Eplasty最新文献

{"title":"Can ChatGPT Be Used as a Research Assistant and a Patient Consultant in Plastic Surgery? A Review of 3 Key Information Domains.","authors":"Joseph A Campolo, Daniel Y Kwon, Peter W Henderson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chat Generative Pretrained Transformer (ChatGPT), a newly developed pretrained artificial intelligence (AI) chatbot, is able to interpret and respond to user-generated questions. As such, many questions have been raised about its potential uses and limitations. While preliminary literature suggests that ChatGPT can be used in medicine as a research assistant and patient consultant, its reliability in providing original and accurate information is still unknown. Therefore, the purpose of this project was to conduct a review on the utility of ChatGPT in plastic surgery.</p><p><strong>Methods: </strong>On August 25, 2023, a thorough literature search was conducted on PubMed. Papers involving ChatGPT and medical research were included. Papers that were not written in English were excluded. Related papers were evaluated and synthesized into 3 information domains: generating original research topics, summarizing and extracting information from medical literature and databases, and conducting patient consultation.</p><p><strong>Results: </strong>Out of 57 initial papers, 8 met inclusion criteria. An additional 2 were added based on the references of relevant papers, bringing the total number to 10. ChatGPT can be useful in helping clinicians brainstorm and gain a general understanding of the literature landscape. However, its inability to give patient-specific information and act as a reliable source of information limit its use in patient consultation.</p><p><strong>Conclusion: </strong>ChatGPT can be a useful tool in the conception of and execution of literature searches and research information retrieval (with increased reliability when queries are specific); however, the technology is currently not reliable enough to be implemented in a clinical setting.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e49"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Barbed Sutures for Capsulorrhaphy in Implant-Based Breast Reconstruction.","authors":"Madison Rose Tyle, Matthew Nester, Mariel McLaughlin, Amra Olafson, Nicole K Le, Kristen Whalen, Cameron Juybari, Emily Coughlin, Rahul Mhaskar, Paul D Smith, Deniz Dayicioglu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A common postoperative challenge following implant-based breast reconstruction surgery is lateral or inferior displacement of the implant, which ultimately requires surgical intervention to shape the pocket for improved symmetry. Capsulorrhaphy is traditionally performed with smooth sutures, but the use of barbed sutures has proven to be more efficient and effective in other plastic surgery procedures. This study aimed to demonstrate the safety and efficacy of barbed sutures for breast reconstruction implant capsulorrhaphy.</p><p><strong>Methods: </strong>A retrospective cohort study was performed including all consecutive patients who underwent capsulorrhaphy by the senior author utilizing barbed sutures and, for comparison, another colleague utilizing smooth sutures from the years 2018-2021.</p><p><strong>Results: </strong>Twenty-eight patients were identified who underwent barbed suture capsulorrhaphy (a total of 36 breasts operated on), which was compared with 20 patients who had smooth suture capsulorrhaphy (a total of 34 breasts operated on). The average ages of the barbed and smooth suture cohorts were 55 and 53 years old (<i>P</i> = 1.00), respectively. The average BMI of the barbed and smooth suture cohorts were 26.7 and 25.0 kg/m² (<i>P</i> = .15), respectively. The reoperation rates for both groups were similar at 5%. Overall complication rate was 13.9% in the barbed suture group and 8.8% in the smooth suture group, which was not statistically significant (<i>P</i> = .71). Patients with barbed sutures did not have an increased risk of complications compared with those who received smooth sutures (OR 1.67 (0.37-7.59), <i>P</i> = .51).</p><p><strong>Conclusions: </strong>In conclusion, performing implant-based breast reconstruction capsulorrhaphy with barbed sutures is a safe and effective procedure as compared with smooth sutures.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e50"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstructive Management of a Severe Mentosternal Contracture in a Resource-Limited Setting: A Case Report from Ghana, West Africa.","authors":"Ryan Benson, Erica Rego, Albert Benneh, Edward S Lee","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This case report describes the surgical management of a severe mentosternal contracture in a 49-year-old woman in Ghana, West Africa, secondary to an acid burn injury. With limited resources, the treatment involved scar excision and full-thickness skin grafting in a single operation performed solely under local anesthetic infiltration, with no use of oral, inhaled, or parenteral anesthetic or sedating agents. As we were unable to find any documented cases performed under only local anesthesia, this case highlights a simplified reconstructive and anesthetic approach to managing complex, disabling burn contractures in low-income countries, particularly where advanced reconstructive options and monitored anesthesia care are not readily available.