Michael Bezuhly's research while affiliated with Dalhousie University and other places

Publications (112)

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Background : Improved patient safety (PS) in cosmetic breast surgery relies upon high quality evidence. The objective of this study was to systematically review existing evidence for PS and quality improvement (QI) in cosmetic breast surgery. Methods : A systematic review of published plastic surgery literature from 1965 to 2021 was undertaken thr...
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Background: Improving patient care and safety requires high-quality evidence. The objective of this study was to systematically review the existing evidence for patient safety (PS) and quality improvement initiatives in breast reconstruction. Methods: A systematic review of the published plastic surgery literature was undertaken using a computer...
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Due to resource restrictions related to the COVID-19 pandemic, many pediatric patients are facing substantial delays for surgery, potentially resulting in additional distress for caregivers. We aimed to assess the experiences and psychosocial distress of parents during COVID-19 as they relate to the pandemic, waiting for surgery, and the combined e...
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Background: Despite its increasing use in craniofacial surgery, the evidence for piezosurgery over conventional bone-cutting techniques has not been critically appraised. The purpose of this systematic review and meta-analysis was to identify and assess the evidence that exists for the use of piezosurgery in craniofacial surgery. Methods: A system...
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Objective The relationship between ankyloglossia and speech is controversial. The objective of this study was to determine the effect of tongue-tie release on speech articulation and intelligibility. Methods A prospective cohort study was conducted. Pediatric patients (>2 years of age) being referred for speech concerns due to ankyloglossia were a...
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Background: The last several decades have witnessed an increase in metopic craniosynostosis incidence. Population-based studies suggest that pharmacological exposure in utero may be responsible. This study examined effects of the fertility drug clomiphene citrate (CC) on calvarial development in an established model for craniofacial development, th...
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Objective Various devices and techniques have been proposed to reduce feeding difficulties experienced by infants with cleft palate. The aim of this review is to identify and assess the scope and quality of evidence for these interventions. Methods A systematic review of published literature evaluating feeding interventions for infants with cleft...
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Desmoid-type fibromatosis (DF) is a rare soft tissue lesion with an annual incidence of 2 to 4 per million population and peak incidence occurring at approximately 4.5 years of age. While benign, the tumor has a locally aggressive infiltrative growth pattern and a high rate of recurrence. Given the functional and aesthetic implications of excision...
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Background Abdominal adhesions (AAs) are post-traumatic fibrous bands that connect visceral and/or peritoneal surfaces, leading to possible long-term complications. The effect of a novel antifibrotic selective angiotensin II type 2 receptor agonist, compound 21 (C21) on AA formation was assessed in a murine model. Methods Female BALB/c mice were l...
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Background: Pre-operative anxiety in pediatric patients is a major concern in surgical care due to the future medical and behavioral consequences that can occur. The objective of this study was to understand the factors that lead to pre-operative anxiety before otoplasty. Methods: Participants at a Canadian pediatric hospital were identified to di...
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Objectives: Craniosynostosis is typically diagnosed and surgically corrected within the first year of life. The diagnosis and surgical correction of the condition can be a very stressful experience for families. Despite this, there is little research exploring the impact that craniosynostosis has on families, especially in the period immediately f...
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Objective To provide an inventory of oronasal fistula repair techniques alongside expert commentary on which techniques are appropriate for each fistula type. Design A 4-stage approach was used to develop a consensus on surgical techniques available for fistula repair: (1) in-person discussion of oronasal fistula cases among cleft surgeons, (2) de...
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Learning objectives: After studying this article, the participant should be able to: 1. Describe normal ear anatomy and development, and evaluate the patient's ears for differences in shape, size, prominence, and symmetry. 2. Identify common congenital ear deformities, including prominent ear, macrotia, Stahl ear, cryptotia, constricted ear, and l...
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Objective To compare the effectiveness of conventional (CF), laser (LF), and Z-plasty (ZF) frenotomies for the treatment of ankyloglossia in the pediatric population. Data Sources A comprehensive search of PUBMED, EMBASE, and COCHRANE databases was performed. Review Methods Relevant articles were independently assessed by 2 reviewers according to...
