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1.
Surgeon ; 20(2): 67-70, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33414044

RESUMO

BACKGROUND: The games of hurling and camogie involve fast ball movement and a substantial physical contact with opposing players. The wearing of protective helmets with faceguards became obligatory 10 years ago and resulted in a significant reduction of craniofacial injuries. However since then a trend has emerged of players modifying helmets to improve comfort and vision. As officials are not yet required to perform pre-match checks, many players enter competition with defective protective equipment which poses a risk to both themselves and others. METHODS: We present 4 cases of penetrating upper limb injury in hurlers sustained as a result of helmet faceguards. These injuries were sustained during competitive play and the affected patients presented with portions of the faceguards embedded in their wounds. Each patient required admission to hospital and exploration of their wounds under general anaesthetic. CONCLUSIONS: This case series demonstrates the dangers of modification and damage to protective helmet faceguards used in hurling and camogie. We encourage helmet manufacturers to re-engage with players to ensure that current safety equipment meets the functional demands of the modern player while adhering to approved manufacturing standards. Mandatory helmet checks before competitive games would reduce the likelihood of penetrating upper limb injury to players.


Assuntos
Traumatismos em Atletas , Dispositivos de Proteção da Cabeça , Extremidade Superior , Traumatismos em Atletas/etiologia , Dispositivos de Proteção da Cabeça/efeitos adversos , Humanos , Extremidade Superior/lesões
2.
Dermatol Surg ; 43(6): 805-809, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28323656

RESUMO

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). Basal cell carcinomas were excised with a predetermined surgical margin of either 2, 3,, or 4 mm. Mean histological margin, incomplete excision rate, and method of closure were recorded and compared between LM and control groups, across a range of surgical margins. RESULTS: Ninety-four BCCs were excised from 93 patients, 47 BCCs in each group. The mean histological margin was larger in the study versus control group for each group (2-mm margin, 1.8 vs 1.4, 3-mm margin, 2.4 vs 2.3, 4-mm margin, and 3.1 vs 2.7), but only statistically significant in the 4-mm group (p = .032). There was no difference in method of closure between LM and control groups. CONCLUSION: Loupe magnification improved tumor margin assessment for facial BCC enabling a greater diameter of histological clearance. The use of LM should become a standard practice for facial BCC excision.


Assuntos
Carcinoma Basocelular/patologia , Neoplasias Faciais/patologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/cirurgia , Neoplasias Faciais/cirurgia , Feminino , Humanos , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Estudos Prospectivos , Método Simples-Cego
3.
Aesthetic Plast Surg ; 39(1): 8-16, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25409623

RESUMO

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. The aim of our study was to identify and analyse the characteristics of the top 50 papers in the field of aesthetic surgery in the published literature. METHODS: The 50 most cited papers were identified in several surgical journals through the Web of Science. The articles were ranked in order of the number of citations received. These classic 50 papers were analysed for article type, their journal distribution, level of evidence as well as geographic and institutional origin. RESULTS: Six journals contributed to the top 50 papers in aesthetic surgery with Plastic and Reconstructive Surgery contributing the most with 31 papers.


Assuntos
Bibliometria , Editoração , Cirurgia Plástica , Publicações Periódicas como Assunto
4.
Dermatol Surg ; 40(12): 1284-98, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25357170

RESUMO

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. RESULTS: Each article was examined individually looking at characteristics such as subject matter, article type, country of origin, institution, authorship, and year of publication. The New England Journal of Medicine contributed the most articles to the top 100 with 20 articles, whereas the most cited article originated from the Archives of Surgery and has been cited 2,384 times. The United States produced 74% of the top 100 articles, and the most prolific institution was the National Cancer Institute in Maryland with 18 articles. CONCLUSION: This study has identified the most significant contributions to melanoma research over the past 63 years and identifies many important scientific breakthroughs and landmarks that have occurred during this time.


