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 1-year period before to a 1-year period after the addition of a PA into practice. The practice model was a one-to-one pairing of a plastic surgeon and a PA. RESULTS:A total of 4141 clinic encounters and 1356 surgical cases were reviewed. After the addition of PAs, there was a significant increase in relative value units (1057 vs 1323 per month per surgeon, P < 0.001). Operative times were similar with and without PAs (P = 0.45). However, clinic encounter times for surgeons were shorter for all visit types when patients were first seen by a PA before the surgeon: global follow-up (P = 0.03), other follow-up (P = 0.002), consultation (P = 0.76), and preoperative (P = 0.02), translating to 9 additional patients seen per day. Charges (P = 0.001) and payments (P = 0.007) also increased, which offset the cost of using a PA. However, the financial contribution from PA involvement as first assistant in surgery was limited (5.2%). The peak effect of PAs was observed between the third and fourth quarters. CONCLUSIONS:In breast reconstruction, PAs primarily enhance the efficiency of plastic surgeons, particularly in the clinic, with downstream clinical and financial gains of an indirect nature for surgeons.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Chao AH,Yaney A,Skoracki RJ,Kearns PNdoi
10.1097/SAP.0000000000001087subject
Has Abstractpub_date
2017-09-01 00:00:00pages
249-252issue
3eissn
0148-7043issn
1536-3708journal_volume
79pub_type
杂志文章abstract::We present 2 contrasting cases of congenital interalveolar synechiae. The first occurred in the setting of Van der Woude syndrome and was associated with a cleft palate. In the second case, it was an isolated abnormality and there was no contributory family history or syndromic associations. We review the literature o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000215265.68252.f0
更新日期:2006-08-01 00:00:00
abstract::To date, full-thickness skin ulcers of the heel of the foot are still difficult wounds to cover. Many choices of coverage are available, but few provide long-term coverage due to bone exposure, deficient sensibility, and subsequent breakdown. An advancement flap based on the medial plantar artery with sensory nerve br...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199705000-00018
更新日期:1997-05-01 00:00:00
abstract::Angiosarcomas (AS) of the scalp are rare tumors with an extremely poor prognosis mostly affecting elderly patients. Given the special anatomic nature of the blood supply to the scalp, it must be presumed that the tumor has already spread at the time of the initial presentation. We report a simple and fast surgical pro...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31816b31f8
更新日期:2008-10-01 00:00:00
abstract::Oculopharyngeal muscular dystrophy is a hereditary, autosomal dominant, slowly progressive disorder with onset that occurs during middle age. Major symptoms are ptosis and dysphagia resulting primarily from selectively involved levator palpebrae and the pharyngeal muscles. Progressive, usually symmetrical blepharoptos...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200210000-00015
更新日期:2002-10-01 00:00:00
abstract::A simple, practical alternative to the traditional method of excising small cutaneous lesions is described. It has the advantages of decreased length of final closure and flexibility in determining the orientation of final incisions in areas where it may be difficult to accurately determine skin tension lines. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract::Superiorly based pharyngeal flaps (PFs) are commonly used for the treatment of velopharyngeal insufficiency (VPI) in patients with cleft palate. However, failure may occur with recurrence of hypernasality and surgical revision may be necessary. Hemisphincter pharyngoplasty using either unilateral or bilateral posterio...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181c71063
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:The earlobe plays an important part in the aesthetic appearance of the auricle. Congenital cleft earlobe may vary considerably in severity from a simple notching to extensive tissue deficiency. Most patients with cleft earlobe require surgical correction because of abnormal appearance. In this article, a new...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31824144a7
更新日期:2013-06-01 00:00:00
abstract::Diagnosing osteomyelitis in patients with pressure ulcers is complicated by overlying soft-tissue inflammation and reactive bone formation. We set out to evaluate the efficacy of indium scanning in the diagnosis of chronic osteomyelitis in spinal-cord-injury patients with grade IV pressure ulcers. The goal was to esti...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000164467.97551.ed
更新日期:2005-06-01 00:00:00
abstract::The effect of 2 to 10 hours of tourniquet ischemia on the microcirculation of the tenuissimus muscle in 29 cats was studied by in vivo microscopy and electron microscopy. After release of the tourniquet there was immediate reperfusion and hyperemia in all muscles. Arterioles of 20 micron increased in diameter by 50% a...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198703000-00008
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:Exposure to the plastic surgery department is an important experience for medical students interested in the field. However, the impact of medical students in the plastic surgery operating room has not been previously examined. The aim of this study is to understand whether the presence of medical students i...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001000
更新日期:2017-07-01 00:00:00
abstract:INTRODUCTION:Mallet finger injuries are common and involve disruption of the terminal extensor mechanism overlying the distal interphalangeal joint. Many operative techniques have been advocated. The pull-in suture technique is a useful surgical procedure for the treatment of mallet finger. Although this procedure allo...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SAP.0b013e31822f9ac1
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:The prepuce is an excellent donor site for skin grafts with minimal donor site morbidity. Full-thickness grafts are often required for correction of congenital syndactyly and in burn contractures. METHODS:Preputial skin was used for grafting in 18 children: 5 with burn contractures and 13 with congenital sy...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001644
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:Combined ventral hernia repair and panniculectomy (VHR/PAN) is controversial, and the safety profile including anticipated complications has been questioned. We present a retrospective case series review of patients from the University of Maryland Medical Center to help surgeons counsel patients on the risks an...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001277
更新日期:2018-04-01 00:00:00
