Eur J Plast Surg (2012) 35:747 755
DOI 10.1007/s00238-011-0681-z
ORIGINAL PAPER
The use of the Internet and social software
by plastic surgeons
Roger J. G. Stevens & Neil M. Hamilton &
Joseph M. O Donoghue & Michaela P. Davies
Received: 24 August 2011 /Accepted: 13 December 2011 /Published online: 15 March 2012
#
Springer-Verlag 2012
Abstract Social software allows users to communicate and consultants and non-consultants were 48.7 years (35 61)
share data through online social interaction using Web 2.0 and 32.8 years (24 38), respectively. Fifty-eight (100%) plas-
technology. Three hundred and fifty-six members of the tic surgeons used the Internet and e-mail, 48 (82.8%) owned a
British Association of Plastic, Reconstructive and Aesthetic handheld device and 48 (82.8%) owned a digital media player.
Surgeons (BAPRAS) within the UK and Ireland were invit- Sixteen plastic surgeons (27.6%) used instant messaging, 29
ed by e-mail to complete an online survey (e-survey) anon- (50.0%) used Internet telephone, 12 (20.7%) used videocon-
ymously on their knowledge and use of Web 2.0 technology ferencing, 23 (39.7%) used media sharing, 2 (3.4%) used
and whether they would like this to be used in BAPRAS s social bookmarking, 21 (36.2%) used social networking, 24
e-Learning for Plastic, Reconstructive and Aesthetic Surgery (41.4%) used forums, 29 (50.0%) used podcasts, 1 (1.7%)
(e-LPRAS). Fifty-eight members completed the e-survey contributed to a wiki, 6 (10.3%) wrote a blog and 18 (31.0%)
(response rate of 58 out of 356 or 16.3%). The respondents read a blog. Non-consultants were more likely to use social
comprised 52 males (89.7%) and 6 females (10.3%) with a networking and forums than consultants. Forty-one (70.7%)
mean age (range) of 44.1 years (24 61). Forty one (70.7%) plastic surgeons used e-learning, and 31 (53.4%) would like
were consultants and 17 (29.3%) were non-consultants with a Web 2.0 technology to be used in e-LPRAS, whilst 5 (8.6%)
mean time (range) at this level of 10.1 years (1 30) and would not and 22 (37.9%) do not know what Web 2.0 tech-
3.4 years (1 6), respectively. The mean (range) ages of nology is. Most respondents either used Web 2.0 technology
or were aware of it. Over half of respondents would like Web
2.0 technology to be used in e-LPRAS. We recommend that
This paper was partly presented at the 3rd Annual Meeting of the Burns BAPRAS adopts Web 2.0 technology in their development of
and Plastic Surgery Section of the Society of Academic and Research
e-LPRAS.
Surgery, 5 January, 2012, University of Nottingham Medical School,
Nottingham, United Kingdom.
. . .
Keywords Plastic surgery Education Training
:
R. J. G. Stevens ( ) M. P. Davies
.
e-Learning Web 2.0
Department of Plastic and Reconstructive Surgery,
Aberdeen Royal Infirmary,
Foresterhill,
AB25 2ZN, Aberdeen, Scotland, UK
e-mail: [e-mail] Introduction
:
R. J. G. Stevens N. M. Hamilton
Social software encompasses a variety of computer software
Medi-CAL Unit, College of Life Sciences and Medicine,
applications that allow users to communicate and share data
University of Aberdeen,
Aberdeen, Scotland, UK through online social interaction. It includes instant messaging
(e.g. MSN Messenger), Internet telephone via Voice over
J. M. O Donoghue
Internet Protocol (VoIP) for voice calls (e.g. Skype or Google
Department of Plastic and Reconstructive Surgery,
Talk), videoconference software for videoconferencing (e.g.
Royal Victoria Infirmary,
Newcastle upon Tyne, England, UK Adobe Connect or Microsoft Office Communicator), media
748 Eur J Plast Surg (2012) 35:747 755
Table 1 Questions and responses for e-survey of consultants and non-
sharing (e.g. Flickr or YouTube), social bookmarking sites
consultants in plastic surgery
(e.g. Delicious, Digg or reddit), social network sites (e.g.
Facebook, MySpace or Twitter), forums (e.g. PLASTA
Q1 What is your gender?
Forum), wikis (e.g. Wikipedia or Ganfyd) and blogs (e.g.
