melanoma.

The oncologic safety and practicality of breast conservation surgery in large breast tumors 5 centimeters or more.

Background: Surgery remains a therapeutic strategy for women with breast cancer, and long-term outcomes for breast conservation surgery (BCS) and radiotherapy are equivalent to those for mastectomy. To date, there are few published data assessing the oncologic safety and practicality of BCS in women with large breast cancers ≥ 5 cm. The current study compares survival outcomes for women with breast cancer ≥ 5 cm undergoing BCS or mastectomy.

Rapidly enlarging cutaneous nodules on a full-thickness skin graft following an excision of a squamous cell carcinoma - a diagnostic clue for multiple myeloma.

Cutaneous extramedullary plasmacytomas (EMPs) are rare plasma cell neoplasms of the skin occurring in 2-4% of patients with multiple myeloma (MM). We describe a man diagnosed with IgA lambda MM (Stage III) after rapidly enlarging cutaneous nodules developed in the surgical site of recently excised skin malignancies. Cutaneous EMP must be considered for expanding cutaneous nodules at sites of surgery or trauma.

Incisional hernia appendicitis: A report of two unique cases and literature review.

Introduction: Acute appendicitis is a common surgical emergency. The presence of an inflamed appendix in an incisional hernia is rare. Incisional hernias complicate both open and laparoscopic surgery.

An unusual presentation of a calcified thyroid gland.

A multinodular goitre with cystic degeneration with haemorrhage and subsequent calcification is a common occurrence in long-standing multinodular goitres. But extensive enlargement and calcification causing obstructive symptoms including dysphagia and tracheal shift has not been commonly reported in the literature. Our patient, an 82-year-old man presented with long-standing dysphagia and tracheal shift.