Assuntos
Bibliometria , Pesquisa Biomédica , Melanoma/terapia , Neoplasias Cutâneas/terapia , Humanos , Publicações Periódicas como Assunto/estatística & dados numéricos , Editoração/estatística & dados numéricos
5.
Expert Rev Proteomics ; 9(4): 415-23, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22967078

RESUMO

Despite advances in our knowledge of the disease, malignant melanoma remains an unpredictable entity. The revolution in molecular biological techniques, such as DNA sequencing and gene-expression profiling, has uncovered many potential protein targets and biomarkers relevant to melanoma progression. Successful clinical application would be aided significantly by downstream proteomic validation of those candidate markers using a combination of immunohistochemistry and tissue microarrays. Yet, research in this context seems to lag behind the output of genomic data relating to melanoma. In this article, we look at the strengths and pitfalls of tissue microarrays in malignant melanoma. We will show how tissue microarrays have become a vital step in the transition from molecular techniques to useful clinical assays and interventions and look at likely future developments for advances in this field.


Assuntos
Melanoma/diagnóstico , Proteínas de Neoplasias/química , Análise Serial de Tecidos/métodos , Biomarcadores Tumorais/química , Ensaios Clínicos como Assunto , Progressão da Doença , Perfilação da Expressão Gênica/métodos , Testes Genéticos/métodos , Humanos , Imuno-Histoquímica , Melanoma/química , Melanoma/genética , Estadiamento de Neoplasias/métodos , Prognóstico , Sensibilidade e Especificidade
6.
Microsurgery ; 32(8): 649-56, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23086761

RESUMO

BACKGROUND: Proficient microsurgical skills are considered essential in plastic and reconstructive surgery. Specialized courses offer trainees opportunity to improve their technical skills. Trainee aptitude may play an important role in the ability of a trainee to acquire proficient skills as individuals have differing fundamental abilities. We delivered an intensive 5-day microsurgical training course. We objectively assessed the impact of the course on microsurgical skill acquisition and whether aptitudes as assessed with psychometric tests were related to surgical performance. METHODS: Sixteen surgical trainees (male = 10 and female = 6) participated in the courses. Trainees' visual spatial, perceptual, and psychomotor aptitudes were assessed on day 1 of the course. The trainees' performance of an end-to-end arterial anastomosis was assessed on days 2 and 5. Surgical performance was assessed with objective structured assessment of technical skills(OSATS) and time to complete the task. RESULTS: The trainees showed a significant improvement in OSATS scores from days 2 to 5 (P < 0.001) and the time taken to complete the anastomosis (P < 0.001). Aptitude scores correlated strongly with objectively assessed microsurgical skill performance for male trainees but not for females. CONCLUSIONS: We demonstrated that participating in a microsurgical training course results in significant improvement in objectively assessed microvascular surgical skills. The degree of skills improvement was strongly correlated with psychomotor aptitude assessments scores for male trainees.


Assuntos
Aptidão , Competência Clínica , Educação de Pós-Graduação em Medicina , Microcirurgia/educação , Adulto , Anastomose Cirúrgica/educação , Animais , Testes de Aptidão , Artérias/cirurgia , Percepção de Profundidade , Feminino , Alemanha , Humanos , Irlanda , Masculino , Microcirurgia/psicologia , Variações Dependentes do Observador , Desempenho Psicomotor , Ratos , Ratos Sprague-Dawley
7.
Plast Reconstr Surg Glob Open ; 7(9): e2408, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31942387

RESUMO

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. Systematic review of research published in Plastics and Reconstructive Surgery journal over the years, 10-year period (2008, 2013, 2018), was performed. LOE for each article was determined using the American Society of Plastic Surgeons (ASPS) guidelines. Each level was calculated as percentage of publications per year and compared yearly and between different topics. Eight hundred eighty-four studies were included in the final analysis. The LOE of the research improved over the study period. Level 4 evidence was the most frequent published (50.6%, 447/884), with a decline from 63.2% in 2008 to 41.3% in 2018. Level 1 evidence improved each year and accounted for 2.1% of all research in 2018. Aesthetic surgery was the most frequent published topic with upper limb research demonstrating an 18.5% increase in high-quality evidence over the study period. Increased awareness of evidence-based medicine has improved the quality of plastic surgery research over the past decade. It is vital this continues to provide gold standard patient care.

