Abstract:
:Surgery is accepted as one of the most demanding professions that create both physical and mental strain on the performers. Therefore, the authors aimed to elucidate the mental burden of surgeons, which is dedicated to operative stress. They also tested the hypotheses that participating in surgery creates mental stress on surgeons that leads to cardiovascular changes, and that this stress is more pronounced for actual operators than for first assistants. The method chosen for this purpose was an analysis of heart rate variability. Twelve surgeons (five plastic surgery staff and seven plastic surgery residents) were monitored by a digital ambulatory Holter recorder on at least two occasions. Half of the recordings were carried out on operating days and the other half on office days. Heart rate variability indices (low frequency, high frequency, high frequency/low frequency ratio, and heart rate) were analyzed from those recordings using computerized research tool software. The heart rate variability indices of the operators showed statistically significant differences between operating days and office hours in favor of an increased sympathetic and decreased parasympathetic activity for the former. For first assistants, three of the parameters, with the exception of heart rate, changed in favor of a sympathetic predominance over parasympathetic activity; these changes were also statistically significant. These results showed a sympathetic hyperactivity for both operators and first assistants during the operations. When the sympathovagal balance of the actual operators was compared with that of assistants, the former group showed a more pronounced sympathetic arousal. This difference is accepted as a proof for the mental stress of the surgery being the main factor responsible for the sympathetic hyperactivity that we detected during the operations. Surgeons continuously face a unique mental strain that other professions rarely bring forth, and these psychological stressors are associated with alterations in cardiac autonomic control that may contribute to the development of cardiac disease. Prolonged sympathetic hyperactivity could anticipate cardiac discomfort in more experienced surgeons with marginal cardiac reserve. Such cardiac diseases would be reconsidered as occupation-related illnesses, which might be reimbursed to the physician. In addition, the legal responsibility of surgeons concerning their unfavorable results might be assessed with more understanding with a realization of their undue working conditions.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Demirtas Y,Tulmac M,Yavuzer R,Yalcin R,Ayhan S,Latifoglu O,Atabay Kdoi
10.1097/01.prs.0000133166.50279.7csubject
Has Abstractpub_date
2004-09-15 00:00:00pages
923-31; discussion 932-3issue
4eissn
0032-1052issn
1529-4242journal_volume
114pub_type
杂志文章abstract::Using the rat sciatic nerve model, we evaluated the merits of homologous fibrin glue in the repair of peripheral nerve transections as compared to standard epineural suture repairs. A total of four study groups were used, with 10 animals assigned to each group. In group I, the transected sciatic nerve was repaired wit...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198609000-00015
更新日期:1986-09-01 00:00:00
abstract:BACKGROUND:Plastic surgery demographics are transforming, with a greater proportion of women and younger physicians who desire balance between their career and personal lives compared with previous generations. The authors' purpose was to describe the patterns and correlates of satisfaction with work-life balance among...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318208d1b3
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Vascularized composite allotransplantation is an emerging field, but the complications of lifelong immunosuppression limit indications. Vascularized composite allotransplantation in solid organ recipients represents a unique opportunity because immunosuppression has already been accepted. This report of a si...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002153
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Attempted separation of craniopagus twins has continued to be associated with devastating results since the first partially successful separation with one surviving twin in 1952. To understand the factors that contribute to successful separation in the modern era of neuroimaging and modern surgical technique...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000002269
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Common peroneal neuropathy shares the same pathophysiology as carpal tunnel syndrome. However, management is often delayed because of the traditional misconception of recognizing foot drop as the defining symptom for diagnosis. The authors believe recognizing common peroneal neuropathy before foot drop can r...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000007096
更新日期:2020-09-01 00:00:00
abstract::Patients with severe open tibial fractures may have a low rate of reemployment after reconstruction. Sixty-five limb-salvage patients were followed for at least 2 years to determine the factors that influence future employment. The preinjury conditions found to influence reemployment included age less than 40, higher ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199404001-00019
