Breast Microsurgery in Plastic Surgery Literature: A 21-Year Analysis of Publication Trends

Abstract

Introduction Microsurgical reconstruction of the breast represents an area of continual evolution, as new autologous flaps are introduced and principles are refined. This progression can be demonstrated by bibliometric analysis of the scientific literature.

Methods The top 10 plastic surgery journals were determined by impact factor (IF). Each issue of every journal from 1993 to 2013 was accessed directly, and all articles discussing microsurgery on the female breast were classified by authors' geographic location, study design, and level of evidence (LOE, I–V). The productivity index and productivity share of each geographic region was calculated based on number of articles published and IF.

Results A total of 706 breast microsurgery articles were analyzed. There was a significant increase in microsurgical breast research (p < 0.01), with an average 33.6 ± 31.1 articles per year and a mean increase of 4.4 articles per year. Most research was of lower LOE, with level I constituting 0.14% and level II constituting 5.21% of all articles. United States contributed the most research with 336.4 articles, followed by Western Europe with 242.2. However, Western Europe experienced the greatest increase in productivity share, with + 0.50 ± 0.29 growth, while United States demonstrated the greatest decrease in productivity share with − 1.23 ± 0.31 growth. Among autologous flaps, transverse rectus abdominis muscle research had the greatest yearly publication volume until 2002, when overtaken by deep inferior epigastric perforator flap research.

Conclusion Over the 21-year study period, the United States not only contributed the greatest volume of research on female breast microsurgery but also demonstrated the greatest decline in research productivity. Efforts should be made to increase the LOE in breast microsurgery research.

Keywords

bibliometry - microsurgery - breast microsurgery - plastic surgery literature - trends