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BACKGROUND: The cost effectiveness of combining vascularized lymph node transfer (VLNT) with autologous breast reconstruction has not been established. Herein we describe the use of Markov modeling to evaluate the cost utility of VLNT with delayed autologous breast reconstruction for patients with breast cancer related lymphedema (BCRL). METHODS: W...
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Background: Autogenous costal cartilage grafts (ACCG) are frequently used in secondary rhinoplasty; however, these grafts tend to warp. The objective of this study is to systematically evaluate current interventions to prevent warping of ACCGs and to assess long-term outcomes with their use. Methods: A systematic review was undertaken using a co...
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Background: Inequities in health care predispose Indigenous populations to poor health outcomes. The objective of this study is to examine patient survival and other post-transplant outcomes of kidney transplantation among Indigenous patients compared to non-Indigenous populations. Methods: A systematic review of MEDLINE, Embase, and Google Scho...
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Objectives: Shared decision making describes a collaborative process in which healthcare providers and patients/families make treatment decisions using the best available evidence, while taking into account the patient's values and preferences. The objectives of this study were to assess the level of decisional conflict and shared decision-making...
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Background: Angiotensin II engagement of angiotensin II type 1 receptor (AT1R) is implicated in fibrogenesis, with AT1R blockers (ARB) used clinically to attenuate cardiac and renal fibrosis. The authors tested the hypothesis that the ARB losartan could reduce post-surgical cutaneous scarring in rats. Methods: Human dermal fibroblasts (HDFs) wer...
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Objectives: To explore weather seasonal variation in Necrotizing soft tissue infections (NSTI) in Halifax, Nova Scotia, Canada could be attributed to changes in environmental factors of temperature and humidity specifically. Methods: A retrospective chart review of NSTIs between 2001 and 2015. Regional temperature and humidity data were obtained...
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Background: Meta-analyses are common in the plastic surgery literature, but studies concerning their quality are lacking. The authors assessed the overall quality of meta-analyses in plastic surgery, and attempted to identify variables associated with scientific quality. Methods: A systematic review of meta-analyses published in seven plastic su...
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Background: Cell-assisted lipotransfer involves enrichment of autologous fat with supraphysiologic numbers of adipose-derived stem cells to improve graft take. Adipose-derived stem cells have been shown to promote cancer progression, raising concerns over the safety of adipose-derived stem cells and cell-assisted lipotransfer in postoncologic brea...
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Background: Unilateral coronal craniosynostosis is a challenging condition in craniofacial surgery. Frontoorbital advancement by single-stage resorbable remodeling and distraction osteogenesis (DO) techniques have known intraoperative differences, but their comparative outcomes are less well characterized. Methods: A systematic literature search...
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Wound closure strips are used in the repair of superficial, low tension wounds, lacerations, and surgical incisions.They represent an inexpensive, easy, and painless way to close such wounds or as an adjunct in a multi-layered closure. There is debate over correct orientation (transverse, oblique, zig-zag or parallel) and importance of wound closur...
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Objective:: To investigate parents' understanding of the risks of primary cleft palate surgery after counseling with and without the use of a written informational aid. Design:: Prospective, randomized, single-blind trial. Setting:: Academic tertiary care center. Participants:: Parents of children undergoing primary cleft palate surgery. In...
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Background: Establishing continuity of the cutaneous roll is critical to cleft lip repair. Unfortunately, this landmark can be difficult to appreciate depending on the patient's skin tone, surgical lighting, or preexisting scar. Solution: When applied to the lip, dilute povidone-iodine solution beads off the cutaneous roll and dry vermilion, cle...
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Background: Accurate knowledge of adverse events is critical for evaluation of the safety and efficacy of interventions. Historically, adverse events in surgical trials have been poorly reported. The objective of this study was to systematically evaluate the reporting of adverse events in randomized controlled trials (RCTs) in the plastic surgery...
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Objective: Using a well-established measure of attention, we aimed to objectively identify differences in severity between types of simulated secondary cleft lip deformities. Design: Volunteer participants viewed a series of images of a child digitally modified to simulate different secondary unilateral cleft lip deformities (long lip, short lip...
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Objective:: The current review and survey aim to assess the effectiveness of acellular dermal matrix (ADM) in the repair of cleft palate and oronasal fistula and to evaluate the current trends of ADM use in palate surgery. Design:: A systematic review of English articles was conducted using MEDLINE (1960 to July 1, 2016), the Cochrane Controlled...
