Conor M. Sugrue

A bibliometric analysis of the 100 most influential papers in burns

The importance of a published paper to a particular area is reflected in the quantity of citations obtained from peers. In burns, it is unknown which papers have been the most influential on this specialty. The purpose of our study was to identify the 100 most cited papers in burns and to analyze their characteristics. Twenty-seven journals were chosen for analysis. These included high impact factor scientific journals and journals dedicated to burns and trauma. Only twelve of these journals contributed to the 100 most cited papers in burns and we analyzed each paper individually looking at its subject matter, authorship, article type, institution, country and year of publication. Our citation analysis revealed an interesting mix of clinical and scientific papers that documents the key landmarks in burn care over the past 66 years.

A Barbed Suture Repair For Flexor Tendons: A Novel Technique With No Exposed Barbs

Background: Barbed suture technology has shown promise in flexor tendon repairs, as there is an even distribution of load and the need for a knot is eliminated. We propose that a quick and simple, novel, barbed technique without any exposed barbs on the tendon surface has comparable strength and a smaller cross-sectional area at the repair site than traditional methods of repair. Methods: Forty porcine flexor tendons were randomized to polybutester 4-strand barbed repair or to 4-strand Adelaide monofilament repair. The cross-sectional area was measured before and after repair. Biomechanical testing was carried out and 2-mm gap formation force, ultimate strength of repair, and method of failure were recorded. Results: The mean ultimate strength of the barbed repairs was 54.51 ± 17.9 while that of the Adelaide repairs was 53.17 ± 16.35. The mean 2-mm gap formation force for the barbed group was 44.71 ± 17.86 whereas that of the Adelaide group was 20.25 ± 4.99. The postrepair percentage change in cross-sectional area at the repair site for the Adelaide group and barbed group was 12.0 ± 2.3 and 4.6 ± 2.8, respectively. Conclusions: We demonstrated that a 4-strand knotless, barbed method attained comparable strength to that of the traditional Adelaide repair technique. The barbed method had a significantly reduced cross-sectional area at the repair site compared with the Adelaide group. The 2-mm gap formation force was less in the barbed group than the Adelaide group. Barbed repairs show promise for tendon repairs; this simple method warrants further study in an animal model.

Plastic surgery and the breast: a citation analysis of the literature.

Background: A large proportion of the plastic surgery literature is dedicated to the breast. It is one of the most common topics in our specialty, yet it is unclear which articles have been the most influential. The purpose of this study was to identify the top 100 most-cited articles on breast in the plastic surgery literature and examine the characteristics of each individual article. Methods: Using an electronic database through the Web of Science, we were able to determine the 6 journals that contributed to the 100 most-cited articles on breast in the plastic surgery literature. Results: Each article was examined individually looking at characteristics such as subject matter, article type, country of origin, institution, authorship, and year of publication. Plastic and Reconstructive Surgery contributed the most articles to the top 100 with 81 articles including the most-cited article which has been referenced 673 times to date. The United States produced 73% of the top 100 articles, and the most prolific institution was the University of Texas M. D. Anderson Cancer Center with 15 articles. Conclusions: This study has identified the most influential articles on breast in the plastic surgery literature over the past 68 years and highlighted many important scientific breakthroughs and landmarks that have occurred during this time.

Trends in the Level of Evidence in Clinical Hand Surgery Research.

Background: The application of evidence-based medicine (EBM) to the practice of hand surgery has been limited. Production of high-quality research is an integral component of EBM. With considerable improvements in the quality evidence in both orthopedic and plastic and reconstructive surgery, it is imperative that hand surgery research emulates this trend. Methods: A systematic review was performed on all hand surgery articles published in 6 journals over a 20-year period. The journals included Plastic and Reconstruction Surgery, Journal of Plastic, Reconstructive and Aesthetic Surgery, Journal of Hand Surgery–European Volume, Journal of Hand Surgery–American Volume, Journal of Bone & Joint Surgery, and the Bone & Joint Journal. The level of evidence of each article was determined using the Oxford level of evidence. The quality of methodology of randomized controlled trials (RCTs) was assessed using Jadad scale. Statistical analysis involved chi-squares and Student t test (P < .05). Results: A total of 972 original hand surgery research articles were reviewed. There was a significant increase in the average level of evidence of articles published between1993 and 2013. High-quality evidence only accounted for 11.2% of evidence published, with a significant increase over the study period (P = 0.001). Quantitative evaluation of the 26 published RCTs, using Jadad scale, revealed a progressive improvement in study design from 0.3 in 1993 to 3.33 in 2013. Conclusions: Hand surgery research has mirrored trends seen in other surgical specialties, with a significant increase in quality of evidence over time. Yet, high-quality evidence still remains infrequent.

