ESPRAS Survey: National and European Societies for Plastic Surgeons.

BACKGROUND: The European Society of Plastic, Reconstructive and Aesthetic Surgery (ESPRAS) comprises 40 national societies across Europe. In addition to ESPRAS, there are 8 different European Plastic Surgery societies representing Plastic Surgeons in Europe. The 4th European Leadership Forum (ELF) of ESPRAS, held under the motto "Stronger together in Europe" in Munich in 2023, aimed to collect and disseminate information regarding the national member societies of ESPRAS and European societies for Plastic Surgeons. The purpose was to identify synergies and redundancies and promote improved cooperation and exchange to enhance coordinated decision-making at the European level. MATERIAL AND METHODS: An online survey was conducted regarding the organisational structures, objectives and challenges of national and European societies for Plastic Surgeons in Europe. This survey was distributed to official representatives (Presidents, Vice Presidents and General Secretaries) and delegates of national and European societies at the ELF meeting. Missing information was completed using data obtained from the official websites of the respective European societies. Preliminary results were discussed during the 4th ELF meeting in Munich in March 2023. RESULTS: The ESPRAS survey included 22 national and 9 European Plastic Surgery societies representing more than 7000 Plastic Surgeons in Europe. Most national societies consist of less than 500 full members (median 182 members (interquartile range (IQR) 54-400); n=22). European societies, which covered the full spectrum or subspecialities, differed in membership types and congress cycles, with some requiring applications by individuals and others including national societies. The main purposes of the societies include research, representation against other disciplines, specialisation and education as well as more individual goals like patient care and policy regulation. CONCLUSION: This ESPRAS survey offers key insights into the structures, requirements and challenges of national and European societies for Plastic Surgeons, highlighting the relevance of ongoing close exchange between the societies to foster professional advancement and reduce redundancies. Future efforts of the ELF will continue to further explore strategies for enhancing collaboration and harmonisation within the European Plastic Surgery landscape.

Interventions, stakeholders, and organisation related to pressure ulcer prevention for individuals with spinal cord injuries in transition from hospital to home - A scoping review.

STUDY DESIGN: Scoping review. AIM OF THE STUDY: To obtain an overview of initiatives, organisational components, and stakeholders' perspectives on PU prevention in transitional care. METHODS: Scoping review searching the databases: MEDLINE, EMBASE), CINAHL, Cochrane Library, Web of Science, and SCOPUS in May 2022. Inclusion of English-written research on pressure ulcer prevention in adult people with spinal cord injury in transition from hospital or rehabilitation centre to the home care environment. RESULTS: Fifteen studies of different types are included in this study: six qualitative studies, four randomized controlled trials, three cohort studies, one cross-sectional study and an interventional study. The included studies are relatively low-level evidence but of acceptable quality. CONCLUSION: Continuous tailored education and information about PU prevention and follow-up services are essential components in preventing PUs and rehabilitating people with SCI. The complexity of SCI requires adaptations, equipment and access to specialist care and treatment after discharge. However, there is a discrepancy between the international recommendations, the perceived needs, and the delivered healthcare services. The consequences are a lower quality of life and a higher risk of PUs for people with SCI.

International study to develop the WOUND-Q patient-reported outcome measure for all types of chronic wounds.

Patient-reported outcome measures (PROMs) for chronic wounds mainly focus on specific types of wounds. Our team developed the WOUND-Q for use with all types of wounds in any anatomic location. We conducted 60 concept elicitation interviews with patients in Canada, Denmark, the Netherlands, and the United States. Analysis identified concepts of interest to patients and scales were formed and refined through cognitive interviews with 20 patients and input from 26 wound care experts. Scales were translated into Danish and Dutch. An international field-test study collected data from 881 patients (1020 assessments) with chronic wounds. Rasch measurement theory (RMT) analysis was used to refine the scales and examine psychometric properties. RMT analysis supported the reliability and validity of 13 WOUND-Q scales that measure wound characteristics (assessment, discharge, and smell), health-related quality of life (life impact, psychological, sleep impact, and social), experience of care (information, home care nurses, medical team, and office staff), and wound treatment (dressing and suction device). The WOUND-Q can be used to measure outcomes in research and clinical practice from the perspective of patients with any type of wound.

Danish translation and linguistic validation of the BODY-Q Chest Module.