8.
Acta Radiol Open ; 6(6): 2058460117716703, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28717518

RESUMO

BACKGROUND: Mixed martial arts is a sport that has recently enjoyed a significant increase in popularity. This rise in popularity has catapulted many of these "cage fighters" into stardom and many regularly use social media to reach out to their fans. An interesting result of this interaction on social media is that athletes are sharing images of their radiological examinations when they sustain an injury. PURPOSE: To review instances where mixed martial arts fighters shared images of their radiological examinations on social media and in what context they were shared. MATERIAL AND METHODS: An Internet search was performed using the Google search engine. Search terms included "MMA," "mixed martial arts," "injury," "scan," "X-ray," "fracture," and "break." Articles which discussed injuries to MMA fighters were examined and those in which the fighter themselves shared a radiological image of their injury on social media were identified. RESULTS: During our search, we identified 20 MMA fighters that had shared radiological images of their injuries on social media. There were 15 different types of injury, with a fracture of the mid-shaft of the ulna being the most common. The most popular social media platform was Twitter. The most common imaging modality X-ray (71%). The majority of injuries were sustained during competition (81%) and 35% of these fights resulted in a win for the fighter. CONCLUSION: Professional mixed martial artists are sharing radiological images of their injuries on social media. This may be in an attempt to connect with fans and raise their profile among other fighters.

9.
J Hand Surg Asian Pac Vol ; 22(4): 452-456, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29117839

RESUMO

BACKGROUND: Fight bite injuries are typically sustained by young, combative males and are the direct consequence of an aggressive act. Second to fourth digit ratios (2D:4D) are dependent on prenatal androgen exposure and lower ratios have been shown to be linked to various psychological and physical traits, including aggression. The aim of this study was to examine the 2D:4D ratios in a cohort of patients with fight bite injuries and compare these to an age and gender-matched control group. METHODS: The 2D:4D ratios were calculated using plain films of the hand from 133 patients (122 males, 11 females) with fight bite injuries. A further 133 radiographs were obtained from patients that did not have fight bite injuries and digit ratios were calculated in the same fashion. Statistical analysis was then carried out to compare the 2D:4D ratios between the different groups. RESULTS: The 2D:4D ratios for male fight bite patients was significantly smaller than the male control group (p < 0.05). No significant difference was observed between the female fight bite patients and the female control group (p > 0.05). CONCLUSIONS: Fight bite injuries are usually sustained as a result of aggression. 2D:4D ratios are reflect intrauterine androgen exposure and low ratios have been linked to aggressive tendencies. We have demonstrated that male patients who sustained fight bite injuries have a lower 2D:4D ratio then the general population, thereby suggesting that exposure to prenatal androgens can lead to aggressive tendencies in adulthood. This suggests that lower ratios may predict a predisposition to acts of aggression, and as such result in an increased likelihood of sustaining an injury such as a fight bite.


Assuntos
Agressão , Mordeduras Humanas/epidemiologia , Traumatismos dos Dedos/epidemiologia , Dedos/anatomia & histologia , Estudos de Casos e Controles , Pré-Escolar , Feminino , Humanos , Masculino
10.
Head Neck ; 39(9): 1840-1844, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28640533

RESUMO

BACKGROUND: Squamous cell carcinomas (SCCs) of the external ear have a significant rate of metastasis. The purpose of this study was to present analyzed factors associated with auricular SCC metastasis in order to identify a group that may benefit from sentinel lymph node biopsy (SLNB). METHODS: We performed a retrospective review of all operable SCCs between 2009 and 2014. The association between high-risk features and metastasis were analyzed. RESULTS: One hundred eighty-nine auricular SCCs were excised. Local recurrence was noted in 11% and 9.5% developed metastases. Cartilage, perineural, and lymphovascular invasion were significantly associated with metastasis, as were increased tumor depth and diameter (P < .001). All patients with metastasis developed nodal disease. CONCLUSION: Factors, including poor differentiation, perineural, cartilage, and lymphovascular invasion, are associated with auricular SCC metastasis. Patients with 2 or more high-risk features may benefit from SLNB in order to identify and treat early nodal disease and possibly reduce the risk of further spread.


