Peterson Erin C, Ghosh Trina D, Qureshi Ali A, Myckatyn Terence M, Tenenbaum Marissa M
Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO.
Aesthet Surg J Open Forum. 2019 Oct 7;1(4):ojz026. doi: 10.1093/asjof/ojz026. eCollection 2019 Dec.
Duration of surgery is a known risk factor for increased complication rates. Longer operations may lead to increased cost to the patient and institution. While previous studies have looked at the safety of aesthetic surgery with resident involvement, little research has examined whether resident involvement increases operative time of aesthetic procedures.
We hypothesized that resident involvement would potentially lead to an increase in operative time as attending physicians teach trainees during aesthetic operations.
A retrospective cohort analysis was performed from aesthetic surgery cases of two surgeons at an academic institution over a 4-year period. Breast augmentation and abdominoplasty with liposuction were examined as index cases for this study. Demographics, operative time, and resident involvement were assessed. Resident involvement was defined as participating in critical portions of the cases including exposure, dissection, and closure.
A total of 180 cases fit the inclusion criteria with 105 breast augmentation cases and 75 cases of abdominoplasty with liposuction. Patient demographics were similar for both procedures. Resident involvement did not statistically affect operative duration in breast augmentation (41.8 ± 9.6 min vs 44.7 ± 12.4 min, = 0.103) or cases for abdominoplasty with liposuction (107.3 ± 20.5 min vs 122.2 ± 36.3 min, = 0.105).
There was a trend toward longer operative times that did not reach statistical significance with resident involvement in two aesthetic surgery cases at an academic institution. This study adds to the growing literature on the effect resident training has in aesthetic surgery.
手术时间是并发症发生率增加的一个已知风险因素。手术时间越长，患者和医疗机构的成本可能越高。虽然之前的研究探讨了住院医师参与美容手术的安全性，但很少有研究考察住院医师的参与是否会增加美容手术的手术时间。
我们假设，由于主治医师在美容手术过程中指导住院医师，住院医师的参与可能会导致手术时间增加。
对一所学术机构的两名外科医生在4年期间的美容手术病例进行回顾性队列分析。本研究将隆胸术和抽脂腹壁成形术作为索引病例进行研究。评估人口统计学、手术时间和住院医师参与情况。住院医师的参与被定义为参与手术的关键部分，包括暴露、解剖和缝合。
共有180例符合纳入标准，其中隆胸术105例，抽脂腹壁成形术75例。两种手术的患者人口统计学特征相似。住院医师的参与在统计学上对隆胸术的手术时长没有影响（41.8±9.6分钟对44.7±12.4分钟，P = 0.103），对抽脂腹壁成形术的手术时长也没有影响（107.3±20.5分钟对122.2±36.3分钟，P = 0.105）。
在一所学术机构的两例美容手术中，住院医师参与手术时手术时间有延长的趋势，但未达到统计学意义。本研究为关于住院医师培训对美容手术影响的文献增添了内容。