Male
Blogger, Google Blog or Twitter). Such applications comprise
Female
Web 2.0 technology and have enhanced communication and
Q2 What age are you?
collaboration between users of the Internet or World Wide
Q3 In which region or deanery are you based for working or
Web (WWW). The concept of Web 2.0 is a development of training in plastic surgery?
the original WWW that had been first developed by Tim East of England (e.g. Chelmsford, Norwich and Stevenage)
Berners-Lee in 1989 [1, 2]. London (e.g. Chelmsford, East Grinstead, London and Slough)
Data previously published by the primary author have
Mersey (e.g. Chester and Liverpool)
shown that both trainees and consultants in plastic surgery
East Midlands (e.g. Derby, Leicester, Northampton and Nottingham)
within the UK and Ireland would like access to electronic
West Midlands (e.g. Birmingham, Coventry, Dudley and
Stoke on Trent)
learning (e-learning) and that, furthermore, this e-learning
Northern (e.g. Durham, Middlesborough and Newcastle upon Tyne)
should be developed nationally [3, 4]. E-learning in plastic
surgery is being developed nationally by the British Associa- North Western (e.g. Manchester and Preston)
Oxford (e.g. Aylesbury, Oxford and Slough)
tion of Plastic, Reconstructive and Aesthetic Surgeons
(BAPRAS) as the e-Learning for Plastic, Reconstructive and Severn (e.g. Bristol)
Aesthetic Surgery (e-LPRAS) project [5, 6]. We surveyed South West Peninsula (e.g. Bristol, Exeter and Plymouth)
members of BAPRAS on their knowledge and use of Web Yorkshire & Humber (e.g. Bradford, Hull, Leeds, Sheffield
and Wakefield)
2.0 technology and whether they would like this technology to
Wessex (e.g. Portsmouth and Salisbury)
be used in e-LPRAS.
Northern Ireland (e.g. Belfast)
North of Scotland (e.g. Aberdeen)
East of Scotland (e.g. Dundee)
Subjects and methods
South East of Scotland (e.g. Edinburgh)
West of Scotland (e.g. Glasgow)
This study was approved by the Education and Research
Wales (e.g. Swansea)
Committee of BAPRAS. To assess the use of the Internet
and social software by plastic surgeons, 356 members of Republic of Ireland or Eire (e.g. Cork, Dublin and Galway)
BAPRAS who were based in the UK and Ireland were Q4 At what level are you in plastic surgery?
invited to complete a web-based survey, or e-survey, com- Foundation doctor (i.e. FY1, FY2)
prising 22 questions (Table 1) that had been created using Specialty registrar (MMC, i.e. ST)
SurveyMonkey (Palo Alto, CA; www.surveymonkey.com)
Specialist registrar (Calman, i.e. SpR)
and located within the domain www.e-plasticsurgery.co.uk.
Clinical fellow (i.e. SHO level/CT1-CT3 level/ST1-ST2 level)
The e-survey was anonymous and individual members
Clinical fellow (i.e. registrar level/ST3 level and above)
responses were deemed to be confidential. The e-survey
Trust grade (i.e. SHO level/CT1-CT3 level/ST1-ST2 level)
was accessible initially for 4 weeks. Thereafter, all members
Trust grade (i.e. registrar level/ST3 level and above)
were contacted by e-mail and invited for a second time to
Research fellow
complete the e-survey within an additional 4 weeks, after
Associate specialist
which the survey was terminated.
Consultant
Other (please specify)
Q5 In which year at this level of working or training in plastic
Statistics surgery are you?
1st
Data were downloaded as a Microsoft Excel spreadsheet file
2nd
from www.surveymonkey.com. The data were then
3rd
imported into IBM SPSS Statistics 19.0 for Windows (SPSS
4th
Inc., Chicago, IL, USA) for statistical analysis. The inde-
5th
pendent t test was used to compare unpaired parametric
6th
data, and the �2 test or Fisher s exact test was used to
7th
compare nominal data. When comparing data from the e-
8th
survey between consultants and non-consultants, the  No
9th
responses were combined with  I do not know what this
Eur J Plast Surg (2012) 35:747 755 749
Table 1 (continued) Table 1 (continued)
10th I do not know what this is
Other (please specify number of years) Q17 Do you read blogs (e.g. Blogger, Google Blog, Twitter)?
Q6 Do you use the internet? Yes
Yes No
No I do not know what this is
I do not know what this is Q18 Do you write your own blog (e.g. Blogger, Google Blog, Twitter)?
