The Canadian Contribution to the Global Plastic Surgery Literature: A 10-Year Bibliometric Analysis

Background: Research is an integral part of plastic surgery residency training and practice, and provides a foundation for knowledge advancement in our field. Furthermore, it improves patient care by facilitating the delivery of evidence-based therapies. Because research is dynamic, and is often contingent on funding sources, it is important to continuously assess output. To our knowledge, this is the first study to describe Canadian plastic surgery research trends, and highlights recent Canadian contributions to the existing global body of evidence. 

Method: Data was obtained from the Scopus Database and included articles published in the top general and specialty plastic surgery journals. All articles written in English and related to document-types 'articles', 'reviews', and 'letters' published over a 10-year period (2005-2015) were tracked. Articles were then individually analyzed, and only those who had a first and/or corresponding author with an appointment at a Canadian institution were included in our final analysis.

Results: Between 2005 and 2015, a total of 909 documents were identified, ranking Canada the 9^th most productive country. A total of 602 documents (66%) met our inclusion criteria and were included in our final analysis. Publications followed a bimodal distribution, peaking in 2008 (n=70) and again in 2012 (n=80). There was approximately a 7:3 predominance of male to female first authors and a 9:1 predominance of male to female corresponding authors. The journals most frequently published in were Plastic and Reconstructive Surgery (41%), Canadian Journal of Plastic Surgery (17%), and Journal of Plastic, Reconstructive and Aesthetic Surgery (12%). The top producing institutions were The University of Toronto/University Heath Network (31%), Dalhousie University (13%), and McMaster University (10%) and the most frequently studied domains of plastic surgery were craniofacial (25%), hand and upper extremity (16%), and breast (13%). Finally, the most commonly employed clinical study designs were case series and case reports (62%). 

Conclusion: Canada continues to be a leading contributor of high impact research in plastic and reconstructive surgery. This study provides novel insight into a number of pertinent trends, which may be used to determine funding patterns, understudied domains of plastic surgery, domains most likely to be funded, and changes in publication practices.