| 1. |
- Almeland, Stian, et al.
(författare)
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The effect of microsurgical training on novice medical students’ basic surgical skills—a randomized controlled trial
- 2020
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Ingår i: European journal of plastic surgery. - : Springer Science and Business Media LLC. - 0930-343X .- 1435-0130. ; 43, s. 459-466
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Tidskriftsartikel (refereegranskat)abstract
- Background It has been demonstrated that medical students are capable of learning microsurgical techniques. We hypothesize that microsurgical training might give insight into the importance of delicate tissue handling and correct knot tying that could have a positive influence on macrosurgical skills. The primary aim of this study was to evaluate the effect of microsurgical training on macrosurgical suturing skills in novice medical students. Subjects and methods In 2018, 46 novice medical students were enrolled and randomized into two groups. The intervention group received both macro- and microsurgical training and the control group received only microsurgical training. Both groups underwent an assessment test that consisted of macrosurgical tasks of three simple interrupted sutures with a square knot and continuous three-stitch long over-and-over sutures. These tests were individually filmed and assessed using the University of Bergen suturing skills assessment tool (UBAT) and the Objective Structured Assessment of Technical Skill global rating scale (OSATS). Questionnaires regarding future career ambitions and attitudes towards plastic surgery were also completed both prior to and following the tests. Results The intervention group needed a longer time to complete the tasks than the control group (12.2 min vs. 9.6 min, p>0.001), and scored lower on both the UBAT (5.6 vs. 9.0, p>0.001) and the OSATS (11.1 vs. 13.1, p>0.001) assessments. The microsurgery course tended to positively influence the students’ attitudes towards a career in plastic surgery (p=0.002). This study demonstrates poorer macrosurgical skills in the medical students group exposed to microsurgical training. The true effect of microsurgical training warrants further investigation.
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| 2. |
- Andreasson, My, et al.
(författare)
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Narrow neovaginal width in a transgender patient due to short interramic distance
- 2017
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Ingår i: European Journal of Plastic Surgery. - : Springer Science and Business Media LLC. - 0930-343X .- 1435-0130. ; 40:5, s. 487-488
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Tidskriftsartikel (refereegranskat)abstract
- Vaginoplasty is one of the core procedures for transgender patients. Aneovaginal cavity is created between the prostate and rectum. The width of the introitus is determined by the distance between the inferior pubic rami. A 32-year-old transgender patient underwent vaginoplasty. Surgery was uneventful. When starting the dilation regimen, insertion of the usual stent was impossible since the neovagina had restricted width. A CT scan of the pelvis showed that the interramic distance, at 3.0 cm below the lower border of bony structure of the symphysis pubis, was only 3.2 cm. If a transgender patient presents with short stature, a short interramic distance may be expected. Preoperative radiologicalimagingshouldbeconsidered. Surgeonsshouldbe equipped with adequate-size stents for postoperative dilation regimen.
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| 3. |
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| 4. |
- Hallberg, Håkan, et al.
(författare)
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Complications, long-term outcome and quality of life following Surgisis® and muscle-covered implants in immediate breast reconstruction: a case-control study with a 6-year follow-up
- 2019
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Ingår i: European Journal of Plastic Surgery. - : Springer Science and Business Media LLC. - 0930-343X .- 1435-0130. ; 42:1, s. 33-42
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Tidskriftsartikel (refereegranskat)abstract
- © 2018, The Author(s). Background: Matrices are now commonly used in breast reconstruction, but the scientific evidence is still scares. The main aim was to compare complications and the need for corrections in immediate breast reconstruction with the porcine-derived Surgisis®with the traditional muscle-covered technique. The secondary aim was to compare long-term quality of life and satisfaction. Methods: All consecutive patients who had their breast reconstructed with a Surgisis®or muscle-covered tissue expander/implant were included. Patients were followed clinically and with BREAST-Q. Results: During the study period, 116 reconstructions (71 patients) were operated in the Surgisis®group and 132 reconstructions (90 patients) in the control group. The median follow-up time was 74months (min 43–max 162). The total early complication rate was 37% in the Surgisis®group and 27% in the control group. There were no differences in implant loss (p = 0.68) or total number of complications (p = 0.24) between the two groups. Risk factors for complications were mainly patient characteristics and the use of a tissue expander. There was a slightly higher capsular contracture frequency in the Surgisis®patients (4.2% vs. 2.5%). The need for corrections and patient satisfaction and quality of life were similar in the two groups. Conclusions: The use of Surgisis®in implant-based reconstruction seems to result in an acceptable total early complication rate. The rate might be higher in tissue expander-based reconstruction. Risk factors are mainly patient characteristics. The capsular contracture rate and need for corrections, as well as patient satisfaction and quality of life, are similar in the Surgisis®patients and muscle-covered controls. Level of evidence: III.
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| 5. |
- Hansson, Emma, et al.