Q6 Do you use e-mail? Yes
Yes No
No I do not know what this is
I do not know what this is Q19 Do you download and listen to podcasts?
Q8 Do you use a handheld device (e.g. iPhone, Blackberry) Yes
to access the internet?
No
Yes
I do not know what this is
No
Q20 Do you own a digital media player or MP3 player
I do not know what this is (e.g. iPod, iPhone)
Q9 Do you use instant messaging (e.g. MSN Messenger)? Yes
Yes No
No I do not know what this is
I do not know what this is Q21 Do you use e-learning?
Q10 Do you use Voice over Internet Protocol (VoIP) to make Yes
voice calls (e.g. Skype, Google Talk)?
No
Yes
I do not know what this is
No
Q22 Would you like to see Web 2.0 technology used in the
I do not know what this is e-learning project being developed by BAPRAS (e-LPRAS)?
Q11 Do you use videoconference software to make videoconference Yes
meetings (e.g. Adobe Connect, Microsoft Office Communicator)?
No
Yes
I do not know what this is
No
I do not know what this is
responses for individual questions and compared to the
Q12 Do you use media sharing (e.g. Flickr, YouTube)?
 Yes responses. A p value of less than 0.05 was considered
Yes
to be statistically significant.
No
I do not know what this is
Q13 Do you use social bookmarking sites
(e.g. Delicious, Digg, reddit)?
Results
Yes
No
The 356 members who were invited to complete the e-survey
I do not know what this is comprised 323 males (90.7%) and 33 females (9.3%) and had a
Q14 Do you use social network sites mean (range) age of 49.2 years (35 79). Of these 356 members,
(e.g. Facebook, MySpace, Twitter)?
66 accessed and 58 completed the e-survey (response rate of 58
Yes
out of 356 or 16.3%). The respondents comprised 52 males
No
(89.7%) and 6 females (10.3%) with a mean age (range) of
I do not know what this is
44.1 years (24 61). Forty one (70.7%) were consultants, and
Q15 Do you use forums (e.g. PLASTA Forum)?
17 (29.3%) were non-consultants with a mean time (range) at
Yes
this level of 10.1 years (1 30) and 3.4 years (1 6), respectively
No
(Table 2). The 17 non-consultants comprised one (1.7%) foun-
I do not know what this is
dation doctor, two (3.4%) research fellows, five (8.6%) spe-
Q16 Have you ever contributed to a wiki (e.g. Wikipedia, Ganfyd)?
cialist registrars, seven (12.1%) specialty registrars and two
Yes (3.4%) trust grade doctors. There was no significant difference
No between the number of males and females for consultants
versus non-consultants (p>0.05). The mean (range) age of
750 Eur J Plast Surg (2012) 35:747 755
Table 2 Demographics of consultants and non-consultants in plastic
Discussion
surgery
The last survey of plastic surgeons and their use of the
Number (% of total)
Internet was completed in 2002 by Koch et al. in which
Consultants Non-consultants
they surveyed 3,139 plastic surgeons. Of these, 565 plastic
surgeons responded (18% response rate) and about 90%
Number 41 (70.7%) 17 (29.3%)
used the Internet and over 85% used e-mail professionally
Mean age (range), years 48.7 (35 61) 32.8 (24 38)
[7]. In our sample of 58 plastic surgeons, 100% used the
Mean (range) time at level, years 10.1 (1 30) 3.4 (1 6)
Internet and e-mail. Although e-mail is the fastest and the
Gender
most cost-effective method of communication, there are con-
Male 39 (67.2%) 13 (22.4%)
cerns in ensuring security while transferring clinical data [8].
Female 2 (3.4%) 4 (6.9%)
Data from two surveys published by the primary author
Country
of the present study have demonstrated that plastic surgeons
England 36 (62.1%) 13 (22.4%)
would like access to nationally developed e-learning to
Ireland (Northern Ireland 0 (0.0%) 2 (3.4%)
support their education and training [3, 4]. Those surveys
and Republic of Ireland)
showed that about 40% of plastic surgeons had previous
Scotland 4 (6.9%) 1 (1.7%)
experience in e-learning [3, 4], but in the present study, this
Wales 1 (1.7%) 1 (1.7%)
proportion is greater at 70.7%. The publicity for e-learning
generally and the e-LPRAS project in particular provided by
consultants and non-consultants were 48.7 years (35 61) and these two surveys might have increased the use of e-learning
32.8 years (24 38), respectively. by plastic surgeons seen in the present study.
