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Table of Contents
ORIGINAL ARTICLE
Year : 2019  |  Volume : 27  |  Issue : 3  |  Page : 107-122

An Academic Picture of Plastic Surgery from Past to Present: Bibliometric Analysis of Turkish Plastic Surgery Literature in International Journals (1976–2018)


1 Department of Plastic, Reconstructive and Aesthetic Surgery, Antalya Training and Research Hospital, Antalya, Turkey
2 Department of Plastic, Reconstructive and Aesthetic Surgery, Bahcesehir University, Istanbul, Turkey

Date of Web Publication4-Jul-2019

Correspondence Address:
Dr. Ahmet Demir
Varlık Mahallesi Kazım Karabekir Caddesi, Antalya Training and Research Hospital, Plastic, Reconstructive and Aesthetic Surgery, 07100 Muratpaşa, Antalya
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjps.tjps_78_18

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  Abstract 


Introduction: In this study we aimed to analyze the international and Turkish contribution of the plastic surgery literature in the last 42 years and compare results to each other. Materials and Methods: Web of Science online library (v.5.30) was used as a database. Papers that published between 1976-2018 were analyzed for both international and Turkey separately in terms of distribution of papers according to the years, rankings of source countries, rankings of source organizations, publishing journals, numbers of citations and contributing authors. Results were presented as numerical data. Results: Rohrich RJ is in the first place with 743 publications in the field of plastic surgery history. In the ranking of countries contributing to the plastic surgery literature, Turkey ranks 4th standings. Conclusions: Publishing papers in highly populated journals would add on the papers itself is a false belief. In recent years Turkey's contribution to the international plastic surgery literature has as decreasing trend. Repeating of this type bibliometric analyze studies every five 5 year may aid to understand academical progresses and trends better for both international arena and Turkey.

Keywords: Bibliometric, citation, impact factor, plastic surgery


How to cite this article:
Demir A, Isken T. An Academic Picture of Plastic Surgery from Past to Present: Bibliometric Analysis of Turkish Plastic Surgery Literature in International Journals (1976–2018). Turk J Plast Surg 2019;27:107-22

How to cite this URL:
Demir A, Isken T. An Academic Picture of Plastic Surgery from Past to Present: Bibliometric Analysis of Turkish Plastic Surgery Literature in International Journals (1976–2018). Turk J Plast Surg [serial online] 2019 [cited 2019 Jul 16];27:107-22. Available from: http://www.turkjplastsurg.org/text.asp?2019/27/3/107/262133




  Introduction Top


Plastic, reconstructive, and esthetic surgery as a field is relatively innovative and open to novelties compared to other surgical fields. A characteristic of this surgical field is that it has a vast scope and has a relationship with almost all anatomical parts of the body. The dynamic and varying nature of plastic surgery can be traced in a review of the literature published in this field. New papers are published in national and international circles almost every day. We conducted a bibliometric analysis to picture the history of the academic literature in plastic surgery and to comparatively demonstrate the contributions of the papers produced in Turkey to the international plastic surgery literature.

Production of academic papers is an essential need. What is more important than the number of papers produced by researchers is the impact the reports have on their respective fields. Eugene Garfield, pioneer of modern libraries and father of citation indexing, studied the criteria which ascribe scientific status to a scientific paper.[1],[2] He carried out the first bibliometric analyses in today's terms and statistically analyzed the papers which stood out in his reviews.[3] He extended his bibliometric analyses to the international arena.[4],[5] In 1960, he defined science citation indexing, and in 1965, he described the impact factor of journals.[6],[7],[8],[9],[10],[11] In his work, Garfield mainly aimed to establish which papers were one step or more ahead of the others.

The Turkish plastic surgery community has an esteemed and important place in the global plastic surgery community. Nevertheless, it may be difficult for us to advance academically if our scientific performance is not assessed by standard criteria and status analyses are not performed.

We therefore carried out a statistical analysis of the contributions Turkey has made to the international plastic surgery literature. International bibliometric analyses in other medical fields are also available for the most cited – in a manner of speaking, classic – papers.[12],[13] In this study, we present an overall analysis of the plastic surgery literature and then compare these results with the results identified for the papers produced in Turkey.


