scholarly journals Impact of COVID-19 outbreak on plastic surgery: Taken precautions, distribution of surgical procedures and changes in admissions to outpatient clinic

Author(s):  
Murat Kara ◽  
Burkay Akduman ◽  
Yahya Melih Işık ◽  
Koray Gürsoy ◽  
Ugur Koçer
2021 ◽  
pp. 325-358
Author(s):  
Ömer Faruk Dilek ◽  
Fuat Uslusoy ◽  
Mustafa Asım Aydın

Author(s):  
LUIGI CARLO DA SILVA COSTA ◽  
JOÃO GABRIEL ROMERO BRAGA ◽  
VALDIR TERCIOTI JUNIOR ◽  
JOÃO DE SOUZA COELHO NETO ◽  
JOSÉ ANTÔNIO POSSATTO FERRER ◽  
...  

ABSTRACT Objective: to analyze the surgical treatment of patients with recurrent megaesophagus followed at the esophageal-stomach-duodenal outpatient clinic of the Hospital de Clínicas - UNICAMP. Methods: a retrospective study, from 2011 to 2017, with 26 patients with Chagas or idiopathic megaesophagus, surgically treated, and who recurred with dysphagia. Clinical, endoscopic and radiographic aspects were assessed and correlated with the performed surgical procedures. Results: 50% had dysphagia for liquids, 69% regurgitation, 65.3% heartburn, 69.2% weight loss and 69.2% had Chagas disease. In addition, 38.4% had megaesophagus stage 1 and 2 and 61.5% stage 3 and 4. Regarding the reoperations, 53% of them underwent Heller-Pinotti surgery by laparoscopy, Serra-Dória in 30.7% and esophageal mucosectomy in 7.9%. In 72% of the reoperations there were no postoperative complications, and 80% of the patients had a good outcome, with reduction or elimination of dysphagia. Among the reoperated patients undergoing the laparoscopic Heller-Pinotti technique, three reported little improvement of dysphagia in the postoperative period and among those who underwent Serra-Dória surgery, 100% had no dysphagia. It was observed that, when the time between the first procedure and the reoperation was longer, the better the surgical result was, with statistical significant decreased dysphagia (p=0.0013, p<0.05). Conclusions: there was a preference to perform laparoscopic re-miotomy and, as a second option, Serra-Dória surgery, for patients with recurrent megaesophagus. Esophagectomy or esophageal mucosectomy were reserved for more severe patients.


Author(s):  
Jonathan Warwick

This chapter discusses the anaesthetic management of plastic surgery. It begins with general principles of the anaesthetic management of plastic surgical patients. Surgical procedures covered include breast augmentation, reconstruction, and reduction surgery, correction of prominent ears, facelift (rhytidectomy), free-flap surgery, liposuction, and skin grafting. The chapter concludes with a series of vignettes of minor plastic surgical operations.


2012 ◽  
Vol 98 (2) ◽  
pp. 23-27
Author(s):  
CA Fries ◽  
RF Rickard

IntroductionSurgical trauma care on operations is delivered by consultants. The DMS presently delivers training to surgeons to enable them to deliver this care as newly-qualified consultants. Deploying as a trainee is one of many training evolutions available to achieve this competency. This paper describes the process involved in trainees deploying, and the training received by the first author (CAF) during a recent deployment.MethodsPre-deployment training and the process for gaining recognition of training time by the GMC are described. All surgical procedures performed by the first author were recorded prospectively, together with the level of supervision.ResultsThe first author performed 210 procedures in 124 operations on 87 patients in a seven week deployment. This was prospectively recognised for training by the GMC. All procedures were supervised by consultant trainers. Procedures included trauma surgical procedures and those under the specialties of Plastic Surgery, Orthopaedic Surgery and General Surgery.ConclusionsDeploying on operations as a trainee is invaluable in preparing DMS juniors for their future roles as consultants in the DMS. Training is received not only in a breadth of surgical and resuscitative procedures, beyond a trainee’s “base specialty”, but also in other critical aspects of deployments including Crew Resource Management.


2016 ◽  
Vol 8 (2) ◽  
pp. 173-179 ◽  
Author(s):  
Joseph A Gil ◽  
Alan H Daniels ◽  
Edward Akelman

ABSTRACT  Variability in case exposures has been identified for orthopaedic surgery residents. It is not known if this variability exists for peripheral nerve procedures.Background  The objective of this study was to assess ACGME case log data for graduating orthopaedic surgery, plastic surgery, general surgery, and neurological surgery residents for peripheral nerve surgical procedures and to evaluate intraspecialty and interspecialty variability in case volume.Objective  Surgical case logs from 2009 to 2014 for the 4 specialties were compared for peripheral nerve surgery experience. Peripheral nerve case volume between specialties was performed utilizing a paired t test, 95% confidence intervals were calculated, and linear regression was calculated to assess the trends.Methods  The average number of peripheral nerve procedures performed per graduating resident was 54.2 for orthopaedic surgery residents, 62.8 for independent plastic surgery residents, 84.6 for integrated plastic surgery residents, 22.4 for neurological surgery residents, and 0.4 for surgery residents. Intraspecialty comparison of the 10th and 90th percentile peripheral nerve case volume in 2012 revealed remarkable variability in training. There was a 3.9-fold difference within orthopaedic surgery, a 5.0-fold difference within independent plastic surgery residents, an 8.8-fold difference for residents from integrated plastic surgery programs, and a 7.0-fold difference within the neurological surgery group.Results  There is interspecialty and intraspecialty variability in peripheral nerve surgery volume for orthopaedic, plastic, neurological, and general surgery residents. Caseload is not the sole determinant of training quality as mentorship, didactics, case breadth, and complexity play an important role in training.Conclusions