Assuntos
Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Orelha Externa/patologia , Invasividade Neoplásica/patologia , Biópsia de Linfonodo Sentinela/métodos , Neoplasias Cutâneas/patologia , Adulto , Idoso , Carcinoma de Células Escamosas/cirurgia , Estudos de Coortes , Intervalo Livre de Doença , Diagnóstico Precoce , Feminino , Humanos , Excisão de Linfonodo/métodos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Medição de Risco , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/cirurgia , Análise de Sobrevida , Resultado do Tratamento
11.
Hand (N Y) ; 11(2): 211-5, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27390565

RESUMO

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. METHODS: A systematic review was performed on all hand surgery articles published in 6 journals over a 20-year period. The journals included Plastic and Reconstruction Surgery, Journal of Plastic, Reconstructive and Aesthetic Surgery, Journal of Hand Surgery-European Volume, Journal of Hand Surgery-American Volume, Journal of Bone & Joint Surgery, and the Bone & Joint Journal. The level of evidence of each article was determined using the Oxford level of evidence. The quality of methodology of randomized controlled trials (RCTs) was assessed using Jadad scale. Statistical analysis involved chi-squares and Student t test (P < .05). RESULTS: A total of 972 original hand surgery research articles were reviewed. There was a significant increase in the average level of evidence of articles published between1993 and 2013. High-quality evidence only accounted for 11.2% of evidence published, with a significant increase over the study period (P = 0.001). Quantitative evaluation of the 26 published RCTs, using Jadad scale, revealed a progressive improvement in study design from 0.3 in 1993 to 3.33 in 2013. CONCLUSIONS: Hand surgery research has mirrored trends seen in other surgical specialties, with a significant increase in quality of evidence over time. Yet, high-quality evidence still remains infrequent.

12.
J Hand Surg Asian Pac Vol ; 21(3): 388-94, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27595959

RESUMO

BACKGROUND: Knowledge of hand anatomy and pathology is important for final year medical students as it frequently appears in examinations as a short case or in a written paper. Studies have shown that doctors in the Emergency Department have a deficient grasp of musculoskeletal anatomy secondary to a lack of dedicated teaching in medical school. METHODS: A questionnaire was handed out to 111 final year medical students. Students were asked to fill it out before and after dedicated upper limb teaching sessions during their rotation. The questionnaire consisted of an anatomical and pathological component. Students were tested on basic anatomy and pathology of several common upper limb conditions. RESULTS: There was a significant improvement in the medical students knowledge after the dedicated hand teaching. The identification of the carpal bones showed the most improvement overall. CONCLUSIONS: Basic musculoskeletal knowledge is essential to the practice of medicine. The majority of medical students gravitate towards a career in general practice or emergency medicine and good knowledge of upper limb anatomy is important. We have piloted a new interactive dedicated upper limb teaching module and have shown that there has been a significant improvement in students knowledge.


Assuntos
Anatomia/educação , Educação de Graduação em Medicina/métodos , Avaliação Educacional , Mãos/anatomia & histologia , Faculdades de Medicina , Estudantes de Medicina , Humanos , Inquéritos e Questionários
13.
J Plast Surg Hand Surg ; 49(1): 52-8, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25196126

RESUMO

Citation analysis is an established bibliometric method which catalogues papers according to the number of times they have been referenced. It is believed that the total number of citations an article receives reflects its importance among its peers. Never before has a bibliometric analysis been performed in the area of Cleft Lip and Palate. Our citation analysis creates a comprehensive list of the 50 most influential papers in this field. Journals specializing in Cleft Palate, Craniofacial, Plastic Surgery, Maxillofacial Surgery, Aesthetics and Radiology were searched to establish which articles most enriched the specialty over the past 70 years. The results show an interesting collection of papers which reveal developing trends in surgical techniques. These landmark papers mould and influence management and decision-making today.


