A Novel Approach for the Treatment of Spider Veins.

BACKGROUND: Spider veins on the lower limbs are very common and have been reported to be present in 41% of women over 50. Sclerotherapy as a traditional treatment for spider veins has a low cost, though it may have adverse sequelae. Lasers have shown fewer but still substantial complications as well. Its lower efficacy relative to sclerotherapy has limited laser application for the treatment of spider veins. OBJECTIVES: To present a new alternative in management of spider veins which involves a low voltage current delivered via an insulated micro needle with beveled tip. METHODS: Thirty female patients were treated with the "Given Needle." The technique utilizes a micro needle with an insulated shaft with an exposed beveled tip, which is inserted into a hand piece connected to a mono-polar electrical generator. The needle is introduced through the skin into or on the spider vein. The current is then applied with obliteration of the vein. RESULTS: Twenty patients (66%) had more than a 70% resolution. The most common complication was skin erythema, which developed in 15 patients, followed by bruising in 13 patients. Both of these complications resolved in 2-3 weeks. CONCLUSIONS: A novel approach for the treatment of spider veins has been described. The development of an insulated micro needle with an exposed beveled tip utilizing low current has minimized adjacent tissue damage and improved efficacy. The low cost, low level of complications, and comparable results offer a valuable alternative to sclerotherapy and laser treatment.

The independent plastic surgery match: an in-depth analysis of the applicants and process.

BACKGROUND: The independent plastic surgery match is an extremely competitive process that remains the most common training model for residents. The purpose of this study was to analyze the candidates and the overall process, both quantitative and qualitatively. METHODS: Between 2006 and 2008, an anonymous 25-question online survey was sent to all applicants of the match. Questions regarding demographics, the match process, financial burden, and qualitative issues were all included. Information from the American Board of Plastic Surgery and The San Francisco Match was also used to evaluate the application and distribution process. RESULTS: A total of 137 applicants responded (29.2% response rate). Of the responders, 62.5% were aged 30 to 34 years, 77.2% male, 66.2% white, 94.1% in general surgery residencies, and 66.2% at an academic setting, with 39.7% at an institution that also had a plastic surgery residency program. For successful matchers, an average of 13.6 invitations were awarded, 10.02 interviews were attended, and they matched to number 2.52 on their list. Of all, 64.5% spent more than $4000 on the process, whereas 9.2% spent more than $10,000. Applicants receiving 1 to 4, 5 to 9, and 10 or more interviews had successful match rates of 47.2%, 62.9%, and 92.9%, respectively. In all, 45% of unsuccessful applicants stated that the stress on themselves and their family was the number one reason to not reapply. CONCLUSIONS: Candidates applying to the independent plastic surgery match need to be aware of the competitiveness and financial commitment the process requires.