A.E. Belousov. Practical Reconstructive and Aesthetic Surgery (St. Petersburg, 1998)

Professional advancement in academic plastic surgery may depend on scholarly activity. The authors evaluate gender-based publishing characteristics in three international plastic surgery journals. A retrospective review of all articles published in 2016 in the following journals was undertaken: Plastic and Reconstructive Surgery, Journal of Plastic, Reconstructive and Aesthetic Surgery, European Journal of Plastic Surgery, Annals of Surgery, and New England Journal of Medicine. Data were collected on lead author gender (first or senior author) and differences in author gender proportions, by journal, by article topic, and by geographic location were evaluated. Overall, 2610 articles were retrieved: 34.1 percent were from plastic surgery journals, 12.8 percent were from the Annals of Surgery, and 53.1 percent were from the New England Journal of Medicine. There was a lower proportion of female lead authors among plastic surgery journals compared with the Annals of Surgery and the New England Journal of Medicine (31 percent versus 39 percent versus 39 percent; p = 0.001). There were no differences in female lead author geographic location in the Annals of Surgery or the New England Journal of Medicine; within the plastic surgery journals, there were differences (p = 0.005), including a lower proportion arising from East Asia (15 percent) and a higher proportion arising from Canada (48 percent). Within plastic surgery, Plastic and Reconstructive Surgery had the lowest proportion of female lead author (p < 0.001). The proportion of female lead author varied by article topic (p < 0.001) and was notably higher in breast (45.6 percent) and lower in head and neck/craniofacial-orientated articles (25.0 percent). There are gender disparities in three mainstream plastic surgery journals-Plastic and Reconstructive Surgery, the Journal of Plastic, Reconstructive and Aesthetic Surgery, the European Journal of Plastic Surgery-and there are lower proportions of lead female authorship compared with the Annals of Surgery and the New England Journal of Medicine. Further research should focus on understanding any geographic disparities that may exist.

Sir: After the initiative by Plastic and Reconstructive Surgery and the American Society of Plastic Surgeons to promote evidence-based medicine1 and to strive for high levels of reporting quality,2 it is current belief that randomized controlled trials are the key to guiding and helping clinical decision making. The broad field of plastic surgery with its subdisciplines reconstructive surgery, burn surgery, aesthetic surgery, and hand surgery often lacks a fair amount of published randomized controlled trials. However, to date, there is no comparative analysis on the recent developments of randomized controlled trials in reconstructive, burn, aesthetic, and hand surgery. Furthermore, reporting quality of randomized controlled trials was addressed by the Consolidated Standards of Reporting Trials group first in 1996, and was updated in 2001 and very recently in 2010.3 The Consolidated Standards of Reporting Trials items aim to improve the reporting quality of randomized controlled trials in full article and in abstract form.4 Using the Consolidated Standards of Reporting Trials items, one can compare the reporting quality of randomized controlled trial conference abstracts, which was a second aim of this analysis. To analyze up to date, we decided to analyze various conferences rather than full articles, given the fact that not all randomized controlled trials presented as abstracts will find their way to a full article within the next 5 years. We analyzed 65 oral abstracts and 94 poster abstracts from the 2008 meeting of the American Society of Plastic Surgeons by two independent researchers. In addition, 152 oral and 100 poster presentations from the 2008 meeting of the American Burn Association were analyzed, as were102 abstracts from the American Society for Surgery of the Hand annual meeting. We determined the evidence-based medicine level of evidence for study design. Furthermore, the level of reporting quality according to the Consolidated Standards of Reporting Trials recommendations was determined with a maximum score of 17 of 17 points. We found that at the American Society of Plastic Surgeons 2008 meeting, 9 percent (5 percent oral and 4 percent poster abstracts) of presentations were randomized controlled trials. Reporting quality at the American Society of Plastic Surgeons meeting was 6.7 ± 1.2 for oral randomized controlled trials and 7.3 ± 1 for poster randomized controlled trials (p = 0.498; 95 percent confidence interval, –2.62 to 1.46) of 17 achievable points according to Consolidated Standards of Reporting Trials criteria. At the American Burn Association Annual Meeting, 7 percent randomized controlled trials were presented, with 5 percent oral and 2 percent poster presentations. Reporting quality according to Consolidated Standards of Reporting Trials criteria was not significantly different for oral versus poster randomized controlled trials (7.2 ± 1.4 versus 6.5 ± 1 of 17 points, p = 0.552; 95 percent confidence interval, –1.78 to 3.06). We identified 10 percent randomized controlled trials at the American Society for Surgery of the Hand meeting. Consolidated Standards of Reporting Trials reporting quality was 8.2 ± 1.4 of 17, somewhat higher than for randomized controlled trials presented at the American Society of Plastic Surgeons meeting. Our results indicate that the amount of randomized controlled trials presented either in oral or poster abstract form at American Society of Plastic Surgeons, American Burn Association, and American Society for Surgery of the Hand meetings is still below 10 percent of all presentations. Given the fact that not every conference abstract will be followed by a full article, these numbers should be discussed. In 1996, Amadio and colleagues studied the rate of full article randomized controlled trials from volume 1 to volume 19 (1994) of The Journal of Hand Surgery. From 3107 articles, letters, and abstracts, they identified 25 controlled clinical trials and eight randomized controlled trials (0.26 percent).5 A 10-year analysis of publications in Plastic and Reconstructive Surgery, Annals of Plastic Surgery, and Aesthetic Surgery Journal revealed a randomized controlled trial publication rate of 3.2 percent.6 A 16-year analysis of all articles published in Aesthetic Plastic Surgery revealed only a 1 percent randomized controlled trial publication rate (11 of 1048 original articles).7 In Plastic and Reconstructive Surgery, the number of randomized controlled trials published increased from 1983 to 2003 from 0 percent to 7 percent.8 As far as reporting quality is concerned, all conference abstracts presented at American Society of Plastic Surgeons, American Burn Association, and American Society for Surgery of the Hand meetings have plenty of room for improvement, with the Consolidated Standards of Reporting Trials statement to be endorsed substantially. Karsten Knobloch, M.D. Uzung Yoon Peter M. Vogt, M.D., Ph.D. Plastic, Hand, and Reconstructive Surgery Hannover Medical School Hannover, Germany