(författare)
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Designing and arranging an undergraduate elective course in plastic surgery—the experiences of a Scandinavian department
- 2016
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Ingår i: European Journal of Plastic Surgery. - : Springer Science and Business Media LLC. - 0930-343X .- 1435-0130. ; 39:3, s. 207-212
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Tidskriftsartikel (refereegranskat)abstract
- Background: In recent years, the medical curricula have become more crowded and the majority of medical students are no longer exposed to plastic surgery in medical school. Previous studies have revealed that most medical students are not aware of what the speciality entails.The aims of this paper were to describe the development of an elective course, as a method for including more plastic surgery in undergraduate medical training, and to investigate how many students were attracted to the course. Methods: The course was designed to build on knowledge the students had acquired previously in their training. The aims and learning objectives were chosen so that they would be potentially useful to all future doctors and were described according to the SOLO taxonomy and the levels of Miller’s pyramid of learning were applied. Results: The course attracted students who had not previously considered a career in plastic surgery. The number of students applying for the course exceeded the number of places on offer and the course was well received by the students taking it. Conclusions: The course has the potential to increase the knowledge about plastic surgery among future doctors, possibly leading to improvements in both referrals and recruitment of suitable young doctors to the speciality. Level of Evidence: Not ratable.
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| 6. |
- Holm, Sebastian, et al.
(författare)
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Cutaneous steam burns and steam inhalation injuries : a literature review and a case presentation
- 2022
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Ingår i: European journal of plastic surgery. - : Springer Nature. - 0930-343X .- 1435-0130. ; 45:6, s. 881-896
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Tidskriftsartikel (refereegranskat)abstract
- Scald is one type of burn that s often mentioned alone and occurs mostly in the paediatric population. Inhaled steam is mostly cooled off in the airways, why thermal damage is rarely seen. A sudden exposure to hot steam/inhalation can cause a thermal inhalation injury. A scoping review was performed, with the aim to summarize all published papers in English, about steam-related injuries. The search was conducted using the PubMed (R) and Cochrane libraries on 19th of May 2021, without a set time period. Out of a total of 1186 identified records, 31 were chosen for review. Burns related to the contact with steam are generally rare and can be both minor and severe. The more severe cases related to steam exposure are mostly workplace accidents and the minor injuries reported in the literature are often related to steam inhalation therapy, especially in the paediatric population. This review describes the challenges that can be found dealing with patients suffering from cutaneous steam burns and/or steam inhalation injuries. A steam injury to the airways or the skin can be directly life-threatening and should be treated with caution. This type of injury can lead to acute respiratory insufficiency and sometimes death. A case of a male patient with extensive cutaneous steam burns and a steam inhalation injury who passed away after 11 days of treatment is also presented to illustrate this review. Level of evidence: Level V, Therapeutic; Risk/Prognostic Study.
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| 7. |
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| 8. |
- Madura, Tomas, et al.
(författare)
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Circumoral complications in hereditary sensory and autonomic neuropathy - A case of simple lip reconstruction?
- 2013
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Ingår i: European journal of plastic surgery. - : Springer. - 0930-343X .- 1435-0130. ; 36:5, s. 319-321
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Tidskriftsartikel (refereegranskat)abstract
- We report a case of a 7-year-old Bangladeshi boy who caused himself oral incontinence by self-mutilation. The patient was known to suffer from hereditary sensory and autonomic neuropathy type V. As definitive management, a full dental clearance was performed along with reconstruction of the lower lip with a good functional and aesthetic outcome. He did not experience any adverse effects from the full dental clearance with regard to feeding, nutrition or development. We discuss the dilemma and challenges raised in the management of this patient and highlight the need for a multi-disciplinary specialist input for what appeared to be a simple case of lip reconstruction for a plastic surgeon.
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| 10. |
- Ockell, Jonas, et al.
(författare)
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Physical measurements and patients' perception of excess skin on arms and thighs before and after bariatric surgery
- 2022
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Ingår i: European Journal of Plastic Surgery. - : Springer Science and Business Media LLC. - 0930-343X .- 1435-0130. ; 45:4, s. 631-640
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Tidskriftsartikel (refereegranskat)abstract
- Background Bariatric surgery is an effective weight loss method for patients with obesity. One side effect of bariatric surgery is uncomfortable excess skin. Much remains to be learned about physical measurements and patients' subjective perceptions of it. Here, we investigated the pre- to post-bariatric changes in patients' perception and physical measurements of the skin on the arms and thighs, in order to find possible subgroups especially affected by post-operative excess skin and to identify predicting factors. Methods One hundred forty-seven patients eligible for bariatric surgery completed the Sahlgrenska Excess Skin Questionnaire (SESQ) and underwent measurements of their skin before and 18 months after the procedure. Results Although most physical measurements decreased post-operatively, many patients reported increased discomfort. We identified one subgroup particularly prone to report excess skin on the arms post-operatively: women with high discomfort from excess skin on the arms and high body mass index (BMI), pre-operatively. Ptosis of the excess skin seems to be a feasible measurement for predicting post-operative discomfort. For every centimetre of ptosis pre-operatively, patients had 1.37- and 1.31-fold higher odds of achieving a score for post-operative discomfort from excess skin on the upper arms and thighs, respectively, of >= 6 (on a 0-10 scale). Conclusions We identified a subgroup especially affected by discomforting excess skin on arms and thighs after weight loss. Furthermore, we suggest a pre-operative pro-operative ptosis measuring to predict post-operative discomfort level. The result of this study further increases the knowledge of excess skin and should be useful in further improving patient education.
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