Background: Breast augmentation is one of the most frequently performed aesthetic procedures in the United States. Online information is often used by patients to make decisions when undergoing cosmetic procedures. It is vital that online medical information includes relevant decision-making factors and uses language that is understandable to broad patient audiences. Ideally, online resources should aid patient decisions in aesthetic surgical planning, especially implant size selection for breast augmentation. We describe patient decision-making factors and readability of breast implant size selection recommended by private practice plastic surgery webpages. Methods: Using a depersonalized, anonymous query to Google search engine, the terms "breast implant size factors" and "breast implant size decision" were searched, and 52 plastic surgery private practice webpages were identified. Webpages were analyzed for reported decision-making factors of implant size selection. Readability analyses of webpages were performed with Readability Studio and Hemingway Editor. Results:The two major decision-making factors for implant size selection reported by webpages were body/tissue-based measurements and surgeon input. Ten factors related to patient lifestyle, surgical goals, and procedural options were also identified. Average webpage scores for five readability measures exceeded recommended levels for medical information. Conclusions: Reported decision-making factors for implant size selection emphasize a plastic surgeon's expertise but may enhance the patient's role in preoperative planning. Webpages describing breast implant size selection exceed the sixth and eighth grade reading levels recommended by the AMA and NIH, respectively. Improving the readability of webpages will refine the role of online medical information in preoperative planning of breast augmentation.
Background: We describe the creation and impact of a novel Surgical Subspecialty Experience (OR vs clinic shadowing and surgical skills sessions) Program (SSEP) for pre-clinical medical curricula. Methods: The program was offered to first year medical students (Fall 2018). Students completed the following surveys: Pre-SSEP, Post-Experience, and Post-SSEP. Paired samples t-test were utilized to determine changes in interest as well as factors that impact this interest. Results: After one year of participation, there was no significant change in interest in the included surgical subspecialties. Sub-analyses demonstrated an increasingly negative impact of specialty specific characteristics on student interest in the diversity of procedures, work hours, patient outcomes, and call nights. Conclusions: We successfully designed and implemented the SSEP to supplement our medical school curriculum. Our hope is that other institutions can utilize our model via our online Handbook to provide students firsthand insight into surgical subspecialties prior to the clinical years: https://github.com/SSEPUVM/SSEP-supplemental-materials.git.
Diabetic patients are predisposed to adverse complications after surgery, especially when their A1c is above 8. 0% (1). Despite the heightened risk for post-operative complications such as wound dehiscence and infection (2), no formal recommendations by the American Council of Academic Plastic Surgeons (ACAPS) exist regarding preoperative A1c thresholds. This study reviews the current online recommendations for diabetic patients undergoing plastic surgery and examines the readability and technical metrics presented on these webpages. We hypothesized that these webpages would enforce stricter preoperative A1c levels (< 8%) in comparison to the 8% threshold put forth by Diabetes Care in 2014. An anonymous, depersonalized Google search with the search term "diabetes and plastic surgery" was run. The initial 50 results were analyzed and 11 webpages meeting inclusion criteria extracted. 45.45% (5/11) of the webpages stated specific A1c recommendations, with 4 of the webpages recommending an A1c <7% and one webpage recommending an A1c <6%. A number of the websites recommended that patients consult their primary care physician (PCP) or endocrinologist, 63.6% (7/11). 100% (11/11) of webpages discussed poor wound healing and 45% (5/11) discussed the heightened risk of postoperative infection in diabetic surgical patients. Webpage average readability scores for seven readability measures greatly exceeded the 6th grade reading level recommended for medical information. This study determined that online resources for diabetic patients undergoing plastic surgery utilized stricter than standard preoperative criteria and exceeded recommended readability levels. Standardizing requirements for diabetic patients and improving readability may help patients better understand the preoperative expectation for better surgical outcomes. References: (1) Underwood, Patricia et al. "Preoperative A1C and clinical outcomes in patients with diabetes undergoing major noncardiac surgical procedures." Diabetes care vol. 37,3 (2014): 611-6. doi: 10.2337/dc13-1929(2) Goltsman, David et al. "Defining the Association between Diabetes and Plastic Surgery Outcomes: An Analysis of Nearly 40,000 Patients." Plastic and reconstructive surgery. Global open vol. 5,8 e1461. 17 Aug. 2017, doi: 10.1097/GOX. 0000000000001461 Presentation: No date and time listed
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