  Materials and Methods Top


Our study is a retrospective study. The Web of Science (v. 5.30) (WoS) online library, which is known to be the earliest citation database, was used for collecting and processing data.[14] To specify the journals to be included in the study, the keywords [English] “plastic,” “reconstructive,” “esthetic,” “microsurgery,” “hand,” “maxillofacial,” “craniofacial,” and “burn” were individually searched in the WoS database. Journals listed in the “science citation index” (SCI) and the “science citation index expanded” (SCIE) were included in the study.

Journals that had published less than 1000 issues were excluded from the study – exceptions are the “Journal of Plastic Surgery and Hand Surgery” and the “Hand” since the former is a continuation of the “Scandinavian Journal of Plastic Reconstructive Surgery and Hand Surgery” and the latter was renamed from the “Journal of Hand Surgery European Volume.” In total, 21 journals were included in the study. The earliest paper included in the journals' database from Turkey was dated 1976; therefore, this was taken as benchmark year in the general analysis on plastic surgery to allow for correct matching. In fact, however, the earliest paper found in the journals included in the database dates back to 1946 and was published in “Plastic and Reconstructive Surgery.” The WoS was scanned for the dates from 1976 to August 18, 2018 to specify the journals to be included in the study. Impact factors and active years of the journals included in the study are given in [Table 1].
Table 1: Journals included in the study, their impact factors, years published, and number of issues per year for active journals

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  Results Top


A total of 112,471 journals that matched the inclusion criteria were included in the study. Although, in general, an upward trend was seen over the years in the number of papers published in the international plastic surgery literature, this trend was observed to have reversed in some years. Most significant are the declines in 2007 when the number of published papers (223) is seen to have decreased by 0.185% from the previous year, and in 2016, when the number of published papers (316) is seen to have decreased by 0.288% from the previous year. The most significant change throughout the years is the gradual decline over the 3 years after an ever-high 5140 papers in 2014 [Figure 1].
Figure 1: Number of publications in the plastic surgery literature in the last 25 years

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Journal-based analysis showed that 30,701 of the 112,471 published papers appeared in the “Plastic and Reconstructive Surgery.” This constitutes 27.297% of all publications. The “Annals of Plastic Surgery” came next with 10,508 papers, followed by the “Journal of Craniofacial Surgery” with 9704, the “Journal of Hand Surgery American Volume” with 9428, and “Burns” with 6471 papers [Table 2]. In terms of the types of the papers published in plastic surgery literature, 79,345 (70.547%) were original articles and 19,072 (16.542%) were letters to the editor [Figure 2]. In terms of the countries in which the manuscripts were produced, country data were not indicated in 6629 papers (5.894%). Of those with country data, the U.S.A. ranked first with 43,929 papers (39.058%) and almost 5 times the number of its closest follower, the U.K. (9076 papers). The U.K. was followed by Japan with 6450 in the 3rd place, Turkey with 5319 papers in the 4th place, and the P.R.C. with 4359 papers in the 5th place [Figure 3].
Table 2: Ranking of journals in terms of number of papers in plastic surgery literature

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Figure 2: Top 5 publications in plastic surgery literature by paper type

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Figure 3: Top 25 countries by number of papers published in plastic surgery

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Four of the 5 institutions that have most contributed to the plastic surgery literature were based in the U.S.A. The University of Toronto in Canada which ranks 5th among the top contributing institutions is the only non-US institution among the top 10 [Table 3]. Of the top 25 institutions where the highest number of papers were produced in plastic surgery literature, only 5 are from a country other than the U.S.A. The author who has published the highest number of papers in plastic surgery is Rohrich RJ with 743 papers (0.661%), followed by Onu Chung KC with 418 papers (0.372%) and Longaker MT with 385 papers (0.342%) [Figure 4].
Table 3: Top 10 institutions in terms of the number of papers published in plastic surgery literature

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Figure 4: Top 25 authors by number of papers published in plastic surgery

