210 research outputs found
Wound healing kinetics of the genetically diabetic mouse
No full textThe increased number of chronic nonhealing wounds mirrors the epidemic of type 2 diabetes. Diabetic animal models may allow for better understanding of the pathophysiology of wound healing and may lead to the pre-clinical testing of a variety of therapeutic modalities for this patient group. The authors present an overview of the literature on excisional wound mouse models and focus on the authors' experience with the db/db mouse. Excisional wounds in wild type mice heal quickly due primarily to wound contraction, which is delayed in the db/db mouse. In this animal model it is possible to study and quantify the main mechanisms of healing and produce highly reproducible information. Differences in methodologies, infection control, as well as fine details such as the dressing option, partially explain heterogeneous results in the literature. Given the increase of the diabetic population, the db/db mouse model provides a powerful tool to study the effects of therapeutics for improving wound healing. The standardization of this animal model represents an important aspect to improve in the wound care field
Feasibility and parental perception of home sleep studies during Covid-19: a tertiary sleep centre experience
No full textNoninvasive induction of angiogenesis in tissues by external suction: sequential optimization for use in reconstructive surgery
No full textDeveloping evidence-based plastic surgery: the role of research registration, protocols and reporting quality
No full textBACKGROUND: Evidence-based medicine has had a profound impact on healthcare. In the field of Plastic surgery, powerful examples include; less radical skin cancer excision margins and skin-sparing or even nipple-sparing mastectomies and microsurgical reconstruction. Sustained progression of the field, relies on the development of a high-quality evidence base, with strong use of peer-reviewed research protocols, which are publicly registered and completed studies transparently reported. The extent of compliance with these principles is currently unknown and the author hypothesised that it would be low. The author further hypothesised that registration could be improved by the development of a new global research registry and reporting quality can be improved by the mandatory implementation of reporting guidelines in a journal.
METHODS: This thesis incorporated 11 studies. The first two studies used a literature review to determine; the levels of evidence, rates of study registration and protocol publication in the recent Plastic Surgery literature. Thirdly, the design, build and launch of a new global research registry to boost compliance with registration and to determine barriers to it using a survey amongst users. This would be followed by systematic reviews to determine compliance with the STROBE and PRISMA guidelines respectively. An analysis of each guide for authors (GFA) of the surgical journals listed in the Thomson Reuters journal citation report for surgery to determine support for reporting guidelines. The impact of the mandatory implementation of reporting guidelines in a surgical journal would be assessed using a before and after design. Finally, to develop a reporting guideline for surgical case reports (SCARE) and surgical case series (PROCESS) using a DELPHI consensus exercise amongst an expert panel.
RESULTS: Protocols were registered in 4% of 595 recent research studies and 0.5% were published. There was a mean compliance of 12/22 for the STROBE guideline (n=94) and 16/27 for the PRISMA guideline (n=79). The Research Registry® was launched in February 2015. Analysis of the first 500 previously unregistered studies, showed they came from 57 countries and included 1.77 million patients. Key barriers to registration were a lack of awareness of the need to register and lack of time (n=149). In addition, 45% registered their study at the time of journal submission. The GFA analysis showed 62% didnât mention reporting guidelines at all (n=193). Subsequent mandatory implementation in a single surgical journal, increased compliance with STROBE by 12% (n=152), with CONSORT by 40% (n=13) and with PRISMA by 58% (n=28). The SCARE and PROCESS reporting guidelines were developed and published in late 2016. According to Google Scholar, they have accumulated over 200 citations at the time of writing.