The aim of this study was to translate and linguistically validate the patient-reported outcome (PRO) instrument body-q chest module, designed to measure outcomes following chest contouring surgery. The BODY-Q Chest Module includes two scales that measure appearance of chest and nipples. The translation and validation were performed according to the guidelines from the world health organization (who) and the international society for pharmacoeconomics and outcomes research (ISPOR). This approach involved two independent forward translations, a backwards translation, an expert panel meeting and cognitive debriefing interviews with patients. Each step was undertaken with the aim of achieving a conceptual and culturally equal instrument. This process led to a linguistically validated and conceptually equivalent danish version of the body-q chest module. The forward translation resulted in several discrepant translations of items that were harmonized to form the backward translation. This translation included three items with conceptual differences that required further revision. The revised version presented at the expert panel meeting had six items that needed to be revised due to conceptual discrepancies. The cognitive debriefing interviews led to revision of one item. The practices from the who and ispor guidelines were essential to developing a translation that preserved the meaning of the content of the body-q chest module from the original development study. The translation and linguistic validation methods used in our study could be used for further translations and validation of pro instruments. These new scales have since been field-tested as part of an international psychometric study.

The Post-mastectomy Pain Syndrome-A Systematic Review of the Treatment Modalities.

Post-mastectomy pain syndrome (PMPS) is a chronic neuropathic pain condition, affecting many women who have undergone breast cancer surgery. The development of PMPS is complex and the treatment options are limited. In this systematic review, we have analyzed the existing treatment modalities of PMPS. Six studies on five treatments were carefully selected, critically evaluated, and presented. The treatments were: antidepressants, anti-epileptics, topical capsaicin, and autologous fat grafting. Four of these treatments had a significant effect on PMPS. However, most of the studies had several flaws and therefore larger studies of high quality should be performed in the future.

Femoral hernia, a rare complication following deep inguinal lymph node dissection.

A 72-year-old woman underwent complete deep inguinal lymph node dissection on her right side subsequent to metastasis from malignant melanoma. On the second postoperative day, the patient reported of nausea and vomiting. She presented with a mass in the resected area that gradually increased in size to approximately 15×20 cm. The wound was opened a few hours after onset of symptoms and a large femoral hernia with 40 cm of small intestine was immediately revealed protruding in the groin. Prophylactic suturing of the inguinal ligament and Coopers ligament can reduce the risk of postoperative femoral hernia. Further, the authors argue that drainage for seroma and haematoma should be performed with utmost care, considering other possible causes and, if necessary, guided by ultrasonography.

The usual suspects-influence of physicochemical properties on lag time, skin deposition, and percutaneous penetration of nine model compounds.

The influence of physicochemical properties of nine model compounds on lag time, skin deposition, and percutaneous penetration was evaluated. Static diffusion cells mounted with human skin were used as the experimental model, and experiments were carried out in accordance with Organization for Economic Cooperation and Development (OECD) guidelines. The model compounds were chosen to cover a wide spectrum of solubilities and molecular weights. The pesticides included were glyphosate, dimethoate, pirimicarb, malathion, paclobutrazol, methiocarb, prochloraz, and benzoic acid, with the ninth model compound being caffeine. The fastest dermal penetration was observed for compounds with log Pow values between 1.5 and 4. Malathion did not fit into this generalization. No clear relationship was observed between molecular weight and Kp values. The shortest lag time was observed for the most hydrophilic model compounds. With increasing molecular weight, the lag time rose. Thus, the lag time for the smallest model compound was close to 1.5 h, while the lag time exceeded 20 h for a model compound with a molecular weight of 377 g. A difference in lag time of this magnitude inevitably produces differences in the amounts of a chemical able to penetrate the skin within a limited period of time. The relative deposition in the skin was highest for the lipophilic model compounds. For log Pow values between -1 and 2, a linear relationship was observed between log Pow and log Kp. Comparisons between theoretical Kp values based on the Potts-Guy equation and experimental Kp values demonstrated good agreement. Experimental Kp values based on experiments using full-thickness human skin generally underestimated the calculated Kp values by 25%. The observations are relevant to industrial hygienists and regulatory agencies using experimental data for assessing systemic toxicity following dermal exposures as for development of structure activity relationships for dermal absorption of chemicals.