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Until 1989, the number of papers contributed from Turkey was seen to be <5 papers per year in the journals included in the study. Until 1993, this number remained at single digits. While the number of papers contributed from Turkey were seen to have gradually increased from 1987 to 2003, a disruption was seen in this trend with 227 papers in 2003, i.e., 15 papers less than the previous year. After 2003, this number was seen to increase and reach a first-ever high with 300 papers in 2006. A decrease from the previous year was also seen in 2007, after which came a stagnation period with an average of 241 papers per year until 2013. The increases in 2013 and 2014 were seen to reach an ever-high 349 papers in 2015, followed by a decline in the following 2 years. Number of the papers submitted to journals from Turkey in the last 25 years is shown in [Figure 5].
Figure 5: Papers submitted to the indicated journals from Turkey in the last 25 years

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Regarding the journals, the papers submitted from Turkey were published in the “Journal of Craniofacial Surgery” was seen to rank first with 1570 papers, followed by the “Plastic and Reconstructive Surgery” with 943 papers [Table 4]. Of the papers submitted from Turkey, 3873 (72,814%) were original articles and 1296 (24,365%) were letters to the editor [Figure 6]. Four hundred and ten of the papers submitted from Turkey had coauthors from a country other than Turkey. Of these papers, 201 had coauthors from the U.S.A. and 39 had coauthors from Japan [Table 5].
Table 4: Listing of papers from Turkey by publishing journals

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Figure 6: Number of published papers from Turkey by top manuscript types

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Table 5: Top 14 countries of coauthors who have contributed to the papers produced in Turkey

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In review of the institutions where the papers were produced in Turkey, İstanbul University was seen to rank first with 421 papers (7.915%) and Gülhane Training and Research Hospital (formerly Gülhane Military Medical Academy, GATA) was seen to rank second with 379 papers (7.125%) [Figure 7]. Among the contributing authors of the papers from Turkey, Sensoz O was seen to rank first with 109 papers and Akoz T second with 102 papers [Figure 8]. Data for the top 5 authors from Turkey are given in [Table 6].
Figure 7: Top 25 contributing institutions in Turkey by number of published papers

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Figure 8: Top 25 authors who have most contributed to papers produced in Turkey

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Table 6: Analysis of the top 5 authors from Turkey

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Papers produced in Turkey were cited in 24,830 papers (excluding 22,927 citations to own previous paper) and 32,945 times (excluding 29,275 citations to own previous paper). The mean number of citations per paper is 6.19. About 1290 papers from Turkey (approximately 25%) were never cited. Excluding the citations to own previous papers, the papers produced in Turkey were most cited in papers from the U.S.A. (5663 papers), followed by those from the P.R.C. (2052 papers) and from Turkey (1988 papers) [Figure 9]. Among the authors who have cited the papers produced in Turkey, Lee JH ranked first with 73 citations, Zhang F second with 60 citations, and Siemienow M third with 58 citations [Figure 10]. The most cited paper from Turkey is “The Turkish delight: A pliable graft for rhinoplasty” by Erol OO with 188 citations and a yearly mean of 9.89.[15] The top 25 most cited papers from Turkey are listed by first author names in [Table 7]. The same information for the papers produced worldwide is given in [Table 8].
Figure 9: Top 25 countries by number of citations to papers produced in Turkey

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Figure 10: Top 25 authors by number of citations to papers produced in Turkey

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Table 7: List of top 25 most cited papers produced in Turkey by first author names

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Table 8: List of top 25 most cited globally produced papers by first author names

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Distribution of the papers submitted from Turkey to the top 5 journals in which they were published is as follows by year, institution, and author:

A total of 1570 papers were submitted to the “Journal of Craniofacial Surgery,” of which 1410 were original articles and 148 were letters to the editor. The top contributing institution was İstanbul University with 180 papers and the top contributing author was Yılmaz M with 38 papers [Figure 11], [Figure 12], [Figure 13].
Figure 11: Manuscripts submitted to “Journal of Craniofacial Surgery” listed by years

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Figure 12: Manuscripts submitted to “Journal of Craniofacial Surgery” listed by institutions

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Figure 13: Manuscripts submitted to “Journal of Craniofacial Surgery” listed by authors