2021 ◽  
pp. 229255032199700
Author(s):  
Peter Mankowski ◽  
Abhiram Cherukupalli ◽  
Karen Slater ◽  
Nick Carr

Background: The use of appropriate preoperative antibiotic prophylaxis decreases the risk of surgical site infections (SSI); however, the breadth of plastic surgery procedures makes it challenging to ensure appropriate use for each unique procedure type. Currently, plastic surgeons lack a cohesive and comprehensive set of evidence-based guidelines (EBG) for surgical prophylaxis. We sought to profile the perioperative antibiotic prescribing patterns for plastic surgeons in British Columbia to investigate if they are congruent with published recommendations. In doing so, we aim to determine risk factors for antibiotic overprescribing in the context of surgical prophylaxis. Methods: A literature review identifying EBG for antibiotic prophylaxis use during common plastic surgery procedures was performed. Concurrently, a provincial survey of plastic surgery residents, fellows, academic and community plastic surgeons was used to identify their antibiotic prophylaxis prescribing practices. These findings were then compared to recommendations identified from our review. The compliance of the provincial plastic surgery community with current EBG was determined for 38 surgical scenarios to identify which clinical factors and procedure types were associated with unsupported antibiotic use. Results: Within the literature, 31 of the 38 categories of surveyed plastic surgery operations have EBG for use of prophylactic antibiotics. When surgical procedures have EBG, 19.5% of plastic surgery trainees and 21.9% of practicing plastic surgeons followed recommended prophylaxis use. Average adherence to EBG was 59.1% for hand procedures, 24.1% for breast procedures, and 23.9% for craniofacial procedures. Breast reconstruction procedures and contaminated craniofacial procedures were associated with a significant reduction in adherence to EBG resulting in excessive antibiotic use. Conclusion: Even when evidence-based recommendations for antibiotic prophylaxis exist, plastic surgeons demonstrate variable compliance based on their reported prescribing practices. Surgical procedures with low EBG compliance may reflect risk avoidant behaviors in practicing surgeons and highlight the importance of improving education on the benefits of antibiotic prophylaxis in these clinical situations.


2015 ◽  
Vol 10 (4) ◽  
pp. 348-354
Author(s):  
Ileana-Carmen MATLAC ◽  
◽  
Dan Mircea ENESCU ◽  
◽  

Objective. The analysis of the soft tissue coverage types employed in complex limb trauma in children towards a potential subsequent optimization of their management. Materials and methods. Data regarding the children admitted to the Burns and Plastic Surgery Clinic of ‘Grigore Alexandrescu’ children’s hospital, between 2005 and 2013 with complex limb trauma requiring soft tissue coverage was obtained from the surgical protocols. Information was gathered regarding patients’ sex and age, the type of incident, the mode of occurence, the region in need of coverage, the number and type of surgical procedures, as well as regarding the type of coverage employed. Results. A number of 80 children required soft tissue coverage in complex limb trauma. Boys accounted for approximately two thirds of all cases. The pacients had a minimum age of 1 year and a maximum one of 16 years. There were approximately 50% more trauma of this type affecting the upper limb than the lower one. The fingers required coverage in the majority of cases (77.5%). In the majority of cases at this level (77%) split-level thickness grafts and local flaps were applied. Conclusions. The majority of the complex pediatric soft tissue limb coverage cases were boys. Fingers were the predominantly affected area and most often the usage of split-level thickness grafts or of local flaps was required. The accidents were predominantly home related. The cases had an uncomplicated evolution, the coverage solutions employed being successful in over 90% of the situations.


2012 ◽  
Vol 94 (9) ◽  
pp. 304-306
Author(s):  
O Gilleard ◽  
N Segaren ◽  
D Markeson ◽  
R Uppal ◽  
Y Tavsanoglu ◽  
...  

Since the introduction of the European Working Time Regulations (EWTR) and Modernising Medical Careers (MMC), concerns have been raised regarding the quality of early surgical training. Recurring issues include the lack of time spent in the operating theatre and outpatient clinic with increased time spent on service provision. As a means of restoring the quality of early surgical training, the Joint Committee on Surgical Training (JCST) has devised a set of SMART (specific, measurable, attainable, relevant, time-framed) standards to be met by core surgical trainees (CSTs). These include the following scheduled weekly activities: four half-day sessions (18 hours) supervised in the operating theatre, one half-day session (4.5 hours) in supervised outpatient clinics and two hours of structured teaching.


2004 ◽  
Vol 30 (4) ◽  
pp. 240-254 ◽  
Author(s):  
Christopher E. Kazor ◽  
Khalaf Al-Shammari ◽  
David P. Sarment ◽  
Carl E. Misch ◽  
Hom-Lay Wang

Abstract Implant dentistry has been established as a predictable treatment modality with high clinical success rates. Esthetic considerations of implant restorations have been gaining increased interest over the years. The role of periodontal plastic surgical procedures in the creation and maintenance of peri-implant soft tissue heights to facilitate better esthetics has become more popular. The available plastic surgery procedures and their clinical applications are reviewed in this article. Emphasis is placed on factors to consider for proper case selection and ideal treatment planning.


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