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e48"},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nitinol Compression Staple Versus Headless Compression Screw Fixation for Scaphoid Waist Fractures.","authors":"Adam M Kurland, Dominick V Congiusta, Ashley Ignatiuk, Abram E Kirschenbaum, Michael M Vosbikian, Irfan H Ahmed","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>There are a variety of ways to surgically manage patients with scaphoid waist fractures. The purpose of this study is to compare the rate of union achieved with a nitinol compression staple versus that of a headless compression screw in the treatment of scaphoid waist fractures.</p><p><strong>Methods: </strong>We performed a retrospective review of patients with middle-third scaphoid fractures treated surgically. Patients were stratified into 2 groups based on fixation device: a nitinol compression staple or headless compression screw (HCS). Primary outcome was radiographic union. Secondary outcomes included time from surgery to union, development of avascular necrosis (AVN), complication rate, and need for revision.</p><p><strong>Results: </strong>Forty-one patients were included in the final analysis. The median follow-up time was 5.7 months. Twenty patients were treated with staples, 21 with HCS. Thirty-seven patients achieved union. All who failed to unite were treated with HCS. Eight patients had postoperative complications, including postoperative AVN, all of whom were in the HCS cohort. This treatment group had a higher rate of revision surgery as well. Staples required less time to achieve union and fewer weeks of immobilization. Postoperative scapholunate angles were similar between the groups.</p><p><strong>Conclusions: </strong>Fixation of scaphoid waist fracture with nitinol compression staples is at least as likely to achieve union as fixation with HCS in patients without prior surgical intervention. This treatment also demonstrated equivalent or better secondary outcomes, including postoperative AVN, complication and revision rates, time to union, and weeks immobilized.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e47"},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation-Induced Angiosarcoma in a Patient With Klippel-Trenaunay Syndrome: A Case Report.","authors":"Timothy Nehila, Carson Bair, Nicholas Alford, Deniz Dayicioglu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Klippel-Trenaunay syndrome (KTS) is a rare vascular disorder that typically presents in the lower limb with unilateral port-wine discoloration of the skin due to capillary malformations, varicose veins, and soft tissue and bone overgrowth. Radiation-induced angiosarcoma (RIAS) is a rare vascular malignancy that develops as a long-term complication secondary to radiation therapy. While there is no well-established direct relationship between KTS and development of angiosarcoma, there is literature that suggests a logical association between the 2 disorders. The present case report highlights the importance of further research into a potential connection between KTS and RIAS.</p><p><strong>Methods: </strong>A 51-year-old female with a history of KTS was referred to the plastic surgery clinic for delayed breast reconstruction following RIAS of the left breast. It was decided that a 2-stage left latissimus dorsi musculocutaneous flap reconstruction with silicone implant would best achieve her goal of symmetry.</p><p><strong>Results: </strong>The patient reported here had an unremarkable postoperative course. Of note, this patient experienced severe body dysmorphia after her mastectomy and RIAS excision due to the absence of her left breast juxtaposed with her prior large right breast augmentation. The choice of 2-stage combined autologous/implant reconstruction likely contributed to her satisfactory cosmetic outcome.</p><p><strong>Conclusions: </strong>While RIAS and KTS are distinct conditions, a link may exist between the two. More research is needed to investigate this possible relationship. Aggressive treatment of RIAS is crucial for patient recovery, and a 2-stage combined autologous/implant reconstruction is an optimal choice for post-RIAS reconstruction, especially in patients hoping to achieve a large breast size.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e46"},"PeriodicalIF":0.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed Neuroendocrine-Squamous Cell Carcinoma of the Hand With Metastatic Dissemination: A Case Report.","authors":"Jubril Adepoju, John A Toms, Elizabeth S O'Neill, Mark Grievous, Jafar Hasan, Christina Tragos, Matthew Doscher","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cutaneous manifestations of mixed neuroendocrine non-neuroendocrine neoplasms remain a diagnostic rarity. Predominantly identified within internal glandular organs, the digestive tract, and in the hepatobiliary system, this case report illustrates a unique occurrence of a mixed squamous cell and neuroendocrine tumor in the index finger of a justice-affected patient. We discuss the complexities of diagnosis and complications as well as emphasize the importance for hand surgeons to recognize presentations like this and the need for vigilant follow-up and improved care coordination.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e45"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased Use of Anti-Inflammatory Medications in Autoimmune Connective Tissue Disease Patients Following Breast Implant Removal: A National Analysis.","authors":"Jennifer K Shah, Daniel Najafali, Ethan Fung, Mallory Rowley, Kometh Thawanyarat, Priscila C Cevallos, Nathan Makarewicz, Karanvir S Raman, Rahim Nazerali","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Recent case studies demonstrate resolution of rheumatologic symptoms following implant explantation, raising concern around breast implant illness and associated inflammatory symptomatology. In patients with connective tissue disorders (CTD) and breast implants, we quantified the number of anti-inflammatory medications as a proxy for inflammation and disease burden before and after implant removal.