更新日期:1994-04-01 00:00:00
abstract::Although externally exposed ventricular assist devices are associated with extremely high mortality rates, salvage may be accomplished by early aggressive wound debridement, transposition of a well-perfused autologous tissue (such as omentum), dead space obliteration, and adequate external coverage using vascularized ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199812000-00025
更新日期:1998-12-01 00:00:00
abstract::We describe the use of the extensor pollicis longus tendon as an extension of the motor unit in an opponens transfer. Its advantages, and its successful application in 4 cases, are illustrated. To the best of our knowledge, this method has not been described before. We believe it to be a satisfactory addition to the o...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197602000-00010
更新日期:1976-02-01 00:00:00
abstract::Multiple-segment osteotomy is defined as an osteotomy that divides the tooth-bearing arch of the maxilla or mandible into three or more segments. Combining large-segment orthognathic surgery and unitooth or small-segment surgery is an effective approach for dealing with a wide range of dentofacial deformities with occ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199908000-00009
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Complete corrugator supercilii muscle resection is important for the surgical treatment of migraine headaches and may help prevent postoperative abnormalities in surgical forehead rejuvenation. Specific topographic analysis of corrugator supercilii muscle dimensions and its detailed association with the supr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000282725.61640.e1
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Although helmet therapy is widely accepted in the treatment of severe positional plagiocephaly, treatment regimens, especially regarding starting age, are controversial. This study investigated the importance of starting age to optimize the management of helmet therapy. METHODS:Sixty-two infants with severe...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31821b62d6
更新日期:2011-08-01 00:00:00
abstract::Radiolucent breast implants filled with triglyceride oil have recently entered limited clinical trials. To investigate the questions of oil bleed and the fate of triglycerides that might escape from ruptured breast implants, experiments reported here used peanut oil labeled with radioisotopes so that it could be trace...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199605000-00012
更新日期:1996-05-01 00:00:00
abstract::The authors studied a rare, congenital, cutaneous vascular anomaly that grows proportionately with the child and does not regress. A total of 53 patients were compiled from three vascular anomaly centers. These patients' lesions were analyzed for presentation, physical findings, radiologic and histopathologic characte...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/00006534-200106000-00002
更新日期:2001-06-01 00:00:00
abstract::Severe crush to the hand is associated with a poor prognosis. The authors investigated the hypothesis that compartment syndrome complicates such injuries. From 1996 to 2000, the authors retrospectively identified 11 patients who, after sustaining a closed crush injury, developed acute hand compartment syndrome. Diagno...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000025183.78057.9B
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Chronic infections affect 17 million people yearly, and approximately 550,000 people die each year from, or with, their chronic infections. Acute and chornic infection differences are well known to clinicians, but the role of bacteria in producing these clinical differences remains poorly understood. METHOD...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e3181fca244
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Several studies have confirmed a correlation between the concentration of serum hyaluronan and progressive fibrotic disorders such as liver cirrhosis. The aim of this study was to explore the relationship between serum hyaluronan levels and capsular contracture after aesthetic breast augmentation. METHODS:T...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000220462.28928.83
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Tibial resection in children presents a unique reconstructive challenge because of technical demands, future growth potential, and repetitive loading of the lower extremity. Positioned in a tibial defect, the free fibula undergoes primary bone healing while maintaining intrinsic resistance to infection and t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318230e463
更新日期:2012-01-01 00:00:00
abstract::After nearly any form of cardiac surgery, an acute febrile illness characterized by leukocytosis, pericarditis with pericardial effusion, and pleural effusion may occur. In some instances, this postpericardiotomy syndrome may suggest the presence of mediastinal infection. Treatment of postpericardiotomy syndrome is co...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1995-09-01 00:00:00