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A total of 943 papers were submitted to the “Plastic and Reconstructive Surgery,” of which 596 were letters to the editor and 280 were original articles. The Ankara Numune Training and Research Hospital was the top contributing institution with 96 papers, and Sensoz O was the top contributing author with 43 papers [Figure 14], [Figure 15], [Figure 16].
Figure 14: Manuscripts submitted to “Plastic and Reconstructive Surgery” listed by years

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Figure 15: Manuscripts submitted to “Plastic and Reconstructive Surgery” listed by institutions

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Figure 16: Manuscripts submitted to “Plastic and Reconstructive Surgery” listed by the first author

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A total of 755 papers were submitted to the “Annals of Plastic Surgery,” of which 529 were original articles and 215 were letters to the editor. The top contributing institution was Hacettepe University with 92 papers and the top contributing author was Aslan G with 36 papers [Figure 17], [Figure 18], [Figure 19].
Figure 17: Manuscripts submitted to “Annals of Plastic Surgery” listed by years

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Figure 18: Manuscripts submitted to “Annals of Plastic Surgery” listed by institutions

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Figure 19: Manuscripts submitted to “Annals of Plastic Surgery” listed by authors

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A total of 354 papers were submitted to the “Aesthetic Plastic Surgery,” of which 296 were original articles and 42 were letters to the editor. İstanbul University was the top contributing institution with 21 papers and Erdogan B was the top contributing author with 17 papers [Figure 20], [Figure 21], [Figure 22].
Figure 20: Manuscripts submitted to “Aesthetic Plastic Surgery” listed by years

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Figure 21: Manuscripts submitted to “Aesthetic Plastic Surgery” listed by institutions

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Figure 22: Manuscripts submitted to “Aesthetic Plastic Surgery” listed by authors

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A total of 281 papers were submitted to the “Burns,” of which 223 were original articles and 52 were letters to the editor. Gülhane Training and Research Hospital (formerly Gülhane Military Medical Academy, GATA) was the top contributing institution with 71 papers and Haberal M was the top contributing author with 22 papers [Figure 23], [Figure 24], [Figure 25].
Figure 23: Manuscripts submitted to “Burns” listed by years

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Figure 24: Manuscripts submitted to “Burns” listed by institutions

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Figure 25: Manuscripts submitted to “Burns” listed by authors

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A comparison of the journals that rank in the top 5 in Turkey and in the top 5 at the global level is given in [Figure 26]. Distribution of the papers submitted from Turkey to the top 5 journals in which they were published is compared in [Table 9] by year, institution, and author.
Figure 26: Comparison of the journals that rank in the top 5 in Turkey and at the global level

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Table 9: Comparison of journals in which papers from Turkey were published by number of issues, publication type, contributing institutions and authors

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  Discussion Top


This study is an evidence-based research in medicine and significant for its unique quality. Unlike other studies of analysis, this study does not focus only on the most cited (or classic) journals. The study first takes an overall picture of the current literature in plastic surgery and then focuses on how Turkish plastic surgery is positioned in the international literature. This approach can also allow for comparative subanalyses at both scales based on country, institution, and journal. Building on this study, the current structure of the plastic surgery literature and the nature of the most inspiring structural papers can be analyzed. Another favorable aspect of this study is that the findings also reveal Turkey's contributions to and impact on the number of papers published internationally.

In the international literature, the highest number of published papers was found to be 5190 in 2014. A mean estimate for 2018 based on the number of year-to-date days indicated about 4915 published papers for this year and this may herald the end of the downward trend seen in the last 3 years. Using the same approach for Turkey, the highest number of published papers was calculated as 349 in 2015. A similar mean estimate for 2018 based on the number of year-to-date days indicated that about 266 papers that were produced in Turkey would be published by the end of this year, and the downward trend seen in the last 2 years would be maintained.