100 citation classics in the melanoma literature: a bibliometric analysis.

BACKGROUND Modern immunologic therapies targeting genetic mutations have created a renewed interest in melanoma research, and this is reflected in the increasing number of published works. OBJECTIVE The purpose of this study was to identify the top 100 most cited articles in melanoma and to examine the characteristics of each individual article. METHODS Using an electronic database through the Web of Science, we were able to determine the 22 journals that contributed to the 100 most cited articles in melanoma. RESULTS Each article was examined individually looking at characteristics such as subject matter, article type, country of origin, institution, authorship, and year of publication. The New England Journal of Medicine contributed the most articles to the top 100 with 20 articles, whereas the most cited article originated from the Archives of Surgery and has been cited 2,384 times. The United States produced 74% of the top 100 articles, and the most prolific institution was the National Cancer Institute in Maryland with 18 articles. CONCLUSION This study has identified the most significant contributions to melanoma research over the past 63 years and identifies many important scientific breakthroughs and landmarks that have occurred during this time.

Has the Quality of Aesthetic Surgery Research Improved over the Last 20 Years

Evidence-based medicine (EBM) incorporates scientific research into clinical practice. When used in conjunction with clinical expertise, EBM guarantees a safe, reliable and cost-effective delivery of health care [1]. Yet, to achieve an EBM approach, it is imperative that high-quality research be available. Therefore, the aim of this study is to evaluate trends in the quality of aesthetic surgery research over the last 20 years. A systematic review was performed on aesthetic surgery articles in journals frequently publishing aesthetic surgery research over a 20-year period (1995, 2000, 2005, 2010, 2015). Journals selected included Plastic and Reconstructive Surgery, Journal of Plastic, Reconstructive and Aesthetic Surgery, Annals of Plastic Surgery, JAMA Facial Plastic Surgery and Aesthetic Plastic Surgery. All original research articles were included. Research quality was determined using the American Society of Plastic Surgeons’ levels of evidence (LOE) classification pyramid [2]. Each article was allocated a LOE based on bias and validity from the study design, ranging from Level I (highest) to Level V (lowest). The LOE were presented as percentages of overall publications per year. A total of 10, 039 articles were reviewed, with 796 meeting the inclusion criteria. There was a significance increase of 60.1% in published aesthetic surgery research between 1995 and 2015 (p = 0.002). The most common aesthetic topics included rhinoplasty 15.3% (122/796), breast augmentation 14.5% (116/796) and rhytidectomy 12.0% (96/796). Case series was the most frequent research design accounting for 45.7% (366/796) of publications. There was a 7.7% decrease in case series over the study period. The majority (98.3%) of studies in aesthetic surgery were therapeutic based. The most frequent LOE were Level IV (336/796) followed by Level V (288/796), both accounting for 78.3% of all published research. Highquality research (Levels I and II) demonstrated little change between 1995 and 2010. However, there was statistically a significant increase in the number of highquality research articles from 2010 to 2015 (p = 0.023) (Fig. 1). The demand for aesthetic surgical procedures is rising at a reported rate of 7.1% per year [3]. An EBM approach towards these procedures offers a much needed safeguard for patients seeking aesthetic surgery. This is difficult to achieve, as over the past 20 years poor-quality research has dominated aesthetic surgery publications. However, over the study period, there was an improvement in the quality of research, mirroring trends in other plastic surgery subspecialties such as hand surgery [4] and facial plastic surgery [5]. Aesthetic surgery is unique. The majority of the procedural outcomes are subjective and difficult to quantity. Comparing surgical technique is challenging, as accurate & C. M. Sugrue conormsugrue@rcsi.ie

An unusual presentation of a calcified thyroid gland.

A multinodular goitre with cystic degeneration with haemorrhage and subsequent calcification is a common occurrence in long-standing multinodular goitres. But extensive enlargement and calcification causing obstructive symptoms including dysphagia and tracheal shift has not been commonly reported in the literature. Our patient, an 82-year-old man presented with long-standing dysphagia and tracheal shift. His case proved challenging with the retrosternal location of the calcified gland, needing a collar neck incision and a manubriotomy to assess the thyroid. There was a large calcified shell to the gland that made mobilising and removing the gland very difficult. Histology revealed a large multinodular goitre with a large calcified cyst representing previous cyst haemorrhage which underwent calcification. Symptoms resolved postsurgical intervention.

