A Scientometric Analysis of 20 Years of Research on Breast Reconstruction Surgery: A Guide for Research Design and Journal Selection

BACKGROUND: Breast reconstruction refers to the rebuilding of a woman's breast using autologous tissue or prosthetic material to form a natural-looking breast. It is increasingly offered to women undergoing mastectomy for breast cancer. However, there is no systematic analysis available for the expanding area of research on breast reconstruction. METHODS: A bibliometric method was used to obtain a view of the scientific production about breast reconstruction by data extracted from the Institute for Scientific Information (ISI). Specific parameters were retrieved from the ISI. Articles about breast reconstruction were analyzed to obtain a view of the topic's structure, history, and document relationships using HistCite software. Trends in the most influential publications and authors were analyzed. RESULTS: The number of articles was constantly increasing. Most highly cited articles described the methods of flap construction in the surgery. Other highly cited articles discussed the psychological or emotional aspects of breast reconstruction, skin sparing mastectomy, and breast reconstruction in the irradiated breast. CONCLUSIONS: This was the first breast reconstruction scientometric analysis, representing the characteristics of papers and the trends of scientific production. A constant increase in the number of breast reconstruction papers and also the increasing number of citations shows that there is an increasing interest in this area of medical science. It seems that most of the research in this field is focused on the technical aspects of surgery.

Short term outcome of treatment of femoral shaft fractures in children by two methods: Traction plus casting, versus intramedullary pin fixation - A comparative study

There is no consensus on treatment of closed femoral shaft fractures in children 6-12 years old .The aim of this study was to evaluate and compare the short term results of pediatric femoral shaft fractures at above ages with two different methods of treatment: skeletal traction followed by a hip spica cast and surgical treatment by intramedullary pin fixation and to determine which of these methods results in earlier union of fracture and independent ambulation of the patients. This study was performed prospectively at two hospitals during a period of 32 months from 2003 through 2006. Sixty six children with closed fractures of the femoral shaft were treated and followed at least through the time of fracture healing, spica cast removal and onset of unprotected walking in two separate groups: [A] skeletal traction by 90 - 90 technique followed by spica cast [n=30], [B] open reduction and internal fixation with intramedullary pin and cast [n=36]. The length of hospital stay, casting period, union of fractures, time to start walking and the rate of complications was evaluated and compared using Chi-Squar test. Mean age of all patients was 7.4 years old. Average follow-up was 6 months. Healing of the fractures was observed in all cases of both groups between 8 and 12 weeks. The length of immobilization was longer in traction versus surgery group. Average treatment duration from admission to hospital till independent walking was 75.3 days for the traction and 61.2 days for surgery group. Limb shortening and malrotation were more in traction versus intramedullary pin patients. Both methods of traction plus spica casting and intramedullary pinning can be used to treat femoral shaft fractures in 6-11 years old children. Intramedullary pin due to its less hospital stay, earlier walking and less complication rates can be used as the first choice in treatment of this fracture at school aged children

Treatment of infected pseudoaneurysm in drug abusers: ligation or reconstruction?

Recently, there has been an increase in the incidence of major vascular complications such as infected pseudoaneurysm due to intravenous drug use. For better understanding of the existing controversies regarding the optimal surgical management of infected pseudoaneurysm, the present study was conducted. Medical charts of 36 consecutive patients who underwent surgery in Taleghani Hospital, Tehran, Iran from 1996 through 2003, were retrospectively analyzed. We studied the hospital records of 33 cases; two patients had bilaterally infected pseudoaneurysms and one underwent an emergency reoperation. The total number of operations was 36. Eleven cases [30.5%] underwent ileofemoral reconstruction and 25 [69.5%] arteries were ligated. All patients presented with infected femoral or brachial pseudoaneurysms due to intravenous drug abuse. Postoperatively, there was no hemorrhage, vascular thrombosis, amputation, or mortality. Three cases [8%] had incisional infections [2 [18%] after reconstruction and 1 [4%] after ligation operation] and 7 patients [19%] had claudication [all after ligation]. Ligation is the optimal management for infected pseudoaneurysm, because it is easy, cost-effective, and safe. Reconstruction is not recommended, because of an extended infection at the location of pseudoaneurysm and at the artificial graft site