abstract::Any split-thickness skin graft donor site is obvious to some degree because of pigment alterations and, at the worst, it can develop hypertrophic scarring. A predictably superior aesthetic result is possible if this site is converted to a full-thickness defect followed by primary closure, because a linear scar is the ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199912000-00057
更新日期:1999-12-01 00:00:00
abstract::Rule of thumb criteria for tongue-lip adhesion in the Pierre Robin anomalad have been formulated on the basis of a review of 38 cases. Babies with this anomalad who do not show a progressive gain in strength and weight after 7 days of nonoperative intensive care or who cannot be successfully extubated after 3 days sho...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198208000-00017
更新日期:1982-08-01 00:00:00
abstract::The use of the dorsalis pedis flap with vascularized extensor tendons was presented. An anatomic study has been carried out that has shown that the vascularization of the foot extensor tendons can be exclusively dependent on the blood contribution coming from the dorsalis pedis artery. In two cases that are presented ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198509000-00015
更新日期:1985-09-01 00:00:00
abstract::A new method of vaginal reconstruction is reported. In the procedure, the left inferior abdominal wall flap with the subcutaneous pedicle containing epigastric superficial blood vessels and/or the circumflex iliac superficial vessel and the external pudendal vessel and their branches is raised and passed through an im...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198906000-00013
更新日期:1989-06-01 00:00:00
abstract:BACKGROUND:A new approach is introduced for the correction of cryptotia using a large triangular flap designed on the temporal scalp and skin over the auricle. METHODS:The posterior limb of the triangular flap was continued to the mastoid area at the midportion of the auricle. The abnormal insertion of the auricular i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000160692.21827.24
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Rejuvenation of the neck is essential to achieve a young facade. Different approaches for aging neck rejuvenation have been developed throughout the years. Most of them focus on specific elements that contribute to the aging neck. The main drawbacks of these techniques are recurrence of the platysma bands, m...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004422
更新日期:2018-06-01 00:00:00
abstract::Understanding wound healing today involves much more than simply stating that there are three phases: inflammation, proliferation, and maturation. Wound healing is a complex series of reactions and interactions among cells and "mediators." Each year, new mediators are discovered and our understanding of inflammatory m...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000222562.60260.f9
更新日期:2006-06-01 00:00:00
abstract::Maternal cigarette smoking during pregnancy as a risk factor for having a child with cleft lip/palate has been suggested by several epidemiologic studies. However, most of these studies contained small sample sizes, and a clear association between these two factors could not be established. The U.S. Natality database ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/00006534-200002000-00001
更新日期:2000-02-01 00:00:00
abstract::Three groups of dogs were studied to compare the bone formation obtained with traditional bone grafting techniques, and that obtained with revascularized periosteum or revascularized bone grafts--all in unstressed bone. Revascularized periosteum did not produce a significant amount of bone in this unstressed model. At...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197909000-00013
更新日期:1979-09-01 00:00:00
abstract::In Part II, the author focused on the lay peelers' history and success using croton oil-containing phenol peeling recipes. In Part III, the author reviews what was known or should have been known about croton oil and phenol as physicians became keenly interested in face peeling in the mid-1950s. The lay peelers recogn...
journal_title:Plastic and reconstructive surgery
pub_type: 传,历史文章,杂志文章
doi:10.1097/00006534-200002000-00046
更新日期:2000-02-01 00:00:00
abstract::Since the development of smooth silicone breast implants in 1962, more than 1 million women throughout the world have opted for breast augmentation surgery. Although initially successful, smooth implants are prone to develop surrounding scar capsules that may harden and contract, resulting in discomfort, weakening of ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199712000-00014
更新日期:1997-12-01 00:00:00
abstract::Women with mammary hypertrophy who present for reduction mammaplasty have several well-described musculoskeletal complaints, but a high prevalence of carpal tunnel syndrome has not been reported. We identified 151 patients from a plastic surgery practice who underwent reduction mammaplasty from 1994 to 1996. To this g...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200004040-00009
更新日期:2000-04-01 00:00:00