[Rethinking scientific integrity in plastic surgery: Reflections on editorial and institutional responsibilities].

Abstract

Plastic surgery, by nature an innovative discipline, has historically relied on clinical case reports to advance its techniques. Often unique, these cases are a valuable vehicle for disseminating breakthroughs - especially in a field marked by highly individualized practices and artisanal surgical approaches, where randomized trials are often impractical. However, this reliance on case reports raises significant ethical concerns. In multidisciplinary settings, attribution of contributions often remains ambiguous. Misconduct, such as unauthorized publications or omission of institutional recognition, threatens the integrity of scientific output. As artificial intelligence reshapes biomedical research - automating literature reviews and meta-analyses - original case reports, by their singularity, escape these predictive models. Their heuristic value fully justifies their inclusion within the spectrum of scientific evidence. For this reason, their publication must be tightly regulated. Redefining publication standards in our field is essential. This includes the systematic application of international guidelines (CARE, SCARE, STROBE, GRIPP2), mandatory institutional approval before submission, formal training in research ethics for junior staff, and full transparency regarding patient consent and authorship attribution. When rigorous, novel, and well-contextualized, the clinical case remains a cornerstone of surgical progress. By safeguarding it from opportunistic misuse, we preserve its scientific and educational value.