</p><p><strong>Methods: </strong>Using the Clinformatics Data Mart Database, adult female patients from 2003 to 2021 were queried. <i>Current Procedural Terminology</i> codes were used to identify patients who underwent implant-based reconstruction and subsequent implant removal. <i>International Classification of Diseases, Ninth</i> (ICD-9) and <i>Tenth Revision</i> (ICD-10) codes identified patients with CTD. Filled prescriptions of anti-inflammatory drugs were quantified for each patient during the preoperative, perioperative, and postoperative windows surrounding breast implant removal.</p><p><strong>Results: </strong>Of 1015 patients meeting criteria (mean age 56 ± 12 years), 821 (81%) filled prescriptions during the preoperative window, 753 (74%) filled during the perioperative window, and 735 (73%) filled during the postoperative window. Patients filled significantly fewer postoperative prescriptions than preoperative prescriptions (<i>P</i> < .001).Statistically significant predictors of the number of anti-inflammatory prescriptions filled in the postoperative window included additional anti-inflammatory prescriptions filled in the preoperative (<i>P</i> < .001) and perioperative (<i>P</i> < .001) windows. Experiencing a complication was not associated with the number of prescriptions filled in the postoperative window (<i>P</i> = .935).</p><p><strong>Conclusions: </strong>We found a significant decrease in filled anti-inflammatory prescriptions in patients with known CTD following implant removal, suggesting that breast implant removal may help diminish inflammatory symptomology in predisposed patients.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e44"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of a Congenital Melocytic Giant Naevi at Age 39 Using Split-Thickness Skin Graft Over an Artificial Dermal Scaffold Through 2-Step Operation: A Novel Technique and Literature Review.","authors":"Merve Akin, Ali Emre Akgün, Huriye Bilge Tuncer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Congenital melanocytic nevus is a benign proliferation seen from birth. However, malignant transformation can be observed in later ages, so the removal of especially large and giant nevi is recommended during childhood. Nevertheless, there are no cases reported in the literature regarding excision of giant congenital melanocytic nevi in advanced age. This article presents the first case of a 39-year-old patient with a giant congenital melanocytic nevus covering 10% of the total body surface area, who underwent treatment with a 2-step operation. The nevus was located on the back, covering 10% of the total body surface area. The patient underwent en-bloc excision. A bilayer dermal matrix was applied over the fascia. Subsequently, a split-thickness skin graft was applied to the entire area. Full re-epithelialization was achieved within a total of 35 days. Thanks to the applied dermal scaffold, the area became pliable.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e43"},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost Effective, Simple, and Reliable Intraoperative Breast Sizer for Selecting Implant Volume in Breast Reconstruction With Double-Drape, Double-Donut: Standard Lap Pad.","authors":"Ryan A Cantrell, Alexander L Mostovych, Carter Prewitt, Claire Fell, Sierra M Shockley, Bradon J Wilhelmi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"QA21"},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Bilobed Flap - Critical Analysis and New Mathematically Precise Design.","authors":"Imran Pathan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A bilobed flap is a workhorse flap to reconstruct the lower third of the nasal defect. It has been described as a double transposition flap. Various changes have been proposed to reduce the drawbacks of this flap. Most of the modifications pay attention to flap width and length without emphasizing the pivot point. In this article, the classic Zitelli design is tested for its mathematical precision, and the key role of the pivot point is discussed.</p><p><strong>Method: </strong>The bilobed flap was designed with accurate mathematical measurement on simple drawing software. Its design and flap movement were studied and critically analyzed. The biogeometry of the flap was investigated with multiple diagrams and various mathematical principles.</p><p><strong>Results: </strong>The classic description carries some mathematical errors. The author describes a new design that is more precise mathematically. A proper pivot point location is vital for accurate design and flaps movement. Putting the pivot point at a distance 2.6 times the radius of the defect makes the movement of the flaps precise. In a proper design, the extension of secondary flap length is an optional step, and the dog-ear so formed can be tackled separately. This new design of the bilobed flap only needs rotation advancement movement.</p><p><strong>Conclusions: </strong>The bilobed flap is one of the major tools for lower third nasal reconstruction. A perfectly designed bilobed flap is primarily a rotation flap. A slight modification of classic design by putting the pivot point at a distance 2.6 times of the radius of the defect makes it more perfect mathematically.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e42"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}