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Objective: To describe characteristics of dog bites and their treatment in a pediatric population including infection, medical specialties involved, rates of admission, and need for surgery. Method: Patients presenting with a dog bite to the emergency department of a tertiary care pediatric hospital between January 1, 2015, and June 30, 2017, we...
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Background: The 2010 AJCC guidelines recommended consideration of sentinel lymph node (SLN) biopsy for thin melanoma (Breslow thickness < 1.0 mm) with aggressive pathological features such as ulceration and/or high mitotic rate. The therapeutic benefit of biopsy-based treatment remains controversial. The authors conducted a meta-analysis to estima...
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Activated platelets promote the proliferation and metastatic potential of cancer cells. Platelet activation is largely mediated through ADP engagement of purinergic P2Y12 receptors on platelets. We examined the potential of the reversible P2Y12 inhibitor ticagrelor, an agent used clinically to prevent cardiovascular and cerebrovascular events, to r...
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Background: Plastic surgery (PS) is considered to be one of the most competitive specialties. As a result, some students are discouraged from applying, reducing the overall number of PS candidates. Still, much of what we know of the match is based in conjecture. Objective: To examine the Canadian PS match data from 1997 to 2016. To our knowledge...
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Background: Although surgical excision and intralesional collagenase injection are mainstays in Dupuytren disease treatment, no effective medical therapy exists for recurrent disease. Compound 21, a selective agonist of the angiotensin II type 2 receptor, has been shown to protect against fibrosis in models of myocardial infarction and stroke. The...
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Background: The p-value is one of the most utilized descriptors in statistical analysis; however, when reported in isolation, it does not convey the effect size of a treatment. The reporting of confidence intervals (CIs) is an essential adjunct to determine the clinical value of treatment, as it permits an assessment of the effect size. The author...
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OBJECTIVE Sagittal craniosynostosis results in a characteristic scaphocephalic head shape that is typically corrected surgically during a child’s 1st year of life. The authors’ objective was to determine the potential impact of being born with sagittal craniosynostosis by using validated health state utility assessment measures. METHODS An online...
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Background Acellular dermal matrices are increasingly used in laryngotracheal and pharyngeal reconstruction, but specific indications and the type of acellular dermal matrix used vary. The authors systematically reviewed outcomes relating to acellular dermal matrix use in head and neck reconstruction. Methods Electronic databases were searched thr...
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Objectives/hypothesis: Mandibular distraction osteogenesis (MDO) involves a lengthy consolidation phase where complications can occur. Strontium is an element that has been shown to improve bone healing. The objective of this study was to determine whether strontium citrate can be used to enhance bone healing during MDO in a rabbit model. Study d...
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Background Brachial plexus birth palsy (BPBP) affects close to 1.5 in 1,000 live births and can lead to significant functional impairment and reduced quality-of-life. To date, studies have focused on grading motor function and strength to assess patient outcomes, with less attention paid to sensory recovery. The authors aimed to systematically revi...
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Objective: Research sets the foundation for developing plastic surgeons who think critically and approach clinical practice with an inquisitive mind. The objective of this study was to characterize current attitudes and perceived barriers towards conducting research during residency. Design: A validated 36-item questionnaire was developed by a n...
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Background: Written information has been thought to help patients recall surgical risks discussed during the informed consent process, but has not been assessed for carpal tunnel release, a procedure with the rare but serious risk of complex regional pain syndrome. The authors' objective was to determine whether providing a pamphlet would improve...
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Clinical experience suggests that flap failure after autologous breast reconstruction can be a devastating experience for women. Previous research has examined women's experiences with autologous breast reconstruction with and without complications, and patients' experiences with suboptimal outcomes from other medical procedures. The authors aimed...
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PURPOSE: The p-value is one of the most utilized descriptors in statistical analysis; however, when reported in isolation, it does not convey the effect size of a treatment.1,2 The reporting of confidence intervals is an essential adjunct to determine the clinical value of a treatment, as it permits an assessment of the effect size.1,3 The objectiv...
