The Level of Evidence Pyramid: Indicating Levels of Evidence in Plastic and Reconstructive Surgery Articles

Sullivan, Daniel C.; Chung, Kevin C.; Eaves, Felmont F.; Rohrich, Rod J.

doi:10.1097/prs.0b013e3182195826

Cited by 189 publications

(117 citation statements)

References 4 publications

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“…A quality score was calculated for each article utilizing a checklist from the American Society of Plastic Surgeons (ASPS) guidelines for therapeutic studies. 16,17 Rating decisions were based on consensus of all 4 co-authors.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…Level of evidence16 from articles is presented.IHigh-quality, multicenter or single-center, randomized controlled trial with adequate power; or systematic review of these studies II Lesser-quality, randomized controlled trial; prospective cohort or comparative study; or systematic review of these studies III Retrospective cohort or comparative study; case-control study; or systematic review of these studies IV Case series with pre/post test or only post test V Expert opinion developed via consensus process; case report or clinical example; or evidence based on physiology, bench research, or "first principles"…”

mentioning

confidence: 99%

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Free vascularized lymph node transfer for treatment of lymphedema: A systematic evidence based review

Öztürk

Glasgow

et al. 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Section: Quality Assessmentmentioning

confidence: 99%

mentioning

confidence: 99%

Free vascularized lymph node transfer for treatment of lymphedema: A systematic evidence based review

Öztürk

Glasgow

et al. 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…The quality of the studies was rated based on the levels of evidence grading system recommended by the American Society of Plastic Surgeons (Table 3). 13 …”

Section: Methodsmentioning

confidence: 99%

A Systematic Review of Outcomes Following Repair of Complex Ventral Incisional Hernias With Biologic Mesh

Ferzoco¹

2013

International Surgery

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Repair of contaminated/infected ventral incisional hernias is marked by high rates of recurrence, complications, and/or explantation of synthetic mesh. Biologic mesh products are recommended for repair to permit reconstruction and reduce complications. A systematic review of PubMed, EMBASE, and Cochrane databases identified Englishlanguage articles reporting postoperative outcomes (e.g., hernia recurrence, infection, mesh explantation) in patients undergoing contaminated/infected ventral incisional herniorrhaphy. Eleven studies met inclusion criteria and contained quantitative outcome data. All were retrospective chart reviews of biologic mesh use (mostly human acellular dermal matrix). Hernia recurrence and wound infection rates were highly variable and inconsistently reported across studies. Mesh explantation was rarely reported. Outcome variability is likely owing to heterogenous patient populations, surgical technique variations, and follow-up duration. Biologic mesh use in contaminated/infected herniorrhaphy was marked by low reported rates of secondary surgeries for infected mesh removal. Data from large, well-controlled, prospective trials with biologic mesh products are needed.

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“…The articles were classified according to their level in the evidence pyramid, 5 which varies in descending order from I to V, as can be seen in Table 2. Certain studies cannot be classified based on this classification, as is the case of animal studies, cadaver studies, review articles, letters and editorials.…”

Section: Methodsmentioning

confidence: 99%

Evidences of autologous fat grafting for the treatment of keloids and hypertrophic scars

Silva

Neto

Horácio

et al. 2016

Rev. Assoc. Med. Bras.

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SUMMARY Introduction Since the 1980s, the use of autologous fat grafting has been growing in plastic surgery. Recently, this procedure has come to be used as a treatment for keloids and hypertrophic scars mainly due to the lack of satisfactory results with other techniques. So far, however, it lacks more consistent scientific evidence to recommend its use. The aim of this study was to review the current state of autologous fat grafting for the treatment of keloids and hypertrophic scars, their benefits and scientific evidences in the literature. Method A review in the Pubmed database was performed using the keywords “fat grafting and scar”, “fat grafting and keloid scar” and “fat grafting and hypertrophic scar.” Inclusion criteria were articles written in English and published in the last 10 years, resulting in 15 studies. Results These articles indicate that autologous fat grafting carried out at sites with pathological scars leads to a reduction of the fibrosis and pain, an increased range of movement in areas of scar contraction, an increase in their flexibility, resulting in a better quality of scars. Conclusion So far, evidences suggest that autologous fat grafting for the treatment of keloids and hypertrophic scars is associated with a better quality of scars, leading to esthetic and functional benefits. However, this review has limitations and these findings should be treated with reservations, since they mostly came from studies with low levels of evidence.

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The Level of Evidence Pyramid: Indicating Levels of Evidence in Plastic and Reconstructive Surgery Articles

Cited by 189 publications

References 4 publications

Free vascularized lymph node transfer for treatment of lymphedema: A systematic evidence based review

Free vascularized lymph node transfer for treatment of lymphedema: A systematic evidence based review

A Systematic Review of Outcomes Following Repair of Complex Ventral Incisional Hernias With Biologic Mesh

Evidences of autologous fat grafting for the treatment of keloids and hypertrophic scars

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