Background: Emergency hand service is a national problem both for civilian and veteran patients. The North Florida/South Georgia Veterans Health system began coordinating emergency hand coverage within the plastic surgery service in 2008. Consult templates were designed to facilitate access to the appropriate service. Trainees were taken out of transfer decisions. Clinic templates were designed to fast track urgent patients to 8 a.m. appointments. The purpose of this study was to evaluate the effectiveness of our templates and triage system.
Methods: All consults completed by the plastic surgery service were reviewed retrospectively. Emergent and urgent hand consults were identified. Time from consult submission to the patient being seen by the plastic surgery provider was recorded. Time frames were categorized as same day, next day, within 2 days, less than or equal to 7 days, and greater than 7 days. Type of emergency (trauma or infection) and treatment plan were noted.
Results: There were 1,090 consults in 2007 and 1,868 consults in 2012 that were completed by the plastic surgery service. We found the number of urgent and emergent hand consults increased by a factor of 6 (49 to 294). Furthermore, 16.3 % (8/49) of patients were seen greater than 1 week after consult submission in 2007, compared with 8.1 % (24/294) of patients in 2012. Only one patient from 2007 and two patients from 2012 went to the OR after regular operating room hours.
Conclusion: A well-coordinated effort to speed access for hand emergencies can minimize expenses and improve quality of care.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4447650 | PMC |
http://dx.doi.org/10.1007/s11552-014-9664-4 | DOI Listing |
Ann Plast Surg
February 2025
From the Department of Plastic and Reconstructive Surgery, Ewha Womans University College of Medicine, Mokdong Hospital, Seoul, Republic of Korea.
Indocyanine green (ICG) is a water-soluble green substance that is detectable through infrared cameras and emits greenish light. Approved for medical use in the 1950s, ICG has gained prominence as a real-time visualization tool. Widely recognized as a generally safe substance, ICG is applied in diverse fields.
View Article and Find Full Text PDFAnn Plast Surg
February 2025
Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA.
Background: Red breast syndrome (RBS) has been noted in past literature as a possible complication of implant-based breast reconstruction (IBBR) with the use of acellular dermal matrices (ADMs). Since its first appearance in 2009, RBS has drawn growing medical attention with reported incidence ranging from 7%-9%. There has been a noted decrease in the emergence of RBS despite its inclusion among the analyzed complications in a number of studies.
View Article and Find Full Text PDFAnn Plast Surg
February 2025
From the Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN.
International medical graduates (IMGs) represent a significant portion of the US physician workforce, comprising 25% across all specialties with a strong presence in internal medicine and primary care. However, their representation in plastic surgery remains limited at only 10%. Matching into a US plastic surgery residency is highly competitive for both US medical graduates and IMGs.
View Article and Find Full Text PDFAnn Plast Surg
February 2025
Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Background: Plastic surgery training continues to evolve with integrated residents spending more time in plastic versus general surgery. Herein, we provide an updated description of interprogram differences in core general, core plastic, and plastic surgery-adjacent training curricula.
Methods: We obtained rotation schedules from US plastic surgery residency websites or program coordinators for AY2021-2022.
Ann Plast Surg
February 2025
From the Department of Plastic, Hand and Faciomaxillary Surgery, The Alfred, Melbourne, Australia.
Hourglass fascicular constrictions have been reported in fewer than 100 cases globally and only in the upper limb. The etiology remains unknown. Patients often present with self-limiting pain in the affected limb followed by flaccid paralysis.
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