Abstract:
:There is an ongoing demand for surgeons to demonstrate that they can operate well, maintain their performance, and deliver acceptable results. Currently, surgeons are assessed by a series of subjective and peer-reviewed interviews, but at no stage is the objective assessment of surgical competence measured. The authors have introduced an objective test of suturing skill as one of an array of tests used to assess technical ability. A range of surgeons with differing surgical skill was tested. The candidates were asked to suture a 4-cm wound on a latex skin pad. They were videotaped during the procedure and were scored by four independent observers using the Objective Structured Assessment of Technical Skill scoring system. Their movements were also monitored using an electromagnetic tracking system. Forty-three plastic surgeons and 46 general surgeons were divided into four groups, depending on grade, and were assessed. The difference in scores among the plastic surgeons gave a value of p < 0.001, whereas the general surgeons gave a value of p = 0.001. However, when similar grade but different specialties were compared, plastic surgeons scored significantly higher (down to senior house officer [resident year 1-2] level; mean p value = 0.019). Interrater reliability was also high (Cronbach alpha = 0.89). This task has shown that technical ability can be assessed objectively. The task has also been shown to exhibit face, construct, and concurrent validity. This has important implications for the future of surgical training in that it allows one to identify whether the fundamentals of surgical technique have been passed on to the trainee and to monitor their progress continually. It also may be used in revalidation of surgeons.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Khan MS,Bann SD,Darzi A,Butler PEdoi
10.1097/01.sap.0000037271.26659.f4subject
Has Abstractpub_date
2003-03-01 00:00:00pages
304-8; discussion 308-9issue
3eissn
0148-7043issn
1536-3708pii
00000637-200303000-00015journal_volume
50pub_type
杂志文章abstract:PURPOSE:This study aimed to describe immediate nasal reconstruction using a forehead flap after dog bite injuries. BACKGROUND:Dog bites to the nose can avulse multiple aesthetic subunits, making primary repair difficult, inadvisable, or impossible. Microsurgical replantation and composite grafting of the nose have bee...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31827ead6c
更新日期:2013-04-01 00:00:00
abstract::As the use of rigid internal fixation of the facial skeleton has become routine in adults, many craniofacial surgeons have expanded its use to the pediatric population. The effects of miniplate and screw fixation on subsequent craniofacial growth, however, have not been examined. Using 6-week-old rabbits as an experim...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199011000-00005
更新日期:1990-11-01 00:00:00
abstract::Parry first described the syndrome of progressive facial atrophy in 1825, followed by Romberg in 1846. The clinical hallmark of the syndrome is atrophy of the facial soft tissues, including fat and muscle as well as underlying bone. Clinicians have classically reserved treatment until the end of the disease process, a...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0b013e31820b3aa8
更新日期:2011-10-01 00:00:00
abstract::Free-tissue transfer with anastomosis has become an important microsurgical technique. Sometimes vasospasm occurs after anastomosis. We examined the changes in blood flow and the effect on the treatment of vasospasm of the femoral artery of rats. The rat models of vasospasm were generated by topical application of epi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181e7dbb6
更新日期:2011-08-01 00:00:00
abstract::Sarcoidosis is a systemic disease of unknown etiology that is characterized by noncaseating granulomatous inflammation of various organs. Isolated nasal cutaneous involvement is very uncommon (0.3%-4.0% of the patients reported) and rarely do sarcoid lesions present as severe nasal deformities and surgical treatment i...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0b013e3181b4051b
更新日期:2010-06-01 00:00:00
abstract::Entrapment of the lateral femoral cutaneous (LFC) nerve as a source of anterolateral thigh dysesthesias has been recognized for 100 years. Despite this historic recognition, its diagnosis today is often delayed, and definitive treatment of refractory cases by surgical decompression rarely reported. This study describe...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1995-12-01 00:00:00
abstract::In previous studies, we were able to demonstrate baseline non-augmented cadaveric silicon tissue values as well as silicone-augmented breast capsular tissue silicon levels from various geographic locations in the United States. One of the limitations of these previous studies was the potential for intracapsular variat...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199612000-00004
