Papers by Giancarlo McEvenue
Plastic surgery as a specialty has embraced evidencebased medicine. 1,2 With innovation at their ... more Plastic surgery as a specialty has embraced evidencebased medicine. 1,2 With innovation at their core, plastic surgeons are striving to increase the levels of evidence in their specialty. This paradigm shift to evidence-based medicine has the potential to improve quality of care and patient safety in areas traditionally lacking evidence such as aesthetic surgery. Aesthetic surgery however is often performed in nontraditional settings for research such as private offices and ambulatory surgery centers independent of larger institutions. Many jurisdictions have medical professional society as well as healthcare government regulated oversight and regulations to safeguard patient safety and maintain standards of clinical care in such independent healthcare facilities. However, no readily identifiable systems to safeguard ethical conduct of research in these same facilities is generally present. Regardless of the location, all human research must be reviewed and approved by an Institutional Review Board (IRB) prior to study initiation. Unfortunately, private facilities typically do not have easy access to an IRB, making approval and oversight difficult to obtain. Obtaining an IRB for plastic surgeons in private practice is often a convoluted process and creates an obstacle in producing research and, in turn, improving the standards of care in aesthetic surgery. Several options exist for ethics board approval after determining whether the study requires it. This article will outline the function of an IRB, when one is required, and the IRB options that are available. In doing so, we hope to clarify some of the issues surrounding the IRB for plastic surgeons in private practice.
The internet and social media are increasingly being used by patients not only for health-related... more The internet and social media are increasingly being used by patients not only for health-related research, but also for obtaining information on their surgeon. Having an online presence via a website and social media profile is one-way plastic surgeons can meet this patient driven demand. The authors sought to document current website and social media usage of Canadian plastic surgeons and to determine if this usage correlated with years in practice. A Google search was performed using publicly available lists of all plastic surgeons registered with the Royal College of Physicians and Surgeons of Canada (RCPSC) and the Canadian Society for Aesthetic Plastic Surgery (CSAPS). This search found 42% (268/631) of RCPSC plastic surgeons had a website and 85% (536/631) had a profile on social media. Younger RCPSC surgeons (registered for less years) were significantly more likely to have a website (12.8 vs. 21.9 years, P < 0.0001) and an active social media profile (16.2 vs. 23.9 years, P < 0.002). The social media platform most used was RateMDs (81%) followed in decreasing order by: LinkedIn (28%), RealSelf (22%), Facebook (20%), Google+ (17%) and Twitter (16%). Dual RCPSC-CSAPS members were more likely than RCPSC-only members to have a website (56 vs. 36%, P < 0.0001) and an active social media profile (P < 0.05). Overall, current website usage and social media presence by Canadian plastic surgeons is comparable to counterparts in the US and UK. It may be possible to better optimize online presence through education of current search engine technology and becoming active on multiple social media platforms.
Background: Hand trauma is a top presenting complaint to hospital emergency departments (EDs) and... more Background: Hand trauma is a top presenting complaint to hospital emergency departments (EDs) and can become costly if not treated effectively. The cornerstone for initial management of the traumatized hand is application of a splint. Improving splinting practice could potentially produce tangible benefits in terms of quality of care and costs to society. Objectives: We sought to determine the following: 1) whether the present standard of ED splint-ing was appropriate and 2) whether a strategically planned educational intervention could improve the existing care. Methods: We used a pre-and postprospective educational intervention study design. In the preintervention phase, patients referred to our hand clinic were assessed for injury and splint type. Splinting appropriateness was evaluated according to a predetermined hand surgeons' expert consensus. Next, an educational intervention was targeted at all ED staff at our institution. Postintervention, all patients were again evaluated for splint appropriateness. A follow-up evaluation was performed at 1 year to see the long-term effects of the intervention. Results: The most common mechanism of injury of referred patients was falling (35%), and the most frequent injury was metacarpal fracture (40%). Splint appropriateness increased significantly postintervention from 49% to 69% (p = 0.048). At follow-up after 1 year, splinting appropriateness was 70% (p = 0.041). Conclusion: Appropriate hand splinting practice is essential for hand trauma management. Our results show that an educational intervention can successfully improve splinting practice. This quality of care initiative was low-cost and demonstrated persistence at 1 year of follow-up.
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Papers by Giancarlo McEvenue