Evidence map›Paper›PMID 32440436›Full record

ArticlePlastic and reconstructive surgery. Global open2020

Do Microsurgical Outcomes Differ Based on Which Specialty Does the Operation? A NSQIP Analysis.

Jacques X Zhang, Melissa Wan, Yichuan Ding, Yiwen Jin, Mahesh Nagarajan, Douglas J Courtemanche, Julie Bedford, Jugpal S Arneja

Open access · goldAbstract read
In one paragraph

Article in Plastic and reconstructive surgery. Global open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 48% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Jacques X ZhangDivision of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
Melissa WanFaculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Yichuan DingSauder School of Business, University of British Columbia, Vancouver, British Columbia, Canada.
Yiwen JinSauder School of Business, University of British Columbia, Vancouver, British Columbia, Canada.
Mahesh NagarajanSauder School of Business, University of British Columbia, Vancouver, British Columbia, Canada.
Douglas J CourtemancheDivision of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
Julie BedfordBC Children's Hospital, Vancouver, British Columbia, Canada.
Jugpal S ArnejaDivision of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
University of British Columbia · CABC Children's Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBecause plastic surgeons do not "own" a specific anatomic region, other surgical specialties have increasingly assumed procedures historically performed by plastic surgery. Decreased case volume is postulated to be associated with higher complication rates. Herein, we investigate whether volume and surgical specialty have an impact on microsurgical complications, specifically surgical site infection (SSI) and reoperation rates.

methodsThe 2005-2015 National Surgical Quality Improvement Program participant use file was queried by Current Procedural Terminology code for breast and head/neck microsurgeries. Multivariate logistic regression was performed to compare the outcomes between surgical specialties. A cumulative frequency variable was introduced to investigate the effect of case volume on complication rates.

resultsWe captured 6,617 microsurgical cases. Multivariate logistic regression revealed that although the rate of SSI was lower in plastic surgery compared with otolaryngology for head and neck reconstructions (13.3% versus 10.5%) and compared with general surgery for breast reconstructions (5.4% versus 4.7%), there was no significant difference between specialties (

conclusionsPlastic surgery is at risk given case cannibalization by other specialties. We conclude that surgical specialty does not affect the rates of SSI and reoperation. We demonstrate a correlation between lower volumes and increased complications, implying that, once a specialty has amassed critical case experience, complication rates may decrease, and outcomes can be equivalent or superior. Case breadth and volumes should be maintained to preserve skills, optimize outcomes, and maintain the specialty as it currently exists.

Identifiers

PMID32440436
PMCPMC7209891
OpenAlexW3020277951

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.