Plastic Surgery Simulator
The design of the huddle was adapted from the IDCOP (idealized design of clinical office practices) literature on primary care huddles and the benefits of huddles to the practice and patients. Drawing from that experience the lead team in the Plastic Surgery Section designed a huddle process to pilot with Dr. Ryan, the lead physician. All the clinicians in the Plastic Surgery Section now conduct interdisciplinary huddles. Here are some of the observed benefits
It is a general rule in facial plastic surgery to sacrifice as little skin as possible. Small wounds that extend obliquely into the tissue should be straightened whenever the surrounding tissue can be mobilized and the wound edges coapted without tension. A subcutaneous suture with a buried knot should always be placed to allow tension-free approximation of the wound margins (see Fig. 2.1). Because the subcutaneous tissue, epidermis, and dermis take different lengths of time to achieve adequate wound strength, early removal of the skin sutures from a wound without subcutaneous sutures would result in a broad, unsightly scar.
Robinson, E., Rumsey, N., & Partridge, J. (1996). An evaluation of the impact of social interaction skills training for facially disfigured people. British Journal of Plastic Surgery, 49,281-289. Shaw, W. (1981). Folklore surrounding facial deformity and the origins of facial prejudice. British Journal of Plastic Surgery, 34, 237-246.
A doctor's first introduction to ocular plastic surgery is often being called upon to repair an acute eyelid laceration. The management of both acute and chronic or established eyelid injuries is laid out in this chapter. Surgical repair depends on a knowledge of eyelid anatomy and of the principles of eyelid reconstruction which are described here.
Plastic Surgery Section A visual display of improvement activities and the 5 P's provide constant reminders of the focus and goals of improvement for the Plastic Surgery Section (see Figure 24.3). The data wall keeps staff current on performance and shows when certain processes FIGURE 24.3. PLASTIC SURGERY SECTION DATA WALL. Plastic Surgery Technical Excellence Surgery Plastic Surgery Surgery Plastic Surgery may need attention to avoid backsliding. The Plastic Surgery playbook continues to grow. Scheduling methods, contingency plans, daily huddles, and shared medical appointments are some of the activities contained in this microsystem's playbook.
Mucosal leishmaniasis due to L. (V.) braziliensis is usually treated with a pentavalent antimony-containing drug, but primary failures and relapses are relatively common. Alternatives include amphotericin B deoxycholate and pentamidine isetionate. Liposome-encapsulated and lipid-associated amphotericin B have not been studied. Preliminary data suggest that the combination of pentavalent antimony and IFNy is more effective, but IFNy is available only in research settings. When necessary, plastic surgery should be delayed for 6-12 months after apparent cure of mucosal disease because relapses are common and associated with a poor cosmetic outcome.
Plastic Surgery Section With the leadership of the lead physician, the practice manager, lead nurse, and lead administrative secretary, an interdisciplinary lead improvement team was convened to participate in a ten-week course to learn improvement application within the context of plastic surgery. The team held one-hour weekly improvement meetings to learn and apply improvement tools and methods.