更新日期:1996-12-01 00:00:00
abstract::The arcuate line is a relevant structure when reconstructing the abdominal wall after rectus abdominis musculocutaneous flap harvest. Its location is classically taught to be half the distance from the pubic symphysis to the umbilicus, but recent anatomic literature provides evidence to the contrary. Better understand...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000112285.44287.21
更新日期:2004-08-01 00:00:00
abstract::Thirty cases of constriction band syndrome diagnosed and treated with surgery at Ramathibodi Hospital, Bangkok, during 1973 to 1986 are reported. The incidence of this congenital anomaly could not be verified in this series because the number of cases was limited and the cause could not be concluded. The less frequent...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198811000-00017
更新日期:1988-11-01 00:00:00
abstract::Venous thromboembolism has become a target for research by the American Society of Plastic Surgery. The current article reviews the steps that plastic surgeons and the American Society of Plastic Surgery have taken for creating guidelines in our field. We summarized the current reported incidences of venous thromboemb...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0b013e3181e35c79
更新日期:2011-03-01 00:00:00
abstract::Madelung disease is an uncommon disease characterized by large subcutaneous adipose masses. Mediterranean countries show higher disease incidence. We review the current concepts concerning this pathology, including etiology, diagnosis, and treatment. Madelung disease usually affects the upper half of the body, but we ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0000000000000714
更新日期:2017-01-01 00:00:00
abstract::Despite the advances in laser treatment of port wine stains (PWS), re-emergence of these lesions still occurs. We carried out a retrospective audit of all children that received laser treatment of PWS between 1997 and 2000 using the flashlamp-pumped dye laser with a 585-nm wavelength. Out of 110 patients treated, 15 r...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000221620.83178.fc
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Physician assistants (PAs) are commonly employed in plastic surgery. However, limited data exist on their impact, which may guide decisions regarding how best to integrate them into practice. METHODS:A review of the practices of 2 breast reconstructive surgeons was performed. A comparison was made between a...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001087
更新日期:2017-09-01 00:00:00
abstract::Piezoelectric sensors have been shown to respond reproducibly to changes in tissue mechanical properties surrounding an implant over a 4-month period. The vibrational amplitude at a frequency corresponding to the radial resonance shows a statistically significant change over time. The initial period of inflammation is...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000189620.45708.5f
更新日期:2006-01-01 00:00:00
abstract::Complete excision of a giant neurofibroma can be technically difficult. Thorough preoperative planning with magnetic resonance imaging, computed tomography, and arteriography are indicated to define the extent of the mass and to facilitate operative planning. By following the treatment guidelines discussed in this cas...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200045040-00017
更新日期:2000-10-01 00:00:00
abstract::Long-term follow-up of free flaps used for skull coverage in this experience has revealed that serious sequela are more likely after muscle-only free flaps. Over the past 2 decades, 8 muscle and 6 composite free flaps have been used in 12 patients. Debulking was the only secondary procedure necessary in 1 composite fl...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000123024.80566.8c
更新日期:2004-05-01 00:00:00
abstract::The development of sophisticated bariatric surgery techniques has led to an increasing number of patients demanding a complexity of body contouring procedures that can be achieved either with a step-by-step approach or by combining dermolipectomy in various regions. The aim of this study was to test the hypothesis tha...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000070644.58346.4A
更新日期:2003-10-01 00:00:00
abstract:INTRODUCTION:Pyoderma gangrenosum following free tissue transfer for breast reconstruction is rare. This unusual ulcerative condition is frequently misdiagnosed, leading to inappropriate debridement and escalation of the subsequent wound through pathergy. Once diagnosed, treatment with immunosuppressive agents, includi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001782
更新日期:2019-07-01 00:00:00