"Background: Robotic surgery currently offers a number of benefits in specific areas of plastic and reconstructive surgery such as head and neck and microsurgery, however, many subspecialties are yet to benefit from robotic operating techniques. In this paper we review recent developments in the use of robotics for head and neck, breast reconstruction, microneural, lymphoedema, craniofacial and aesthetic surgery. Methods: A literature review of English-only articles on the use of robots in plastic and reconstructive surgery was conducted using the PubMed and Web of Science databases along with a free text search using the terms ‘robotic surgery plastic surgery’, ‘robotic-assisted plastic surgery’, ‘robot-assisted reconstructive surgery’, ‘da Vinci plastic surgery’, ‘da Vinci reconstructive surgery’ and ‘supermicrosurgery’. No limitation was placed on time from publication. Results: Of the studies reviewed, the most beneficial to reconstructive surgery is the area of the head and neck, with the most common procedures being transoral surgeries and microvascular procedures. Robotic assisted breast reconstructive surgery is a promising field. The main current limitations are the lack of adequate microsurgical instrumentation and the prolonged setting-up and operative time. Conclusion: As technology improves the outlook for robotic surgery is optimistic. Areas like microsurgery, head and neck, cleft palate, breast reconstructive surgery, lymphatic and microneural surgery already demonstrate promising results. Further technological advances and evidence-based studies are necessary to address current limitations such as appropriate microsurgical instrumentation, high costs and prolonged operative time."

