Outpatient Plastic Surgery An Issue Of Clinics In Plastic Surgery

With approximately 13.8 million minimally-invasive cosmetic surgeries performed in the United States, and approximately 12.2 million minimally invasive cosmetic treatments performed in 2011, most of these are undertaken in surgeons’ group practice or surgery center locations. The most common as well as the most dreaded complications are presented along with articles presenting “best practice for cosmetic surgery centers. Each topic presents Anesthesia, Infection control, Complication avoidance and management, along with technique video. Some of the topics include: Patient Selection in Outpatient Surgery; Airway Management in the Outpatient Setting; Deep Venous Thrombosis - Prevention and Management; Intravenous Sedation from the Surgeon’s Perspective; Postoperative Nausea and Vomiting; among other relevant issues to the surgeon. Guest Editors are Geoffrey Keyes and Robert Singer, both involved with the Association for Accreditation of Ambulatory Surgery and fervent about certified surgeons running ambulatory facilities for best outcomes and avoidance of mortalities and severe morbidities.

Outcomes . . .familiar in medicine fields, but only in recent decades becoming more of an issue for surgeons . . .the highly subspecialized nature of the surgical profession and breadth of procedures along with variance in patient population creates a challenge in achieving useful, informative outcomes. Here, in this issue of Clinics in Plastic Surgery, the focus is on evidence-based practice and outcomes in plastic surgery, spanning the major areas of cosmetic and reconstructive surgery. Outcomes as guidance for the surgeon’s decision regarding approaches and techniques for procedures is the approach. Some of the topics covered are: Measuring Outcomes in Aesthetic Surgery; Measuring Outcomes in Craniofacial and Pediatric Surgery; Measuring Outcomes in Hand Surgery; How to Link Outcomes Data to Quality Initiatives in Plastic Surgery; along with How to Use the Outcomes Questionnaire, Pearls and Pitfalls; among others. Guest Editors Kevin Chung and Andrea Pusic lead this review. Dr. Chung is involved with structuring evidence-based practice and research in hand surgery to derive the best evidence to guide treatment for upper extremity conditions and he developed the Michigan Hand Outcomes Questionnaire. Dr Pusic developed the BREAST-Q, which measures satisfaction and quality-of-life outcomes among breast reconstruction patients. Out of the BREAST-Q has come the FACE-Q, which provides a clinically useful patient-reported outcome measure of satisfaction and quality of life following elective surgical and non-surgical facial rejuvenation.

More and more plastic surgeons are turning to cosmetic medicine and minimally invasive surgery as a way to supplement their practices. This multidisciplinary issue, which includes dermatologists as well as plastic surgeons, gives detailed information on how to perform several procedures, including dermabrasion, botox injection, laser therapy, and thermage.

This issue of Perioperative Nursing Clinics, Guest Edited by Debbie H. Mathis RN, MS, CNOR, RNFA, will focus on Plastic and Reconstructive Surgery, with topics including: The role of interruptions in the OR; Surgical site infections; Special considerations for history and physical for plastic, cosmetic, and reconstructive patients; History and assessment requirement for ambulatory plastic and reconstructive surgery; and Skin assessment.

Evidence base in 2015 remains a subject of controversy for surgeons related to its application in surgery that cannot be approached as it is in medical evidence. Academic surgeons acknowledge that evidence base is necessary and private practitioners know it is woven into the fabric of their practice. Dr. Lisa Ishii and Dr. Travis Tollefson, editors of this publication, are at the forefront of clinical use of and research into evidence based surgery. The Oxford Centre system of evidence is used for this issue. Currently, evidence is dominant in the reconstructive aspect, moreso than the cosmetic aspect; as such, this resource focuses on the nerve and microvascular procedures. Topics include Facial vascular anomalies, Cleft lip and palate; Trauma; Facial reanimation; System reviews and metanalyses; and Skin care, Laser treatments; and Rhinoplasty. Audience for this resource is facial plastic surgeons, otolaryngologists, plastic surgeons, laser therapists, dermatologists, and skin researchers.

The scope of use of local anesthetics in procedures in plastic surgery is covered in this issue of Clinics in Plastic Surgery. Discussion centers on plastic surgeons in private practice in ambulatory facilities and those scheduling time for OR in hospital facilities using local anesthetics while accommodating patient comfort and absence of side-effects post general anesthesia. Presented in this publication are the most common plastic surgeries that can be done under local anesthesia, each with a discussion of the optimal anesthetic, method of administration, and dosage. Video of the procedure or portion of the procedure, as applicable, accompanies the techniques along with a surgical case. The goal of this issue is to provide a concise reference for surgeons’ planning surgeries to review and perhaps adapt currently used methods with this latest information on local anesthetics. Surgical Technique is provided in detail with full analysis of Patient Selection and Planning, Complications and Post-procedure Care. Contents include Complications; Basic Science of Locals; Skin Grafts and Flaps; Peripheral Nerve; Foot Surgery; Breast Surgery; Liposuction; Hand Trauma; Oculoplastic Surgery; Ear Surgery; Hair Transplantation; among others.

In this issue, guest editors bring their considerable expertise to this important topic. Provides in-depth reviews on the latest updates in the field, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.