Collaboration-The Key to Meaningful Plastic Surgery Research

Does the use of post-operative antibiotics decrease the risk of infections in implant-based breast reconstruction? Does the use of acellular dermal matrix increase the risk of infections? Does every patient undergoing a cosmetic abdominoplasty need venous thromboembolism chemoprophylaxis? The list goes on. We still don't have a good answer to many important clinical questions in plastic surgery because we don't have convincing data that categorically answers them. Our literature is full of low powered (aka weak) studies that many times conclude diametrically opposing arguments (the examples in the introductory sentences being some of them) [1-6]. The data we base our clinical judgment on is influenced by our own biases and experiences, and also on how we were trained. But is that the correct way of doing things? Though many of us strive to be ‘evidence-based', it's hard to live up to those standards when the ‘evidence' is not clear, well documented, or frankly, even present. This is especially true for many clinical scenarios in plastic surgery. Though our field has made a concerted effort to move in this direction, the reality is that this lack of actionable research is obvious and this, in my opinion, is a real problem.