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Unicoronal craniosynostosis predisposes to ophthalmologic abnormalities such as strabismus, astigmatism, and amblyopia. The authors explored the ophthalmologic outcomes following fronto-orbital advancement (FOA). A systematic search of PubMed, Embase, and the Cochrane Library was conducted. Included studies reported postoperative rates of strabismu...
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Background: In chronic disease management, shared medical appointments have been shown to improve clinic access, productivity and patient education. However, adoption of this model in surgical consultation is limited, and its effect on surgical patients' satisfaction, comfort and surgical risk recall is unknown. Objective: To determine whether s...
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Microtia is associated with psychosocial burden and stigma. The authors' objective was to determine the potential impact of being born with microtia by using validated health state utility assessment measures. An online utility assessment using visual analogue scale, time tradeoff, and standard gamble was used to determine utilities for microtia wi...
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Background In chronic disease management, shared medical appointments have been shown to improve clinic access, productivity and patient education. However, adoption of this model in surgical consultation is limited, and its effect on surgical patients' satisfaction, comfort and surgical risk recall is unknown. Objective To determine whether share...
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Objectives/hypothesis: Reconstruction of cartilage defects in the head and neck can require harvesting of autologous cartilage grafts, which can be associated with donor site morbidity. To overcome this limitation, tissue-engineering approaches may be used to generate cartilage grafts. The objective of this study was to decellularize and character...
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Author Information Winnipeg, Manitoba, and Halifax, Nova Scotia, Canada From the Section of Plastic Surgery, Department of Surgery, University of Manitoba; the Department of Occupational Therapy and the Division of Plastic and Reconstructive Surgery, IWK Health Centre; and the Department of Surgery, Dalhousie University. Received for publication Ma...
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Sagittal craniosynostosis remains the most common type of isolated craniosynostosis, accounting for nearly half of all nonsyndromic cases. The clinical diagnosis is typically made on the basis of a scaphocephalic head shape and is confirmed by computed tomography or magnetic resonance imaging. The current review examines the major surgical options...
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BACKGROUND Selecting candidates for plastic surgery residency training remains a challenge. In the United States, academic measures (United States Medical Licensing Exam Step I scores, medical school class rank and publications) are used as primary criteria for candidate selection for residency. In contrast, Canadian medical education de-emphasizes...
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Background Selecting candidates for plastic surgery residency training remains a challenge. In the United States, academic measures (United States Medical Licensing Exam Step I scores, medical school class rank and publications) are used as primary criteria for candidate selection for residency. In contrast, Canadian medical education de-emphasizes...
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Background and aim: When observing new faces, most people focus their attention on the central triangle of the face containing the eyes, nose and mouth. When viewing faces with prominent ears, observers may divert their attention from the central triangle. The objective of this study was to determine whether there was an objective attentional bias...
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Autologous fat grafting is a popular reconstructive technique, but is limited by inconsistent graft retention. The authors examined whether a widely available, clinically safe antioxidant, N-acetylcysteine, could improve adipose-derived stem cell survival and graft take when added to tumescent solution during fat harvest. Inguinal fat pads were har...
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Velopharyngeal insufficiency and chronic otitis media with effusion following primary cleft palate repair can be attributed to persistent abnormalities in the levator and tensor veli palatini muscles, respectively. The purpose of this case-control study was to examine the association between otitis media with effusion requiring myringotomy tubes an...
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Objective . Few Canadian studies have examined the relationship between socioeconomic status (SES) and incidence of burn injury. We seek to evaluate this relationship using median income as a measure of SES in Nova Scotia, Canada. Methods . Nova Scotia residents admitted to the Queen Elizabeth II burn unit in Halifax, Nova Scotia, from 1995 to 2012...
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To assess the impact that septoplasty had on health-related quality of life (HRQoL) in paediatric patients and to determine if there were patient characteristics that predicted better outcomes. Academic paediatric otolaryngology practice. Retrospective cohort study. All paediatric patients who underwent septoplasty during the study period were incl...
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Debate remains over the optimal timing of breast reconstruction after mastectomy. Immediate reconstruction has demonstrated superior psychosocial and aesthetic outcomes, but might delay adjuvant therapy. Conversely, delayed reconstruction allows for timely initiation of adjuvant therapy, but with potentially inferior aesthetic results. The authors...