Introduction: As plastic surgeons are continuing to form larger groups, it is essential to select candidates who will contribute to a positive work environment. This article shows which traits may be the most valuable when selecting candidates and in which ways a selection committee may want to focus their search. Methods: For the study, the Canadian Society of Plastic Surgeons' members answered a survey containing questions about demographics, the factors which influence the selection process, and their hiring experiences. Responses were separated and compared in groups based on gender, practice type, group size, and years practising. Significance was established if P < .05 using the w 2 test. Results: The most and least important factors regarding hiring a new group member were established. Statistically significant results were obtained between several different factors, including hiring a non-Canadian, the importance of the candidate's professional reputation, the number of publications by the candidate, and the presence or absence of program director letters. A majority (54%) of society members regret having hired a candidate, with the vast majority of these (75%) indicating personality and work ethic issues as opposite to professional skills as the uncomplimentary feature. Conclusion: This study has identified the key features which influence hiring new candidates. The need to develop a more efficient hiring process has been identified and has highlighted the difficulty faced by Canadian plastic surgery groups when recruiting new members.
Purpose: 1) Review our complication rates with implant/expander reconstruction for breast cancer 2) Determine factors for complications, especially with postmastectomy radiation (PMRT)
Materials and Methods: Data were collected through chart review of all patients (2004–2008) from an academic hospital undergoing implant/expander reconstruction. SAS was used for two or multi-variable analyses (logistic regression) to determine predictive factors for complications. Among PMRT patients, we evaluated complications rates by risk factors.
Results: 237 patients underwent implant/expander reconstruction. Median time from implant placement until last follow-up was 173 days. 21.5% developed major complications (needing operative time or infection needing intravenous treatment). Diabetes was the most consistent factor associated with major complications (46.7 vs 20.1%, p = 0.02 and p = 0.009 in multivariable analysis). Radiation was linked to capsular contractures (18.6 vs 10.1%, p = 0.02). Chemotherapy (25.0 vs 19.0%, p = 0.26) or radiation (26.3 vs 19.1%, p = 0.21) did not predict major complications. Among patients receiving PMRT (80 patients), 26.2% had major complications, 34 had immediate PMRT on the expander and 44 had PMRT to the chest wall, followed by delayed reconstruction with expander/implant placement. In these, delayed reconstruction increased dehiscence (0 vs 18.2%, p = 0.009) compared to immediate reconstruction, with a trend for higher incidence of major complications in the delayed reconstruction group (14.7 vs 34.1%, p = 0.05). 40 Gy/16 versus 50–50.4 Gy/25-28 (28 vs 24%, p = 0.78) was not associated with major complications. Diabetes and smoking were associated with several complications.
Conclusions: Diabetes is associated with a higher rate of major complications after expander/implant reconstruction while radiation increases capsular contractures. If PMRT is indicated, putting in an expander before radiation results in less morbidity than delayed reconstruction. Also, 40 Gy/16 versus 50–50.4 Gy/25-28 do not differ much in terms of complication rates.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-17-08.
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