abstract::We studied the safety and efficacy of laparoscopic jejunal free flap harvesting with total intracorporeal small-bowel anastomosis in an animal model. Eight dogs underwent laparoscopic resection of 8 to 15 cm of jejunum with endoscopic GIA anastomoses and jejunal segment harvesting through the periumbilical laparoscopi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199503000-00005
更新日期:1995-03-01 00:00:00
abstract::The buccal mucosa has begun to be used as a free graft in complex hypospadias repair gradually and successfully in recent years. However, there are limited experiences regarding use of the buccal mucosa in adult patients. In this study, the authors describe their experience using buccal mucosal grafts in hypospadias-c...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000037274.65665.FF
更新日期:2003-04-01 00:00:00
abstract::Congenital absence of the vagina was repaired in twenty patients; the longest follow-up was seventeen years. The surgical method is described, including the skin graft, the sculpted prosthesis, and the mechanic's waste bolus for retention. The patient must be oriented thoroughly before the operation. Even with an opti...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197807000-00004
更新日期:1978-07-01 00:00:00
abstract::The previously reported surgical methods for eyelid entropion are basically manipulations of the skin or the conjunctival surface. When entropion is marked, manipulations also involve the tarsus. In the most widely used method, the eyelashes are directed outward by horizontal wedge resection of an appropriate amount o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000106426.86478.dc
更新日期:2004-07-01 00:00:00
abstract::Seventeen whole-breast tissue specimens of mammary cystic disease were prepared using Marcum's whole-mounting technique. Histological studies were performed on from 10 to 19 slides of tissue containing the suspected pathological foci. Cysts in the cleared breast tissues were numerous, and cyst walls were covered by si...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197911000-00005
更新日期:1979-11-01 00:00:00
abstract:INTRODUCTION:Surgical volunteer organizations (SVOs) focus considerable resources on addressing the backlog of cases in low-resource countries. This model of service may perpetuate dependency. Efforts should focus on models that establish independence in providing surgical care. Independence could be achieved through s...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31826aefc7
更新日期:2014-01-01 00:00:00
abstract::Traumatic hemipelvectomy is an uncommon and devastating injury with few patients alive when they reach the hospital. There are only 19 reported survivors of this injury. This group includes 17 males and 2 females. All had severe, associated injuries. The mechanism of injury involved motorcycle, automobile, pedestrian/...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-199108000-00011
更新日期:1991-08-01 00:00:00
abstract:BACKGROUND:Posttraumatic midface pain secondary to injury of the anterior superior alveolar nerve (ASAN) is characterized as pain localized to the central and lateral incisors, canines, and maxilla. This nerve is susceptible to injury and subsequent formation of neuromas after midface trauma. Surgical intervention requ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000335
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Scalp defects can be reconstructed either with skin graft, local flaps, free flaps, or tissue expansion. Tissue expanders have been proved to be fruitful in the pediatric population. Scalp expansion has proved to be useful in the reconstruction of posttraumatic and postburn alopecic defects. Selective nerve ...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SAP.0000000000001227
更新日期:2018-02-01 00:00:00
abstract::The reverse sural artery flap is frequently used for reconstruction of the distal third of the leg, ankle, and heel. The major disadvantage of the flap is compression of the pedicle within the subcutaneous tunnel and venous congestion. Others have cited a decrease in this problem by harvesting a midline cuff of gastro...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:2005-03-01 00:00:00
abstract::Reconstruction of complex tissue deficiencies in which each missing component is in a different spatial relationship to each other can be particularly challenging, especially in patients with limited recipient vessels. The chimera flap design is uniquely suited to reconstruct these deformities. Chimera flaps have been...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0b013e318193499f
更新日期:2009-10-01 00:00:00
abstract::Dupuytren's contracture, a benign condition characterized by fibrosis of the palmar and digital fascia, may be a debilitating condition that limits daily function. Several techniques exist for managing symptomatic contractures of the hand related to Dupuytren's. These techniques include the more invasive open fascioto...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0000000000001607
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The surgical management of craniofacial fibrous dysplasia is controversial. The purpose of this study was to report the surgical outcomes of individualized management of craniofacial fibrous dysplasia of a single institution. METHODS:Data from patients (n = 20) with craniofacial fibrous dysplasia, who were ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000640
更新日期:2016-08-01 00:00:00
abstract::The painful, boil-like lesion of furuncular myiasis is a result of the invasion of subcutaneous tissues by larvae of Dermatobia hominis, the human botfly. This arthropod is indigenous to Mexico, and Central and South America, and imported cases to the United States are increasing as travel to these regions continues t...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-200102000-00011
更新日期:2001-02-01 00:00:00
abstract::When exposing the orbit, the transconjunctival approach is regarded to have limited surgical exposure. The aim of this study is to demonstrate the versatile usability of extended transconjunctival approach, which can be extended medially and laterally, in reconstruction of medial orbital wall, floor, and even the late...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181855d27
更新日期:2009-04-01 00:00:00
abstract:PURPOSE:Little is known about professional burnout among plastic surgeons. Our purpose is to describe its prevalence among a large national sample of plastic surgeons and identify contributing factors. METHODS:A mailed, self-administered survey was sent to 708 plastic surgeons who were randomly sampled from the Americ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000056
更新日期:2014-03-01 00:00:00
abstract::In this study, the feasibility of Integra acellular collagen used as a vascular carrier in skin flap prefabrication was examined. In all, 20 Sprague--Dawley rats were randomly divided into 3 groups. The saphenous vascular bundle was used as the vascular carrier. In group 1 (n = 8), an arteriovenous fistula was made by...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181fabc32
更新日期:2011-09-01 00:00:00