title: Nipple reconstruction: evidence-based trials in the plastic surgical literature.
abstract: Although many technical descriptions of nipple reconstruction exist in the medical literature, insufficient evidence-based data are present about the outcome. This study aimed to identify randomized controlled trials (RCTs) and controlled clinical trials (CCTs) in the plastic surgical literature addressing nipple reconstruction, and to elucidate whether a hand search was superior to an extensive database search in retrieving all pertinent studies. The hand search included analysis of all "original articles" published in four of the leading plastic surgery journals from January 1990 to December 2005, with subsequent identification of RCTs and CCTs. Additionally, a computerized search was conducted including the following databases: PubMed, Web of Science, and Evidence-Based Medicine Reviews. From a total of 10,476 published original articles in four plastic surgery journals over a 16-year period, only one RCT was identified that addressed nipple reconstruction. The database search, however, retrieved two trials: the RCT identified by hand search and one CCT. The impact of nipple reconstruction is well described in the literature. However, it is astonishing that the plastic surgical literature lacks evidence-based trials addressing this issue. Clearly, more evidence-based trials are necessary to ensure that recommendations for a particular technique are based on solid scientific data.
authors.affiliation: Department of Plastic and Hand Surgery, University of Freiburg Medical Center, 79106, Freiburg, Germany. arash.momeni@googlemail.com
authors.forename: Arash
authors.initials: A
authors.lastname: Momeni
authors.forename: Axel
authors.initials: A
authors.lastname: Becker
authors.forename: Nestor
authors.initials: N
authors.lastname: Torio-Padron
authors.forename: Niklas
authors.initials: N
authors.lastname: Iblher
authors.forename: G Björn
authors.initials: GB
authors.lastname: Stark
authors.forename: Holger
authors.initials: H
authors.lastname: Bannasch
mesh_terms: D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D009558:Nipples / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D013524:Surgical Flaps; D016896:Treatment Outcome