Assuntos
Bibliometria , Fenda Labial , Fissura Palatina , Humanos , Jornalismo Médico , Editoração
14.
Arch Plast Surg ; 42(3): 341-5, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-26015891

RESUMO

BACKGROUND: A tie-over dressing is the accepted method to secure skin grafts in order to prevent haematoma or seroma formation. We describe the novel application of a barbed suture tie-over for skin graft dressing. The barbs act as anchors in the skin so constant tensioning of the suture is not required. METHODS: From January 2014 to August 2014 we used the technique in 30 patients with skin defects requiring split-thickness or full-thickness grafts. Patient demographics, clinicopathological details and graft outcome were collected prospectively. RESULTS: The majority of cases were carried out for split-thickness skin grafts (n=19) used on the lower limb (n=20). The results of this novel technique were excellent with complete (100%) graft take in all patients. CONCLUSIONS: Our results demonstrate the clinical application of a barbed device for securing skin grafts with excellent results. We find the technique quick to perform and the barbed device easy to handle, which can be applied without the need for an assistant.

15.
Arch Plast Surg ; 42(4): 475-7, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26217569

RESUMO

We report the case of a 33-year-old male who presented with a malignant melanoma on his anterior chest wall. The lesion was only found in the red ink pigment of the tattoo, as were several in-transit dermal metastases. Possible explanations include a pre-existing lesion which was seeded with red ink or the possibility of the red ink causing an inflammatory reaction leading to malignant transformation. This is the first reported case of a melanoma developing in the red ink pigment of a multi-colored tattoo.

16.
Arch Plast Surg ; 42(5): 559-66, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26430626

RESUMO

BACKGROUND: Citation analysis is a recognized scientometric method of classifying cited articles according to the frequency of which they have been referenced. The total number of citations an article receives is considered to reflect it's significance among it's peers. METHODS: Until now, a bibliometric analysis has never been performed in the specialty of craniofacial anomalies and craniofacial surgery. This citation analysis generates an extensive list of the 50 most influential papers in this developing field. Journals specializing in craniofacial surgery, maxillofacial surgery, plastic surgery, neurosurgery, genetics and pediatrics were searched to demonstrate which articles have cultivated the specialty within the past 55 years. RESULTS: The results show an intriguing compilation of papers which outline the fundamental knowledge of craniofacial anomalies and the developments of surgical techniques to manage these patients. CONCLUSIONS: This citation analysis provides a summation of the current most popular trends in craniofacial literature. These esteemed papers aid to direct our decision making today within this specialty.

17.
Arch Plast Surg ; 42(5): 596-600, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26430631

RESUMO

BACKGROUND: The uptake of breast reconstruction is ever increasing with procedures ranging from implant-based reconstructions to complex free tissue transfer. Little emphasis is placed on scarring when counseling patients yet they remain a significant source of morbidity and litigation. The aim of this study was to examine the scarring preferences of men and women in breast oncoplastic and reconstructive surgery. METHODS: Five hundred men and women were asked to fill out a four-page questionnaire in two large Irish centres. They were asked about their opinions on scarring post breast surgery and were also asked to rank the common scarring patterns in wide local excisions, oncoplastic procedures, breast reconstructions as well as donor sites. RESULTS: Fifty-eight percent of those surveyed did not feel scars were important post breast cancer surgery. 61% said that their partners' opinion of scars were important. The most preferred wide local excision scar was the lower lateral quadrant scar whilst the scars from the deep inferior epigastric artery perforator (DIEP) flap were most favoured. The superior gluteal artery perforator flap had the most preferred donor site while surprisingly, the DIEP had the least favourite donor site. CONCLUSIONS: Scars are often overlooked when planning breast surgery yet the extent and position of the scar needs to be outlined to patients and it should play an important role in selecting a breast reconstruction option. This study highlights the need for further evaluation of patients' opinions regarding scar patterns.

