Browsing by Author "Wooden, William A."

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    Age at Diagnosis as a Relative Contraindication for Intervention in Facial Nonmelanoma Skin Cancer
    (American Medical Association, 2018-04-01) Chauhan, Ruvi; Munger, Brook N.; Chu, Michael W.; Munshi, Imtiaz; Cohen, Adam C.; Wooden, William A.; Tholpady, Sunil S.; Surgery, School of Medicine
    Facial nonmelanoma skin cancers (fNMSCs), consisting of basal cell carcinoma and squamous cell carcinoma, are the most common cancers diagnosed worldwide and increase with age. Standard treatment for fNMSCs requires biopsy for pathological confirmation, followed by excision. Excision can lead to a pathological diagnosis of no residual carcinoma (NRC) due to no identifiable carcinoma within the excisional specimen. This situation can occur owing to wound healing in the specimen clearing the carcinoma or to the original biopsy shaving off the entire lesion. This study assesses the utility of excising fNMSCs according to age, with the hypothesis that the indolent nature of fNMSCs and the high NRC rate, coupled with increasing age-related all-cause mortality, should cause the surgeon to counsel patients differently. Such counseling may prevent surgery among elderly patients (>90 years) who may never see a benefit from fNMSC excision.
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    Assessing the Necessity of Stopping Antithrombotic Agents Before Wide-Awake Hand Surgery
    (American Medical Association, 2018-03-01) Sasor, Sarah E.; Evans, Tyler A.; Cook, Julia A.; Lucich, Elizabeth A.; Wooden, William A.; Tholpady, Sunil S.; Chu, Michael W.; Surgery, School of Medicine
    This review of 304 carpal tunnel release procedures examines the necessity of stopping antithrombotic medications prior to carpal tunnel release surgery.
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    Congenital ichthyosis patient with squamous cell carcinoma of the skin who received concurrent chemoradiation: A case report
    (Elsevier, 2017-09-05) Cerra-Franco, Alberto; Grethlein, Sara J.; Bertrand, Todd E.; Wooden, William A.; Saito, Naoyuki G.; Radiation Oncology, School of Medicine
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    Management of the Pressure Injury Patient with Osteomyelitis: An Algorithm
    (Elsevier, 2017) Nicksic, Peter J.; Sasor, Sarah E.; Tholpady, Sunil S.; Wooden, William A.; Gutwein, Luke G.; Department of Surgery, School of Medicine
    Pressure injury (PI) is a common complication of inpatient care, affecting an estimated 3 million patients annually in the US. Risk factors include immobility, compromised sensation, malnutrition, urinary or fecal incontinence, and chronic medical illness. Compliance with established guidelines (pressure off-loading, skin care, and frequent inspection) is imperative for the prevention of hospital-acquired PI. Unavoidable PI does occur at times, and is often related to advanced medical illness. Pressure injury complicated by osteomyelitis (OM) can develop in patients with physiologic, behavioral, or treatment-related risk factors, despite the adherence to current standards of prevention.
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    P29. Shifting Applicant Attitudes Towards Virtual Plastic Surgery Residency Interviews
    (Wolters Kluwer, 2022-06-02) Bhagat, Neel; Bamba, Ravinder; Gross, Jeffrey; Hassanein, Aladdin H.; Wooden, William A.; Surgery, School of Medicine
    Background: The COVID-19 pandemic has forced plastic surgery residency programs to transition to virtual interviews for recruitment. In addition to reducing risks of COVID-19 exposure by minimizing travel, virtual interviews are more cost effective and less time consuming for applicants. However, virtual interviews make personal interactions with faculty and residents more challenging for applicants. Assessment of the location and hospital setting is also hindered. This impedes an applicant’s ability to potentially evaluate a program effectively. The purpose of this study is to evaluate the 2021 integrated plastic surgery applicant attitudes towards the current virtual interview process Methods: We surveyed 2021 applicants to our integrated plastic surgery program who interviewed virtually (n=32). Virtual Interview Survey. Applicants were surveyed on how well they became acquainted with our program, faculty, and residents on a scale from 1-5 Results: The survey response was 43.8% (14/32). Most respondents did not have a preference between virtual and in-person interviews (57.1%, n=8). On average, respondents were satisfied with the virtual interview process, rating their overall experience 8.4 (± 1.3) of 10. Applicants responded that they became acquainted with our program, faculty, and residents with respective scores of 3.9 (± 0.62), 3.7 (± 0.73), and 3.6 (± 1.01) on a scale of 1-5. Most applicants did not believe that either a virtual or in-person interview resulted in an advantage to matching (57.1%, n=8). Most applicants responded that virtual interviews allow the opportunity to attend more interviews (78.6%, n=11). Conclusion: We previously published survey data comparing virtual and in-person interviews in the 2020 plastic surgery match during the abrupt transition to virtual interviews during the onset of the pandemic. That study demonstrated lower scores for virtual interviews compared to in-person. However, this survey indicates that applicant attitudes have shifted. Overall, applicants scored the virtual interview process positively in 2021. With the efficiency and financial advantage that virtual interviews offer, it is possible they can become part of the residency selection process even after pandemic restrictions are lifted. Given these findings, residency programs should work on optimizing the virtual interview process.
