Patrick P. Bletsis

Does industry funding mean more publications for subspecialty academic plastic surgeons

BACKGROUNDnConflict of interest among physicians in the context of private industry funding led to the introduction of the Physician Payments Sunshine Act in 2010. This study examined whether private industry funding correlated with scholarly productivity in the respective subspecialties of plastic surgery and the wider academic plastic surgery community.nnnMATERIALS AND METHODSnFull-time plastic surgeons and their academic attributes were identified via institutional websites. Fellowship-trained individuals were segregated into subspecialties of microsurgery, craniofacial surgery, hand surgery, esthetic surgery, and burn surgery. The Center for Medicare and Medicaid Services Open Payment database was used to extract industry funding information. Each individuals bibliometric data were then collected through Scopus to determine the correlation between selected surgeon characteristics, academic productivity, and industry funding.nnnRESULTSnNine hundred and thirty-five academic plastic surgeons were identified, with 532 having defined subspecialty training. Academic bibliometrics among subspecialty surgeons were comparable among the five groups with esthetic and craniofacial surgeons displaying a preponderance of attaining more industry funding (Pxa0=xa00.043) and career publications respectively, with the latter not attaining statistical significance (Pxa0=xa00.12). Overall, research-specific funding (Pxa0=xa00.014) and higher funding amounts (Pxa0<xa00.0001) correlated with higher Hirsch indices in tandem with higher academic rank. A funding level of

Labiaplasty: Indications and Predictors of Postoperative Sequelae in 451 Consecutive Cases

2000 appeared to be the approximate cutoff above which scholastic productivity became apparent.nnnCONCLUSIONSnOur study demonstrated in detail the association between industry funding and academic bibliometrics in academic plastic surgery of every subspecialty. Even at modest amounts, industry support, especially when research designated, positively influenced research and therefore, academic output.

The financial impact and drivers of hospital charges in contralateral prophylactic mastectomy and reconstruction: a Nationwide Inpatient Sample hospital analysis

BackgroundnThe increasing demand for labiaplasty is well recognized; however, the procedure remains contentious.nnnObjectivesnWe aim to provide a large-scale, up-to-date analysis of labiaplasty outcomes and factors influencing postoperative sequelae (POS).nnnMethodsnWe analyzed a single-center, prospectively maintained database of females undergoing labiaplasty between 2002 and 2017. Demographic, procedural, and outcomes data were retrieved. Binary logistic regressions were used to evaluate the odds of developing POS (revisional surgery and complications); presented as odds ratios (OR) with 95% confidence intervals (CI).nnnResultsnData for 451 consecutive patients were retrieved, ten of whom were <18 years of age. Overall, 86% were Caucasian, mean age was 32.6 years, and 11.8% were smokers. Concomitant labia majora reduction was performed in 7.3%, and clitoral hood reduction in 5.8%. There were 32 cases of POS (7.1%), while the complication rate was 3.8%. Comparing those with POS to those without, there were no differences in age (32.8 vs 29.9 years, P = 0.210), operative time (78.5 vs 80.6 minutes, P = 0.246), or comorbidities (P > 0.05 for all). On univariable analysis, increased odds of POS occurred with sexual dysfunction as an indication for surgery (OR 3.778, CI 1.682-8.483). On subgroup analysis of those ≥18 years, both smoking (2.576, CI 1.044-6.357) and sexual dysfunction as an indication (OR 4.022, CI 1.772-9.131) increased the odds of POS. On multivariable analysis of the subgroup, sexual dysfunction as an indication persisted in significance (OR 3.850, CI 1.683-8.807).nnnConclusionsnResults compare favorably with previously reported complication and revisional surgery rates. Smoking and sexual dysfunction may increase the risk of complications.nnnLevel of Evidence 2

Abstract: Institutional Diversity in Academic Plastic Surgery: A Collaborative Solution to Resource Limitations

PurposeRates of contralateral prophylactic mastectomy (CPM) have increased over the last decade; it is important for surgeons and hospital systems to understand the economic drivers of increased costs in these patients. This study aims to identify factors affecting charges in those undergoing CPM and reconstruction.MethodsAnalysis of the Healthcare Cost and Utilization Project National Inpatient Sample was undertaken (2009–2012), identifying women aged ≥18 with unilateral breast cancer undergoing unilateral mastectomy with CPM and immediate breast reconstruction (IBR) (CPM group), in addition to unilateral mastectomy and IBR alone (UM group). Generalized linear modeling with gamma regression and a log-link function provided mean marginal hospital charge (MMHC) estimates associated with the presence or absence of patient, hospital and operative characteristics, postoperative complications, and length of stay (LOS).ResultsOverall, 70,695 women underwent mastectomy and reconstruction for unilateral breast cancer; 36,691 (51.9%) in the CPM group, incurring additional MMHCs of

The National Surgical Quality Improvement Program 30-Day Challenge: Microsurgical Breast Reconstruction Outcomes Reporting Reliability

20,775 compared to those in the UM group (pxa0<xa00.001). In the CPM group, MMHCs were reduced in those aged >60xa0years (pxa0<xa00.001), while African American or Hispanic origin increased MMHCs (pxa0<xa00.001). Diabetes, depression, and obesity increased MMHCs (pxa0<xa00.001). MMHCs increased with larger (pxa0<xa00.001) hospitals, Western location (pxa0<xa00.001), greater household income (pxa0<xa00.001), complications (pxa0<xa00.001), and increasing LOS (pxa0<xa00.001). MMHCs decreased in urban teaching hospitals and Midwest or Southern regions (pxa0<xa00.001).ConclusionThere are many patient and hospital factors affecting charges; this study provides surgeons and hospital systems with transparent, quantitative charge data in patients undergoing contralateral prophylactic mastectomy and immediate breast reconstruction.

Institutional Collaboration in Plastic Surgery Research: A Solution to Resource Limitations

RESULTS: From 2000–2013 the proportion of female surgeons among all female physicians has remained constant at 12–13%. The ratio of femaleto-male surgeons and residents has increased over time in all surgical specialties. While females outnumber males in one surgical specialty (obstetrics and gynecology), the female-to-male ratio in neurosurgery, orthopedic surgery, and thoracic surgery is 1:10 or higher. This discrepancy is lower among resident physicians (1:6 or lower). Presently, the female-to-male ratio of practicing surgeons in plastic surgery is approximately 1:5 with a smaller discrepancy among plastic surgery residents (integrated: 1 to 1.5; independent: 1 to 3.0). The proportion of Asian female surgeons has increased across all specialties.