Fifty-eight (100%) respondents used the Internet and We chose to undertake an e-survey rather than a postal
e-mail. Forty-eight (82.8%) respondents used a handheld de- survey for several reasons. An e-survey has the advantage
vice, such as an iPhone or Blackberry, to access the Internet over a postal survey in that respondents may remain anon-
(Fig. 1a), and the same number owned a digital media player ymous, results can be obtained and analysed more quickly
or MP3 player, e.g. iPod or iPhone (Fig. 1b). Forty-one and they are cost effective [9]. Our e-survey cost about Ł40
(70.7%) respondents used e-learning (Fig. 1c). (the equivalent of Ź 44 or $65), whilst a similar postal survey
Those respondents who did and did not use the various would have cost approximately Ł1,175 (Ź 1,410 or $1,840).
components of Web 2.0 technology and those who did not The reliability and validity of e-surveys are comparable to
know what they were are summarised in Fig. 2 and Table 3. postal surveys [10].
Such technology is further divided into those used for com- However, e-surveys have lower response rates as com-
munication, i.e. instant messaging, Internet telephone and pared to postal surveys. This has been demonstrated in a
software for videoconferencing, and those for sharing, i.e. survey of the opinions of 442 orthopaedic surgeons about
media sharing, social bookmarking sites, social network the treatment of femoral neck fractures in which half were
sites, forums, podcasts, wikis and blogs. Twenty-nine plastic invited to complete a postal survey and the other half were
surgeons (50.0%) used Internet telephone (Fig. 2a), and 21 invited by e-mail to complete an e-survey. The response rate
(36.2%) used social networking (Fig. 2b). Sixteen (27.6%) of the postal survey was 57.9%, and that of e-survey was
plastic surgeons used instant messaging, 12 (20.7%) used 44.8% [11]. The response rate of 16.3% for the present e-
videoconferencing, 23 (39.7%) used media sharing, 2 survey is disappointingly low compared to our two recently
(3.4%) used social bookmarking, 24 (41.4%) used forums, published e-surveys of plastic surgeons in which the re-
29 (50.0%) used podcasts, 1 (1.7%) contributed to a wiki, 6 sponse rates were 57.1% for trainees [3] and 26.0% for
(10.3%) wrote a blog and 18 (31.0%) read a blog (Table 3). consultants [4]. Although our response rate is low, it com-
Thirty-one (53.4%) respondents would like Web 2.0 tech- pares favourably with the response rates of other published
nology to be used in e-LPRAS, 5 (8.6%) would not and 22 e-surveys of plastic surgeons. The response rates of e-
(37.9%) do not know what Web 2.0 technology is. surveys of members of the American Society of Plastic
There was no evidence of a statistical difference between Surgeons on techniques and complications of face-lift and
consultants and non-consultants using a handheld device, a brow-lift surgery was 15% [12, 13], vaginal labioplasty was
digital media player and e-learning. Similarly, there was no 19.7% [14], the use of antibiotic prophylaxis and closed-
evidence of a statistical difference between consultants and suction drains in breast reconstruction was 13.9% [15] and
non-consultants using most components of Web 2.0 tech- venous thromboembolism prophylaxis in body-contouring
nology, except social networking (p<0.05) and forums surgery was 14.6% [16].
(p<0.001) in which non-consultants were more likely to Attempts at improving the response rate were undertaken,
use them than consultants. including sending an e-mail reminder 4 weeks after the initial
Eur J Plast Surg (2012) 35:747 755 751
Fig. 1 Respondents who used a
a
handheld device (a), digital
media player (b) and
Consultants who use a hand held device
e-learning (c)
58.6%
Consultants who do not use a hand held device
Non-consultants who use a hand held device
5.2%
Non-consultants who do not use a hand held device
12.1%
24.1%
b
Consultants who use a digital media player
58.6%
Consultants who do not use a digital media player
Consultants who do not know what a digital media player is
5.2%
Non-consultants who use a digital media player
Non-consultants who do not use a digital media player
10.3%
24.1%
1.7%
c
Consultants who use e-learning
48.3%
Consultants who do not use e-learning
Non-consultants who use e-learning
Non-consultants who do not use e-learning
6.9%
22.4%
22.4%
e-mail. In a Cochrane review of methods that increase the bias [10]. Those in the e-survey population who have used
response rate of postal surveys and e-surveys, financial incen- Web 2.0 technology might be more likely to respond to the
tives, gifts, shorter e-surveys, a statement that others had survey. This is known as self-selection bias and can be
responded, personalised e-surveys, an offer of notification of estimated by measuring the response rate, which is expressed
survey results and use of a white background improve the as the number of people completing the e-survey divided by
response rates of e-surveys [17]. A financial incentive such as those who viewed it [10]. For the present e-survey, this re-
payment of an honorarium might have increased the response sponse rate was 58 out of 66 or 87.9%.