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    Patient-Reported Outcomes and Factors Associated With Patient Satisfaction After Surgical Treatment of Facial Nonmelanoma Skin Cancer
    (American Medical Association, 2019-02-01) Sasor, Sarah E.; Cook, Julia A.; Loewenstein, Scott N.; Wooden, William A.; Cohen, Adam C.; Chu, Michael W.; Tholpady, Sunil S.; Surgery, School of Medicine
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    Tourniquet Use in Wide-Awake Carpal Tunnel Release
    (Sage, 2020-01) Sasor, Sarah E.; Cook, Julia A.; Duquette, Stephen P.; Lucich, Elizabeth A.; Cohen, Adam C.; Wooden, William A.; Tholpady, Sunil S.; Chu, Michael W.; Surgery, School of Medicine
    Background: Carpal tunnel syndrome is a common cause of upper extremity discomfort. Surgical release of the median nerve can be performed under general or local anesthetic, with or without a tourniquet. Wide-awake carpal tunnel release (CTR) (local anesthesia, no sedation) is gaining popularity. Tourniquet discomfort is a reported downside. This study reviews outcomes in wide-awake CTR and compares tourniquet versus no tourniquet use. Methods: Wide-awake, open CTRs performed from February 2013 to April 2016 were retrospectively reviewed. Patients were divided into 2 cohorts: with and without tourniquet. Demographics, comorbidities, tobacco use, operative time, estimated blood loss, complications and outcomes were compared. Results: A total of 304 CTRs were performed on 246 patients. The majority of patients were male (88.5%), and the mean age was 59.9 years. One hundred patients (32.9%) were diabetic, and 92 patients (30.2%) were taking antithrombotics. Seventy-five patients (24.7%) were smokers. A forearm tourniquet was used for 90 CTRs (29.6%). Mean operative time was 24.97 minutes with a tourniquet and 21.69 minutes without. Estimated blood loss was 3.16 mL with a tourniquet and 4.25 mL without. All other analyzed outcomes were not statistically significant. Conclusion: Operative time was statistically longer and estimated blood loss was statistically less with tourniquet use, but these findings are not clinically significant. This suggests that local anesthetic with epinephrine is a safe and effective alternative to tourniquet use in CTR. The overall rate of complications was low, and there were no major differences in postoperative outcomes between groups.
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    The Veterans Affairs Medical Center's Contribution to Plastic Surgery Education
    (American Medical Association, 2018-03-01) Sasor, Sarah E.; Chu, Michael W.; Evans, Tyler A.; Cook, Julia A.; Wooden, William A.; Cohen, Adam C.; Tholpady, Sunil S.; Surgery, School of Medicine
    Veterans Affairs (VA) medical centers have played a major role in graduate medical education since the 1940s. Currently, the VA health system operates 168 medical centers across the United States and supports the clinical training of more than 41 200 medical residents annually. Teaching hospitals within the VA provide subspecialty medical and surgical care and perform the majority of complex and high-risk surgical procedures. The diversity of pathologic conditions requiring a plastic surgery skill set are prominent within the VA population: cancer reconstruction, hand surgery, facial fractures, and burn care. Educational opportunities are ample. Plastic surgery residents in university-based training programs typically rotate at the VA hospital for several months each year. This study examines the relationship between the plastic surgery service and resident education within the VA hospitals.
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    Virtual Interviews for the Independent Plastic Surgery Match: A Modern Convenience or a Modern Misrepresentation?
    (Elsevier, 2020-09-18) Bamba, Ravinder; Bhagat, Neel; Tran, Phu C.; Westrick, Evan; Hassanein, Aladdin H.; Wooden, William A.; Surgery, School of Medicine
    Objective: The virtual interview for residency and fellowship applicants has previously been utilized preliminarily in their respective processes. The COVID-19 pandemic forced many programs to switch to a virtual interview process on short notice. In the independent plastic surgery process, which was underway when the pandemic started, applicants had a heterogeneous experience of in-person and virtual interviews. The purpose of this study was to assess if applicants prefer a virtual interview experience to an in-person interview as well as determine if virtual interview applicants had a different opinion of a program compared to the in-person interview applicants. Design/Setting/Participants: The 2019 to 2020 applicants who interviewed at the Indiana University Independent Plastic Surgery program were administered an anonymous online survey about their interview experience at our program. Results: Our survey response was 60% (18/30). The in-person interview group (n = 10) rated their overall interview experience higher than the virtual interview group (n = 8) 8.8 vs 7.5 (p = 0.0314). The in-person interview group felt they became more acquainted with the program, the faculty, and the residents more than the virtual group (4.7 vs 3.25, p < 0.0001) (4.3 vs 3.25, p = 0.0194) (4.3 vs 2.75, p < 0.0001). The majority of applicants favored in-person interviews (16/18, 88.9%). The in-person interview group spent significantly more money on their interview at our program compared to the virtual interview group ($587 vs $0, p < 0.0001). Conclusion: Our study demonstrated that the virtual interview process was an efficient process for applicants from both a financial and time perspective. However, the virtual interview process left applicants less satisfied with their interview experience. The applicants felt they did not become as acquainted with the program as their in-person counterparts. The virtual interview process may play a large role in residency and fellowship applications in the future, and programs should spend time on how to improve the process.
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    The Virtual Visiting Professor: Temporary Form of COVID-19 Social Distancing or Potential Paradigm Shift?
    (American Society of Plastic Surgeons, 2021-10) Bamba, Ravinder; Tran, Phu C.; Lester, Mary E.; Wooden, William A.; Gordillo, Gayle M.; Hadad, Ivan; Hassanein, Aladdin H.; Medicine, School of Medicine