CONCLUSION: Study registration, protocol use and reporting quality are poor in plastic surgery. Potential solutions to these long-standing problems have been developed and explored within this thesis. These include the development and use of the Research Registry® and the mandatory implementation of reporting guidelines, with both measures front-loaded within a gatekeeper framework for journals. It is now for Plastic Surgeons and the wider surgical community to pick up the gauntlet and drive forward high-quality research, evidence-based surgical practice and better outcomes for their patients and society at large.</p
Beauty Under Pressure: The Impact of Hypertension on Outcomes in 54,000 Cases of Esthetic Breast Surgery
No full textBackgroundHypertension affects nearly one-third of the global adult population and is associated with increased postoperative morbidity. However, its specific impact on outcomes of esthetic breast surgery (EBS) remains poorly understood.MethodsData from the multi-institutional American College of Surgeons National Surgical Quality Improvement Program between 2008 and 2022 were analyzed. Patients undergoing elective EBS procedures (breast augmentation, breast reduction, mastopexy, and augmentation-mastopexy) were classified as either medically treated hypertensive (MedHyp) or non-hypertensive (NoMedHyp). 30-day postoperative outcomes were compared between MedHyp and NoMedHyp patients.ResultsA total of 54,336 patients were included, of whom 83.5% (n = 45,373) underwent breast reduction (MedHyp: 7,625 [16.8%] vs. NoMedHyp: 37,748 [83.2%]), 12.1% (n = 6,548) breast augmentation (MedHyp: 209 [3.2%] vs. NoMedHyp: 6,339 [96.7%]), 2.3% (n = 1,237) augmentation-mastopexy (MedHyp: 90 [7.3%] vs. NoMedHyp: 1,147 [92.7%]), and 2.2% (n = 1,178) mastopexy (MedHyp: 136 [11.5%] vs. NoMedHyp: 1,042 [88.5%]). Multivariate analysis revealed a significant association between MedHyp and increased risk of medical complications (OR 1.6, 95% CI 1.1-2.2, p = 0.0070) as well as general (OR 1.5, 95% CI 1.3-1.8, p < 0.001) and any complications (OR 1.2, 95% CI 1.0-1.3, p = 0.0079) after breast reduction. MedHyp was also found to be an independent risk factor for complications after breast augmentation (OR 2.4, 95% CI 1.1-5.1, p = 0.026). No significant associations were observed for mastopexy or augmentation-mastopexy.ConclusionMedically treated hypertension appears to be an independent risk factor for postoperative complications following breast reduction and breast augmentation. These insights underscore the importance of thorough preoperative hypertension management to maximize patient safety and optimize outcomes in EBS.Level of Evidence IIThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266
Erratum to “Erratum to “The SCARE guidelines: Consensus-based surgical case report guidelines” [Int. J. Surg. 34 (2016) 180–186]” [Int. J. Surg. 36 (2016) 396], (S1743919116310305), (10.1016/j.ijsu.2016.11.021))
No full textThe publisher regrets that the title in the original erratum was incorrect. The correct title of the item referred to is: The SCARE Statement: Consensus-based surgical case report guidelines The author name and affiliation for SCARE group member Mangesh A. Thorat has also been updated. The publisher would like to apologise for any inconvenience caused
“The SCARE guidelines: Consensus-based surgical case report guidelines” [Int. J. Surg. 34 (2016) 180–186]((2016) 34 (180–186)(S174391911630303X)(10.1016/j.ijsu.2016.08.014))
No full textThe publisher regrets that there was an error in the author list of this paper. The members of the SCARE Group were not tagged as a collaborator group. This has now been corrected. The names of the collaborator group are as follows: Raafat Afifi, Cairo University Raha Al-Ahmadi, King Faisal Specialist Hospital and Research Centre Joerg Albrecht, John H. Stroger Jr. Hospital of Cook County Abdulrahman Alsawadi, Colchester Hospital University NHS Foundation Trust Jeffrey Aronson, Radcliffe Infirmary, Oxford M. Hammad Ather, Aga Khan University Mohammad Bashashati, Texas Tech University Health Sciences Center Somprakas Basu, Banarus Hindu University Patrick Bradley, Nottingham University Hospitals Mushtaq Chalkoo, Hyderpora Ben Challacombe, Guy's and St Thomas’ NHS Foundation Trust Trent Cross, James Cook University Laura Derbyshire, North West Deanery Naheed Farooq, Central Manchester University Hospital Foundation Trust Jerome Hoffman, University of California Los Angeles Huseyin Kadioglu, Bezmialem Vakif University Veeru Kasivisvanathan, University College London Boris Kirshtein, Soroka University Medical Center Roberto Klappenbach, Simplemente Evita Hospital Daniel Laskin, Virginia Commonwealth University Diana Miguel, University Hospital Jena James Milburn, Queens Medical Centre Seyed Reza Mousavi, Shohada Medical Center Tajrish Oliver Muensterer, University Medicine Mainz James Ngu, Changi General Hospital Iain Nixon, East Kent University Hospitals Ashraf Noureldin, Cumberland Royal Infirmary Benjamin Perakath, Dr. Gray's Hospital Nicholas Raison, King's College London Kandiah Raveendran, Fatimah Hospital Timothy Sullivan, Minneapolis Heart Institute Achilleas Thoma, McMaster University Mangesh Thorat, Wolfson Institue of Preventative Medicine, Queen Mary University of London Michele Valmasoni, Università di Padova Samuele Massarut, Centro di Riferimento Oncologico Aviano, Italy Anil D'cruz, Tata Memorial Hospital Baskaran Vasudevan, MIOT Hospitals Salvatore Giordano, Turku University Hospital Gaurav Roy, Medanta-The Medicity Donagh Healy, University Hospital Waterford David Machado-Aranda, University of Michigan Bryan Carroll, Eastern Virginia Medical School David Rosin, University of West IndiesThe publisher would like to apologise for any inconvenience caused
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