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Biomedical subjects

George Broughton

Publications and source records attributed to George Broughton.

7 recordsLinked to original sources
PubMed2006

Patient safety in the office-based setting.

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Discern the importance of the physician's office administrative capacity. 2. Recognize the necessity of a system for quality assessment. 3. Assess which procedures are safe in the office-based setting. 4. Know the basic steps to properly evaluate patients for office-based plastic surgery. BACKGROUND: At least 44,000 Americans die annually as a result of preventable medical errors. Medical mistakes are the eighth leading cause of death in the United States, costing between $54.6 billion and $79 billion, or 6 percent of total annual national health care expenditures. Office-based procedures comprise a 10-fold increase in risk for serious injury or death as compared with an ambulatory surgical facility. METHODS: This article reviews the literature on office-based patient safety issues. It places special emphasis on the statements and advisories published by the American Society of Plastic Surgeons' convened Task Force on Patient Safety in Office-Based Settings. This article stresses areas of increased patient safety concern, such as deep vein thrombosis prophylaxis and liposuction surgery. RESULTS: The article divides patient safety in health care delivery into three broad categories. First, patient safety starts with emphasis at the administrative level. The physician or independent governing body must develop a system of quality assessment that functions to minimize preventable errors and report outcomes and errors. Second, the clinical aspects of patient safety require that the physician evaluate whether the procedure(s) and the patient are proper for the office setting. Finally, this article gives special attention to liposuction, the most frequently performed office-based plastic surgery procedure. CONCLUSIONS: Patient safety must be every physician's highest priority, as reflected in the Hippocratic Oath: primum non nocere ("first, do no harm"). In the office setting, this priority requires both administrative and clinical emphasis. The physician who gives the healing touch of quality care must always have patient safety as the foremost priority.

Ambulatory Surgical Procedures↗
PubMed2006

Lifestyle outcomes, satisfaction, and attitudes of patients after liposuction: a Dallas experience.

BACKGROUND: Liposuction is the most common cosmetic operation performed. To the authors' knowledge, no report has examined patients' attitudes and postoperative opinions, lifestyle changes, weight gain changes, and satisfaction with their liposuction procedure in general and by specific site. The authors report on data from a survey provided to patients by two plastic surgeons at the University of Texas Southwestern Medical Center at Dallas. METHODS: Six hundred questionnaires were mailed to all patients who had liposuction surgery performed between 1999 and 2003. There were 108 undeliverable surveys; 209 completed surveys were returned (34.8 percent of 600 and 42.5 percent of 492 surveys). Data were analyzed using the chi-square test. A p value of less than 0.05 was considered significant. RESULTS: The majority of patients (80 percent) were satisfied with their results. Fifty-three percent thought that their appearance was either "excellent" or "very good." With regard to satisfaction by site treated, 60 percent or more of the responders were "very satisfied" or "satisfied" with their results. Weight gain was reported in 43 percent of the responders, with 56 percent of them gaining between 5 and 10 pounds 6 months after their surgery. Fat return was reported in 65 percent of the responders. The abdomen was the most common location for fat return. As a group, 79.7 percent would have the procedure again and 86 percent would recommend the procedure to family or friends. Approximately 75 percent of responders described their postoperative discomfort as mild to moderate, with 60 percent indicating that their discomfort lasted less than 7 days (39.8 percent indicated their pain lasted longer than 7 days); 83 percent indicated that they only needed to use narcotics for 7 days of less. When responders were divided into groups, the great majority of patients were satisfied with the surgery and their results. CONCLUSIONS: Despite postoperative pain, fat return, and weight gain, patients were willing to have the procedure again and recommend it to others. Those patients who were unsatisfied and were less likely to refer patients were those who had the lowest opinion of their appearance.

Abdomen↗
PubMed2006

Wound healing: an overview.

Understanding wound healing today involves much more than simply stating that there are three phases: inflammation, proliferation, and maturation. Wound healing is a complex series of reactions and interactions among cells and "mediators." Each year, new mediators are discovered and our understanding of inflammatory mediators and cellular interactions grows. This article will attempt to provide a concise overview on wound healing and wound management.

Cell Division↗
PubMed2006

A brief history of wound care.

Since the caveman, man has been tending to his wounds. Wound care evolved from magical incantations, potions, and ointments, to a systematic text of wound care and surgery from Hippocrates and Celsus. These advances were lost after the fall of the Roman Empire. In Europe, the Middle Ages were a regression of wound care back to potions and charms. It was'nt until the time of large armies using muskets and cannons that surgical wound care emerged again. This article will briefly highlight major milestones in wound care.

Animals↗
PubMed2006

The basic science of wound healing.

Understanding wound healing today involves much more than simply stating that there are three phases: "inflammation, proliferation, and maturation." Wound healing is a complex series of reactions and interactions among cells and "mediators." Each year, new mediators are discovered and our understanding of inflammatory mediators and cellular interactions grows. This article will attempt to provide a concise report of the current literature on wound healing by first reviewing the phases of wound healing followed by "the players" of wound healing: inflammatory mediators (cytokines, growth factors, proteases, eicosanoids, kinins, and more), nitric oxide, and the cellular elements. The discussion will end with a pictorial essay summarizing the wound-healing process.

Cell Proliferation↗
PubMed2004

The key to long-term success in liposuction: a guide for plastic surgeons and patients.

Patients need to have realistic expectations for a long-term successful body contour result. There are four key elements for long-term successful improvement in body contour, and the patient is responsible for the first three: exercise, a proper diet, and other positive lifestyle changes; and successful body contouring. An extensive survey requesting information about the procedures, areas of liposuction, lifestyle habits, and satisfaction was mailed to 600 patients who had liposuction surgery performed between 1999 and 2003. One hundred and eight surveys were undeliverable and 209 completed surveys were returned (34.8 percent of 600 mailed surveys and 42.5 percent of 492 delivered surveys). Data were analyzed by a binary logistic regression with backward elimination. Weight gain (versus no weight gain) was used as the dependent variable. The results showed that regardless of whether the patient did or did not gain weight, both groups reported being very satisfied (30 percent and 48 percent, respectively) or satisfied (43 percent and 34 percent, respectively) with their procedure. Among the weight gain patients, 72 percent would still have the procedure again, compared with 82 percent of responders who did not gain weight. When asked if they would recommend the procedure to family or friends, 90 percent of responders who did not gain weight would recommend the procedure whereas only 74 percent of responders who did gain weight would recommend the procedure (p < 0.001). Among those patients who gained weight, only 29 percent thought their appearance was excellent or good (compared with 79 percent of those who did not gain weight). Among the 57 percent of patients who did not gain weight, 35 percent report exercising more postoperatively (compared with only 10 percent in the weight gain group, p = 0.002) and 50 percent report eating a healthier diet (22 percent in the weight gain group report eating a healthier diet, p = 0.002). In the weight gain group, 67 percent report no change in their diet regimen and only 17 percent thought their productivity increased (compared with 25 percent among the no weight gain group, p = 0.002). Successful body contouring surgery requires a patient to embrace positive lifestyle habits. The results of this survey have been used to create a quantitative decision-making framework or a "road map" for patients and plastic surgeons to use for navigating toward successful long-term results.

Clothing↗