Walker Nicholas J, Crantford John C, Rudolph Megan A, David Lisa R
From the Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC.
Ann Plast Surg. 2018 Jun;80(6):600-606. doi: 10.1097/SAP.0000000000001443.
Adequate resident training in aesthetic surgery has become increasingly important with rising demand. Chief resident aesthetic clinics allow hands on experience with an appropriate amount of autonomy. The purpose of this study was to compare resident cosmetic clinic outcomes to those reported in the literature. Furthermore, we sought to assess how effective these clinics can be in preparing residents in performing common aesthetic surgery procedures.
A retrospective chart review of 326 patients and 714 aesthetic procedures in our chief cosmetic clinic over a 13-year period was performed, and complication and revision rates were recorded. In addition, an electronic survey was sent to 26 prior chief residents regarding their experience and impressions of the chief resident aesthetic clinic.
A total of 713 procedures were performed on 326 patients. Patient ages ranged from 5 to 75 years old (mean, 40.8 years old) with a mean follow-up of 76.2 days. On average, there were 56 procedures performed per year. Of the 714 total procedures performed, there were 136 minor procedures and 578 major procedures. Of the 136 minor procedures, there were no complications and there was 1 revision of a cosmetic injection. Of the 578 major procedures, the overall complication rate was 6.1% and the revision rate was 12.8%. Complication and revision rates for each individual surgery were further analyzed and compared with the literature. The complication rates for these procedures fell within the reference ranges reported. In regards to the chief resident survey, there was a 77% response rate. All respondents reported that the chief resident clinic positively affected their residency education and future practice. Ninety percent of respondents felt "very comfortable" performing facelifts, body contouring, and aesthetic breast surgery. No respondents completed a subsequent cosmetic fellowship, and 60% stated that their positive experience in chief clinic contributed to their decision not to pursue a cosmetic fellowship.
Chief resident clinics can provide results with acceptable complication and revision rates that fall within the acceptable ranges in the literature. In addition, it provides a valuable experience that leaves residents with high comfort levels in performing key procedures in aesthetic surgery.
随着需求的增加，在美容外科进行充分的住院医师培训变得越来越重要。住院总医师美容诊所允许他们在适当的自主程度下获得实践经验。本研究的目的是将住院医师美容诊所的结果与文献中报道的结果进行比较。此外，我们试图评估这些诊所对于培训住院医师进行常见美容外科手术的有效性。
对我们美容主诊所在13年期间的326例患者和714例美容手术进行回顾性病历审查，并记录并发症和修复率。此外，还向26位前任住院总医师发送了电子调查问卷，询问他们在住院总医师美容诊所的经历和印象。
共对326例患者进行了713例手术。患者年龄从5岁到75岁不等（平均40.8岁），平均随访76.2天。平均每年进行56例手术。在总共714例手术中，有136例小手术和578例大手术。在136例小手术中，无并发症发生，有1例美容注射进行了修复。在578例大手术中，总体并发症发生率为6.1%，修复率为12.8%。对每项手术的并发症和修复率进行了进一步分析，并与文献进行了比较。这些手术的并发症发生率在报道的参考范围内。关于住院总医师调查，回复率为77%。所有受访者都表示住院总医师诊所对他们的住院医师培训和未来实践产生了积极影响。90%的受访者表示在进行面部提升、身体塑形和美容乳房手术时“非常自信”。没有受访者完成后续的美容专科培训，60%的受访者表示他们在主诊所的积极经历促使他们决定不追求美容专科培训。
住院总医师诊所能够提供并发症和修复率在文献可接受范围内的结果。此外，它提供了宝贵的经验，使住院医师在进行美容外科关键手术时具有很高的自信度。