A review by country showed that the U.S.A. led by far in the plastic surgery literature in terms of the yearly published papers and the contributions of institutions. While the reasons are open to debate, the leading publishers in the plastic surgery field are from the US which may be a contributing factor in this outcome. Data on the number of submissions to these journals from each country and rejection ratios may help to better understand and analyze this outcome. Another aspect open to debate is whether the positive or negative opinion of editors regarding the countries has any role in the acceptance of manuscripts submitted from these countries. Since all of the journals included in the study are published in English, the language barrier may be another reason. Writing a paper in an academic language will no doubt pose challenges and limitations for nonnative speakers.

Since all authors desire to find presence in journals with a high impact factor and high popularity, the impact factors, popularity levels, and indexing attributes used by journals have a snowball effect for authors. Papers published in journals with a higher impact factor are more likely to reach a wider audience of researchers and receive more citations.

In a study, Seglen PO wrote, “articles in the most cited half of articles in a journal are cited 10 times as often as the least cited half.”[65] The impact factor of a journal is influenced by the citations received to the papers published by that journal. In other words, it is the papers that add to the value of journals rather than journals to papers. When this aspect is overlooked by authors, on submitting a paper to a journal with high impact, they are most likely to receive a response from the editor saying, “We are experiencing a massive increase in submissions and increasing pressure on limited space available. Therefore, manuscripts to be published in our journal must meet the high criteria applicable to all paper types.”

As mentioned earlier, authors desire to publish their papers in journals with a high impact factor and high popularity, and this may be due to a number of reasons. In Turkey, the institutions that grant academic degrees demand as a prerequisite for academic career advancement that candidates have published papers in the journals that are indexed in the SCI and SCIE. Likewise, from the viewpoint of authors, these journals can serve as a front to showcase the quality of their work as well as their capabilities. Yet, after all, the measured impact factor of a journal is – as is the case in this study – updated based on the citations papers retrospectively receive.

Having their papers published in journals with high impact factors can also have some disadvantages for authors. One is the review process prolonged as a result of the high demand to the journal. Another disadvantage is the high likelihood of rejection, as a result of which the manuscript would be submitted to other journals, hence requiring more time to publication and more effort. This is to say that the effort authors have to make to get their papers printed will increase incrementally.

Even if researchers find highly cited papers in high impact journals appealing, it should be borne in mind that structural and inspiring papers can also be published in other journals, and certainly, there are good alternatives to the journals that have high rejection rates. Of the 25 papers that our study identified as having received the highest number of citations, only 9 are included in Hultman SC's book, “50 Studies every Plastic Surgeon Should Know.”[66]

Although Turkey ranks 4th in the number of internationally published papers per year category, none of these papers rank among the top 25 most cited papers. Moreover, the combined number of papers produced in the two U.S. universities that rank highest among the institutions from which papers were submitted is more than the total of papers produced in Turkey. The total number of papers produced in Turkey per year shows a downward trend. Turkey may aim in the short term to increase its number of published papers to 300 per year and may aim in the medium term to perform better than Japan which ranks 3rd with a total of 6450 papers. If this dynamic is captured and maintained, in the long term, the Turkish plastic surgery community may adopt it as an unwritten goal to naturally produce highly cited papers and internationally rank among the top 25 institutions where papers are produced.

Since the top 25 most cited papers, both at international and at national scale, have been addressed in our study, we anticipate that the presented report will contribute to the awareness of the young plastic surgeons who are new to the community.

Those journals which fell outside of our search criteria were excluded from this study and the use of only one database can be addressed as the limitations of this study. Furthermore, technical competence was not addressed in context of discriminating “complimentary authorship.”


  Conclusions Top


The impact factor of a journal may be helpful in giving insight about the journal's popularity. Citations are effective in showing the scientific strength of a cited paper. It should be borne in mind that it is the papers which add to the value of journals and not the other way around.

Periodic bibliometric studies such as the presented can help to systematically and comprehensively demonstrate the trend and the progress achieved in plastic surgery literature. To that end, conducting this type of study every 5 years may aid plastic surgeons in keeping up with the new trends.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11], [Figure 12], [Figure 13], [Figure 14], [Figure 15], [Figure 16], [Figure 17], [Figure 18], [Figure 19], [Figure 20], [Figure 21], [Figure 22], [Figure 23], [Figure 24], [Figure 25], [Figure 26]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]



 

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