Botulinum Toxin Treatment for Mild to Moderate Platysma Bands: A Systematic Review of Efficacy, Safety, and Injection Technique

Background Platysma bands are characteristic of an aging neck. Resection and plication of the platysma muscle is the basis of treatment. However, unfavorable surgical outcomes and improved understanding of platysma band etiology have shifted treatment towards nonsurgical rejuvenation. Objectives The aim of this paper was to assess the efficacy, injection techniques, and complications associated with botulinum toxin injection for the treatment of platysma bands. Methods A systematic literature search was performed to identify articles reporting botulinum toxin injections for platysma bands in neck rejuvenation. The search included published articles in three electronic databases-Ovid MEDLINE, EMBASE, and the Cochrane Library-between January 1985 and December 2017. Results Three studies met the inclusion criteria, with a total of 78 patients undergoing botulinum toxin injection for platysma bands. Incobotulinumtoxin A was used in 62.3% (n = 45/78) of patients, with 38.4% (n = 30/78) receiving abobotulinumtoxin A. Efficacy was assessed using the Merz platysma score scale. A mean score improvement of 2.0 points, with a response rate of 93.7%, was observed after 14 ± 2 days. At 3 months, the mean score improvement was 1.2 points with a response rate of 86%. Patient-reported metrics demonstrated an improvement in 91% (n = 71/78) of subjects. The three studies used a standard injection technique, with a maximum 20 IU of incobotulinumtoxin A and 5 U abobotulinumtoxin A administered per band. Complications were reported in 15.4% (n = 12/78) of patients, with none requiring further intervention. Conclusions Botulinum toxin is a highly effective treatment for isolated platysma bands. A safe injection technique is described and recommended for clinical practice. Level of Evidence 4

Trends in Authorship Proliferation of Cosmetic Surgery Publications Over a 20-Year Period:

Cosmetic surgery is an evolving surgical subspecialty. Scientific research publications are paramount to progress it as a specialty. Translation of scientific research into aesthetic surgery practice enables an evidence-based medicine approach, improving patient outcomes and experiences. Significant proliferation of authorship in research publications has raised questions surrounding the integrity of authors’ contributions. Authorships are linked with academic, social, and sometimes financial rewards. With a dramatic rise in authorship observed in various surgical specialties, the aim of this study is to assess authorship trends in cosmetic surgery research. An observational study was performed assessing numbers of authors per cosmetic surgery publications over a 20-year period (1995-2015). Interval analyses of 5 years were selected (1995, 2000, 2005, 2010, and 2015). Six journals were selected for review: Plastic & Reconstruction Surgery, Journal of Plastic, Reconstructive and Aesthetic Surgery, JAMA Facial Plastic Surgery, The American Journal of Cosmetic Surgery, Aesthetic Plastic Surgery, and Annals of Plastic Surgery. Only original cosmetic surgery research (clinical and laboratory) design were included in this study. Data collected included date of publication, number of authors per publications, and cosmetic surgery subtopic. The mean number of authors per publication per year was calculated, and statistical analysis was performed with the Student t test (P = .05). In total, 883 cosmetic surgery publications were included in this review. Over the 20 years’ study period, there was a 97.5% increase in published cosmetic surgery research. The number of authors per publications gradually increased for each 5-year interval: 1995 (n = 2.31), 2000 (n = 2.63), 2005 (n = 3.41), 2010 (n = 3.41), and 2015 (n = 4.21) (P = .001). Single-author publications accounted for 43.2% of all publications in 1995. This number significance declined over the 20-year period (Figure 1). Authorship in cosmetic surgery research has gradually increased over the last 20 years. Interestingly, the mean 730899 ACSXXX10.1177/0748806817730899The American Journal of Cosmetic Surgery letter2017

Abstract 65: ASCOT- Autologous use of bone marrow derived Stem Cells for Osteoarthritis of the Thumb-1st CMCJ

PURPOSE: Management of chest wall reconstruction (CWR) following oncologic resection is challenging due to the nature if pathology, the radical procedure, and the employment of prosthetic materials required for biomechanical stability. Traditional material for CWR includes synthetic prosthesis (i.e. polypropylene or polytetrafluorethylene). However, biologic meshes might result in less wound complications. The aim of this study was to determine whether acellular dermal matrix (ADM) is associated with a lower incidence of complications following chest wall reconstruction for an oncologic resection defect compared to synthetic mesh.