18.
Arch Plast Surg ; 42(4): 411-8, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26217560

RESUMO

BACKGROUND: The plastic 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. The aim of this study was to identify the most cited papers in the plastic surgery literature and perform a citation analysis paying particular attention to the evidence levels of the clinical studies. METHODS: We identified the 50 most cited papers published in the 20 highest impact plastic surgery journals through the Web of Science. The articles were ranked in order of number of citations acquired and level of evidence assessed. RESULTS: The top 50 cited papers were published in six different journals between the years 1957 and 2007. Forty-two of the papers in the top 50 were considered as level IV or V evidence. No level I or II evidence was present in the top 50 list. The average level of evidence of the top 50 papers was 4.28. CONCLUSIONS: In the plastic surgery literature, no positive correlation exists between a high number of citations and a high level of evidence. Anatomical reconstructive challenges tend to be the main focus of plastic surgery rather than pathologic diseases and consequently, papers with lower levels of evidence are relatively more valuable in plastic surgery than many other specialties.

19.
J Plast Surg Hand Surg ; 49(6): 363-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26397754

RESUMO

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. The aim of this study is to assess the current practice patterns of drains usage by Plastic & Reconstructive and Breast Surgeons in UK and Ireland performing BBRs. METHOD: An 18 question survey was created evaluating various aspects of BBR practice. UK and Irish Plastic & Reconstructive and Breast Surgeons were invited to participate by an email containing a link to a web-based survey. Statistical analysis was performed with student t-test and chi-square test. RESULTS: Two hundred and eleven responding surgeons were analysed, including 80.1% (171/211) Plastic Surgeons and 18.9% (40/211) Breast Surgeons. Of the responding surgeons, 71.6% (151/211) routinely inserted postoperative drains, for a mean of 1.32 days. Drains were used significantly less by surgeons performing ≥20 BBRs (p = 0.02). With the majority of BBRs performed as an inpatient procedure, there was a trend towards less drain usage in surgeons performing this procedure as an outpatient; however, this was not statistically significant (p = 0.07). CONCLUSION: Even with the high level of evidence demonstrating the safety of BBR without drains, they are still routinely utilised. In an era of evidence- based medicine, surgeons performing breast reductions must adopt the results from scientific research into their clinical practice.


Assuntos
Mama/cirurgia , Drenagem/estatística & dados numéricos , Mamoplastia/métodos , Padrões de Prática Médica/estatística & dados numéricos , Inquéritos e Questionários , Adulto , Medicina Baseada em Evidências , Feminino , Seguimentos , Pesquisas sobre Atenção à Saúde , Humanos , Irlanda , Mamoplastia/instrumentação , Pessoa de Meia-Idade , Segurança do Paciente , Cuidados Pós-Operatórios/métodos , Cuidados Pré-Operatórios/métodos , Cirurgiões/estatística & dados numéricos , Resultado do Tratamento , Reino Unido
20.
Hand Surg ; 20(3): 402-9, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26388001

RESUMO

The literature on Dupuytren's contracture is vast yet little information is known as to which papers have been the most influential. The purpose of this study was to identify the 50 most cited papers on Dupuytren's contracture and perform a citation analysis. Utilizing the Web of Science, 23 surgical, medical, plastic and hand surgery journals were searched for papers on Dupuytren's contracture. Resulting articles were ranked in order of times cited and each paper was analyzed for article-type, year of publication, country of origin, institution and level of evidence. The 50 most cited articles represent many important landmarks in Dupuytren's treatment and contain several seminal works by experts in the field. Whilst the top 50 list highlights the important papers on the condition, they certainly do not provide information about the quality of the evidence of the research, as most papers presented level 4 or 5 evidence.


Assuntos
Bibliometria , Contratura de Dupuytren , Humanos
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