abstract::Repair of unilateral cleft lip is a challenging procedure with no single technique satisfactory for all types of unilateral cleft deformity. This study compares retrospectively five techniques of unilateral cleft lip repair in 72 children (45 boys, 27 girls). Twenty-two children had a Millard rotation-advancement repa...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199812000-00002
更新日期:1998-12-01 00:00:00
abstract::A new method of lower lip reconstruction using a full-thickness cheek island flap based on the facial vessels is described. The functional potential of the method is assessed in six patients. The technique outlined is simple in design and execution. It is capable of total lower lip reconstruction without appreciable m...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198301000-00002
更新日期:1983-01-01 00:00:00
abstract::The purpose of this study was to measure the biomechanical performance for commercially available microsutures, nylon polypropylene, polyester, and polyglactin 910. The biomechanical performance was determined by reproducible, biomechanical parameters that included stiffness, elasticity, resistance to creep, secure kn...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199404000-00014
更新日期:1994-04-01 00:00:00
abstract:INTRODUCTION:The aim of any reconstruction is to provide a robust and cosmetically pleasing result that does not significantly alter function. We describe our experience of using the V-Y principle in advancement flaps designed around a distinct perforator to reconstruct soft tissue defects of the upper limb. The shortc...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002138
更新日期:2020-05-01 00:00:00
abstract::Local infection is a rare complication after aesthetic rhinoplasty. In the past serious complications and 1 death have been reported. We present 5 cases of local infection after primary and secondary procedures. Infection seems to have more to do with technical details during an operation, such as the external lateral...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198610000-00007
更新日期:1986-10-01 00:00:00
abstract::We developed a new operative procedure involving the combination of 5 flaps to treat little toe polysyndactyly. We applied this procedure to 4 toes of 3 patients who had severe polysyndactyly involving skin fusion of the area from the distal interphalangeal joint to the periphery. In all 3 patients, this procedure all...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181cbfcf2
更新日期:2011-08-01 00:00:00
abstract::Definitive repair of recurrent ventral hernias using abdominal wall reconstruction techniques is an essential tool in the armentarium for general and plastic surgeons. Despite the great morbidity associated with incisional hernia, no consensus exists on the best means for treatment (Korenkov et al, Langenbecks Arch Su...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181dc8409
更新日期:2010-05-01 00:00:00
abstract::The thickness of the upper eyelid is a bothersome condition that can be alleviated by blepharoplasty in Asians. Preseptal fat lies widely deep to the orbicularis oculi in the lower part of the upper eyelid, and the retro-orbicularis oculus fat (ROOF) pad lies in the lateral supraorbital area. We demonstrate the effect...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000263094.74682.5f
更新日期:2008-02-01 00:00:00
abstract::This case report illustrates a method of correction for severe hypertrophy of the frontal bone. Accurate preoperative assessment including physical examination, photographs, and radiological studies are necessary. The anterior table of the frontal bone is removed, recontoured, and stabilized to the adjacent bone while...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200044050-00017
更新日期:2000-05-01 00:00:00
abstract::The authors describe the ability of the gracilis muscle to provide multiple tissue components- skin, muscle, nerve, and tendonin the reconstruction of a complex dorsal foot wound resulting from a sarcoma resection. The deficits of skin, deep peroneal nerve, anterior tibialis tendon, and dorsal extensor retinaculum wer...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200103000-00023
更新日期:2001-03-01 00:00:00
abstract::Complications of gynecological laser treatment for perineal disease have been seen with increasing frequency. This may be the result of more women undergoing therapy with this method. Four women presenting with unstable perineal scarring are discussed. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199110000-00015
更新日期:1991-10-01 00:00:00
abstract::Hematogenous ostemyelitis is infrequently seen in adults and primary involvement of the hand skeleton is extremely rare. Little has been reported about the foci of hematogenously spread infections. Two cases of hematogenous osteomyelitis of the hand originating from dental maxillary infections were reported. The first...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199607000-00016
更新日期:1996-07-01 00:00:00