rate, but this would have introduced a participation bias into Social software comprises a range of computer software
the study, as those respondents who were motivated financially applications that allow users to communicate and share data.
would have been more likely to complete the e-survey and It includes instant messaging, VoIP for voice calls, videocon-
decreased the overall cost-effectiveness of the e-survey. ference software for videoconferencing, media sharing, social
Furthermore, e-surveys are associated with certain meth- bookmarking sites, social network sites, forums, wikis and
odological weaknesses. The main disadvantage is selection blogs [2]. The use of Web 2.0 technology in e-learning has
752 Eur J Plast Surg (2012) 35:747 755
Fig. 2 Respondents who used
a
various components of Web 2.0
technology: internet telephone
Consultants who use internet telephone
(a) and social networking (b)
29.3%
Consultants who do not use internet telephone
Consultants who do not know what internet telephone is
39.7%
Non-consultants who use internet telephone
8.6%
Non-consultants who do not use internet telephone
20.7%
1.7%
b
Consultants who use social networking
19.0%
Consultants who do not use social networking
51.7%
Non-consultants who use social networking
12.1%
Non-consultants who do not use social networking
17.2%
been defined by the neologism  e-learning 2.0 and is an social software, and by using it, the learner constructs one s
example of the application of the social-constructivist theory, learning.
which was first developed by Vygotsky in 1978 [18]. His In 2006, Sandars and colleagues undertook two e-surveys
theory emphasises how meanings and understandings develop of the use of social software by undergraduate medical
from social encounters, ensuring that the learner actively seeks students and qualified doctors [19, 20]. From one of these
education [18]. Social interaction is central to the concept of studies, in which they surveyed 212 first-year medical
Table 3 Respondents using various components of Web 2.0 technology for communication and sharing
Number (%)
Consultants Non-consultants
Yes No I do not know what this is Yes No I do not know what this is
Instant messaging 9 (15.5%) 32 (55.2%) 0 (0.0%) 7 (12.1%) 10 (17.2%) 0 (0.0%)
Videoconferencing 8 (13.8%) 32 (55.2%) 1 (1.7%) 4 (6.9%) 12 (20.7%) 1 (1.7%)
Media sharing 13 (22.4%) 28 (48.3%) 0 (0.0%) 10 (17.2%) 7 (12.1%) 0 (0.0%)
Social bookmarking 1 (1.7%) 36 (62.1%) 4 (6.9%) 1 (1.7%) 16 (27.6%) 0 (0.0%)
Forums* 7 (12.1%) 33 (56.9%) 1 (1.7%) 17 (29.3%) 0 (0.0%) 0 (0.0%)
Podcasts 21 (36.2%) 20 (34.5%) 0 (0.0%) 8 (13.8%) 9 (15.5%) 0 (0.0%)
Contribute to wiki 0 (0.0%) 41 (70.7%) 0 (0.0%) 1 (1.7%) 16 (27.6%) 0 (0.0%)
Write blog 5 (8.6%) 36 (62.1%) 0 (0.0%) 1 (1.7%) 16 (27.6%) 0 (0.0%)
Read blog 10 (17.2%) 31 (53.4%) 0 (0.0%) 8 (13.8%) 9 (15.5%) 0 (0.0%)
*
p<0.001 for consultants versus non-consultants (�2 test)
Eur J Plast Surg (2012) 35:747 755 753
students, over 90% of first-year medical students used in- access to the content of the journal Archives of Facial
stant messaging and about 70% used social networking sites Plastic Surgery [38]. The fourth app, known as i-PRAS,
[19]. From their other study, in which they surveyed doctors, provides a calculator for body mass index, estimated body
approximately half of consultants and trainees owned a surface area, ideal body weight, bra size, and hip/waist ratio
digital media player [20]. However, the proportion of con- as well as a reference tool which summarises classifications
sultants and trainees using a digital media player is greater and scales commonly used in plastic surgery [39].