• References

• 1 Ahn CS, Li RJ, Ahn BS, Kuo P, Bryant J, Day CS. Hand and wrist research productivity in journals with high impact factors: a 20 year analysis. J Hand Surg Eur Vol 2012; 37 (3) 275-283
• 2 Antoniou SA, Lasithiotakis K, Koch OO, Antoniou GA, Pointner R, Granderath FA. Bibliometric analysis of scientific contributions in minimally invasive general surgery. Surg Laparosc Endosc Percutan Tech 2014; 24 (1) 26-30
• 3 Mahon NA, Joyce CW. A bibliometric analysis of the 50 most cited papers in cleft lip and palate. J Plast Surg Hand Surg 2015; 49 (1) 52-58
• 4 Gast KM, Kuzon Jr WM, Waljee JF. Bibliometric indices and academic promotion within plastic surgery. Plast Reconstr Surg 2014; 134 (5) 838e-844e
• 5 Labanaris AP, Vassiliadu AP, Polykandriotis E, Tjiawi J, Arkudas A, Horch RE. Impact factors and publication times for plastic surgery journals. Plast Reconstr Surg 2007; 120 (7) 2076-2081
• 6 Sullivan D, Chung KC, Eaves III FF, Rohrich RJ. The level of evidence pyramid: indicating levels of evidence in Plastic and Reconstructive Surgery articles. Plast Reconstr Surg 2011; 128 (1) 311-314
• 7 Rohrich RJ, Eaves III FF. So you want to be an evidence-based plastic surgeon? A lifelong journey. Plast Reconstr Surg 2011; 127 (1) 467-472
• 8 Eaves III FF, Rohrich RJ. So you want to be an evidence-based plastic surgeon? A lifelong journey. Aesthet Surg J 2011; 31 (1) 137-142
• 9 Granzow JW, Levine JL, Chiu ES, Allen RJ. Breast reconstruction with the deep inferior epigastric perforator flap: history and an update on current technique. J Plast Reconstr Aesthet Surg 2006; 59 (6) 571-579
• 10 Sullivan SK, Dellacroce F, Allen R. Management of significant venous discrepancy with microvascular venous coupler. J Reconstr Microsurg 2003; 19 (6) 377-380
• 11 Information of S. Journal Citation Reports®, Thomson Reuters . Available at: http://thomsonreuters.com/journal-citation-reports/ . Accessed 2014
• 12 Rosmarakis ES, Vergidis PI, Soteriades ES, Paraschakis K, Papastamataki PA, Falagas ME. Estimates of global production in cardiovascular diseases research. Int J Cardiol 2005; 100 (3) 443-449
• 13 Falagas ME, Papastamataki PA, Bliziotis IA. A bibliometric analysis of research productivity in Parasitology by different world regions during a 9-year period (1995-2003). BMC Infect Dis 2006; 6: 56
• 14 American Society of Plastic Surgeons. Plastic Surgery Statistics Report . Available at: http://www.plasticsurgery.org/Documents/news-resources/statistics/2013-statistics/plastic-surgery-statistics-full-report-2013.pdf . Accessed October 2013
• 15 The NHS Information Centre for Health and Social Care. National Mastectomy and Breast Reconstruction Audit. Available at http://www.hscic.gov.uk/catalogue/PUB02731/clin-audi-supp-prog-mast-brea-reco-2011-rep1.pdf . Accessed 2011
• 16 Joyce CW, Carroll SM. Microsurgery: the top 50 classic papers in plastic surgery: a citation analysis. Arch Plast Surg 2014; 41 (2) 153-157
• 17 Zhang W-J, Ding W, Jiang H, Zhang Y-F, Zhang J-L. National representation in the plastic and reconstructive surgery literature: a bibliometric analysis of highly cited journals. Ann Plast Surg 2013; 70 (2) 231-234
• 18 Zhang W-J, Zhang J-L, Jiang H. Growing trend of China's contribution to the field of plastic and reconstructive surgery: a 10-year study of the literature. Ann Plast Surg 2012; 68 (3) 328-331
• 19 Sreekar H, Dawre S, Lamba S, Gupta AK. Trend of India's Contribution to the Field of Plastic and Reconstructive Surgery. Ann Plast Surg 2012; 69 (2) 223
• 20 Sinno H, Neel OF, Lutfy J, Bartlett G, Gilardino M. Level of evidence in plastic surgery research. Plast Reconstr Surg 2011; 127 (2) 974-980
• 21 Becker A, Blümle A, Momeni A. Evidence-based Plastic and Reconstructive Surgery: developments over two decades. Plast Reconstr Surg 2013; 132 (4) 657e-663e
• 22 McCarthy JE, Chatterjee A, McKelvey TG, Jantzen EMG, Kerrigan CL. A detailed analysis of level I evidence (randomized controlled trials and meta-analyses) in five plastic surgery journals to date: 1978 to 2009. Plast Reconstr Surg 2010; 126 (5) 1774-1778
• 23 Agha RA, Camm CF, Doganay E, Edison E, Siddiqui MR, Orgill DP. Randomised controlled trials in plastic surgery: a systematic review of reporting quality. Eur J Plast Surg 2014; 37: 55-62
• 24 Xu CC, Côté DWJ, Chowdhury RH, Morrissey AT, Ansari K. Trends in level of evidence in facial plastic surgery research. Plast Reconstr Surg 2011; 127 (4) 1499-1504
• 25 Allen RJ, Treece P. Deep inferior epigastric perforator flap for breast reconstruction. Ann Plast Surg 1994; 32 (1) 32-38
• 26 Wang Y, Kotsis SV, Chung KC. Applying the concepts of innovation strategies to plastic surgery. Plast Reconstr Surg 2013; 132 (2) 483-490
• 27 Pien I, Caccavale S, Cheung MC , et al. Evolving Trends in Autologous Breast Reconstruction: Is the Deep Inferior Epigastric Artery Perforator Flap Taking Over?. Ann Plast Surg 2014; ; 10.1097/SAP.0000000000000339
• 28 Bonde CT, Christensen DE, Elberg JJ. Ten years' experience of free flaps for breast reconstruction in a Danish microsurgical centre: an audit. Scand J Plast Reconstr Surg Hand Surg 2006; 40 (1) 8-12
• 29 Atherton DD, Hills AJ, Moradi P, Muirhead N, Wood SH. The economic viability of breast reconstruction in the UK: comparison of a single surgeon's experience of implant; LD; TRAM and DIEP based reconstructions in 274 patients. J Plast Reconstr Aesthet Surg 2011; 64 (6) 710-715
• 30 Acosta R, Smit JM, Audolfsson T , et al. A clinical review of 9 years of free perforator flap breast reconstructions: an analysis of 675 flaps and the influence of new techniques on clinical practice. J Reconstr Microsurg 2011; 27 (2) 91-98
• 31 Mohan AT, Al-Ajam Y, Mosahebi A. Trends in tertiary breast reconstruction: literature review and single centre experience. Breast 2013; 22 (2) 173-178
• 32 Seglen PO. Why the impact factor of journals should not be used for evaluating research. BMJ 1997; 314 (7079) 498-502