in our study. This difference might be explained by the A podcast is an audio or video file that is released over the
increasing popularity, availability and use of digital media Internet often episodically and can be downloaded for listen-
players nationally since their study in 2006 [21, 22]. Their ing or viewing on the client s computer or digital media player
sample included consultants, general practitioners, trainees [40]. Podcasts have been available on the web site for the
and medical students, but none of their respondents were journal Plastic and Reconstructive Surgery since 2006 to
plastic surgeons [20]. Although most were familiar with the complement and enhance the journal s content [41]. Our
various components of Web 2.0 technology, less consultants survey has shown that although all plastic surgeons know
and trainees had actually used Web 2.0 technology [20]. what podcasts are, equal proportions (50%) of plastic sur-
This pattern of results is similar to those reported in our geons do and do not download and listen to podcasts.
present study. However, only about 5% of their respondents Twitter is a social networking and microblogging service
would like Web 2.0 technology to be used in medical that was developed in March 2006 and allows its users to
education [20] as compared to over 50% of plastic surgeons compose, publish and read short messages known as
who would like Web 2.0 technology to be used in e-LPRAS.  tweets in real time [42]. The Royal College of Surgeons
This difference might be explained by the increasing use of of England [43], the British Association of Aesthetic Plastic
the Internet for social networking nationally [23]. Surgeons (BAAPS) [44] and the journals the European
Handheld devices, such as the iPhone, have revolution- Journal of Plastic Surgery [45] and Plastic and Reconstruc-
ised access to plastic surgery resources for education [24]. tive Surgery [46] frequently publicise relevant news items
Our e-survey has shown that over 80% of plastic surgeons and recent journal articles on Twitter. Other examples of
own a handheld device. This finding is not surprising be- popular social networking software include Facebook which
cause of the increasing popularity of smartphones. Recent was launched in February 2004 [47]. Plastic surgery journals,
evidence has shown that 48% of new mobile handsets sold such as the European Journal of Plastic Surgery [48] and
within the first quarter of 2011 were smartphones [25], with Plastic and Reconstructive Surgery [49], and plastic surgery
the iPhone being the most popular smartphone [26]. Like societies, such as BAAPS [50] and the American Society for
laptops and netbooks, such handheld devices are readily Aesthetic Plastic Surgery, [51] have a presence on Facebook.
portable and allow opportunistic and  on the job e-learning Our survey has shown that all plastic surgeons know what
and microlearning an important concept in surgical training social networking is and that 36.2% of plastic surgeons use
that has been discussed in detail by Larvin [27]. The BAPRAS social networking.
web site is readily accessible using such devices and provides
an educational resource for both plastic surgeons and patients
[28].
Conclusions
Although this e-survey has not investigated the applica-
tion of telemedicine to plastic surgery, the use of secure
Most plastic surgeons either used Web 2.0 technology or
internet-based technology has improved the accuracy of
were aware of it. Non-consultants were more likely to use
the referrals of acute plastic surgery trauma and burns
social networking and forums than consultants. Over half of
[29 32] and suspected skin malignancy to specialist plastic
respondents would like Web 2.0 technology to be used in e-
surgery or burn units [33]. Similar internet-based technolo- LPRAS. We recommend that BAPRAS adopts Web 2.0
gy has improved the monitoring of free flaps and reduced
technology in their development of e-LPRAS.
the failure rate through earlier salvage [34], and has im-
proved the monitoring and management of chronic wounds Acknowledgements The authors thank the plastic surgeons who
completed this survey, BAPRAS for approving this survey and e-
[35].
mailing the members and Dr. Neil Scott who is Statistician in the
Furthermore, there are four plastic surgery applications,
Section of Population Health within the University of Aberdeen for
or  apps , now available for the iPhone. The first provides a
his statistical advice. This research has contributed to a thesis for the
summary of the 2009 BAPRAS and British Orthopaedic degree of the Doctorate of Medicine of the University of Aberdeen.
Association standards for the management of severe lower
Conflict of interest R.J.G.S. is a Junior Member of the British
limb trauma [36]. The second app, known as uBurn, acts as
Association of Plastic, Reconstructive and Aesthetic Surgeons (BAP-
a calculator for total burn surface area and fluid resuscitation
RAS). J.M.O. is the former Chairman of the Education and Research
for the management of burns [37]. The third app provides Committee of BAPRAS.
754 Eur J Plast Surg (2012) 35:747 755
21. Ofcom (2010) The communications market 2010: UK. A third of
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