De la SFCPR à la SOF.CPRE

The Belgian Society of Plastic Surgery was founded in 1955. The five founding members were Dr. M. Coelst, Dr. A. de Coninck, Dr. J. Polus, Dr. A. Fardeau and Dr. C. Steenebruggen. Dr. Maurice Coelst was the initiator and first president, and later became the first honorary member. The purpose of the Society was the scientific study of plastic surgery and related specialties, and the organization of congresses and conferences to promote the development of plastic surgery. From a very small group of five members, the Society has grown to a considerable size: 80 full members, 20 associated members and 75 candidate members. The Society also counts 12 honorary members and 16 foreign members. Full members are officially-certified Belgian and Luxembourg plastic surgeons who limit their activities to the domain of plastic, reconstructive and aesthetic surgery and who have made significant scientific contributions to the activities of the Society. These activities have grown from informal evening meetings in the 1950’s to presently two full-day congresses every year, during which communications of high scientific standard are presented and discussed. Because of the expansion of plastic surgery, the name of the Society has been changed into ‘‘Belgian Society of Plastic, Reconstructive and Aesthetic Surgery’’ and comprises subchapters for the study of burns, microsurgery and aesthetic surgery. The Society sponsors a two-yearly prize, which is attributed to a personal scientific study of exceptionally high standards by a Belgian or Luxembourg plastic surgeon or trainee. The Society also sponsors the activities of the Collegium Chirurgicum Plasticum Belgicum. This Collegium organizes teaching days and yearly examinations for all plastic surgery trainees on a national scale. Successfully passing these evaluations has become a prerequisite for obtaining certification as a specialist in plastic, reconstructive and aesthetic surgery. Together with a training of 6 years: 2 years of basic general surgery and 4 years of plastic surgery in one of the seven certified training centers in Belgium and Luxembourg,this system ensures a very high standard of specialization in plastic surgery. Many members participate very actively in many scientific societies in Belgium and abroad. The Belgian participation in EURAPS is very strong, and the prize for the best presentation has been awarded to Belgian plastic surgeons several times. The Society has a close relationship with its Dutch sister Society. Every 2 years a joint meeting is held, alternately in Belgium and in The Netherlands. In 2005 the Belgian Society of Plastic, Reconstructive and Aesthetic Surgery will celebrate its 50th anniversary with a 2-day Congress in Brussels on May 6 and 7. On the occasion of the Congress, a commemorative book will be published highlighting and illustrating the history of the Society. Finally, the Society is very grateful to Ian Jackson for allowing its members to fill an entire issue of the European Journal of Plastic Surgery.

Plastic Surgeonsʼ Performance during the February 27 Earthquake in Chile

CONSORT

Where is Archives of Plastic Surgery Now? And Where is It Heading?

The Level of Evidence Pyramid: Indicating Levels of Evidence in Plastic and Reconstructive Surgery Articles

Goals/Purpose Plastic and reconstructive surgery (PRS), and especially aesthetic surgery, is uniquely characterized by an increased ability to research and select their surgeon. As the increasing number of female plastic surgeons begin to establish themselves in practice, it remains understudied if gender or implicit gender biases is a variable in patient surgeon-selection. Wallis, et al.’s landmark paper in 2023 suggested that female surgeons exhibited a lower risk-adjusted likelihood of adverse postoperative outcomes, including mortality, hospital readmission, and major medical complications, although the precise mechanisms remain unclear. Currently, it is unknown if the public is aware of these findings, and if it these findings would impact patient-surgeon selection. Patient-surgeon selection may be an opportunity where PRS may lead surgical subspecialties in addressing implicit surgeon gender biases due to the predominance of female patients, and improved gender representation in surgical training programs compared to other surgical subspecialties. The purpose of this study is to explore public preferences and perspectives on the role of surgeon gender in patient surgeon-selection in PRS, and if knowledge of gender-correlated surgical outcomes impact surgeon selection. A secondary aim is to examine if these public preferences differ between reconstructive versus aesthetic surgery. Methods/Technique A cross-sectional survey was distributed through Amazon’s Mechanical Turk (mTurk). Subjects were at least 18 years old and residents of the United States. Participants were briefed about hypothetical scenarios involving aesthetic and reconstructive surgical procedures, and then asked to choose either a male and female surgeon. They were then presented with an excerpt of Wallis, et al. (2023) findings, and reassessed for surgeon gender preference. The participant cohort was stratified by gender, classifying them as female and male responders. Differences between groups were evaluated using the unpaired t-test and Fisher exact tests. Multivariate logistic regression models were constructed to assess associations between plastic surgeon gender preference and sociodemographic characteristics. Stata statistical software (STATA Corp., BE, 18.0) was used to conduct all statistical analyses. Results/Complications A total of 547 participants were included. Of those, 310 (56.7%) were male and 237 (43.3%) were female. The mean age was 33.8 (SD 6.8) for the male group and 35.1 (SD 7.2) for the female group. Both groups had similar percentages of level of education (p=0.071). Significant differences were observed in race (p=0.004), ethnicity (p&amp;lt;0.001), U.S. region of residency (p&amp;lt;0.001), and religion (p&amp;lt;0.001) (Table 1). Both groups had similar percentages of previous PRS background/interest (M: 81.3%, F: 86.1%, p=0.164). However, female participants had higher percentages of aesthetic background/interest (86.1%) compared to the male counterparts (78.7%, p=0.033). Similar interest/background in reconstructive procedures was found between groups (M: 60.0%, F: 45.6%, p=0.222) (Table 2). Statistically significant differences emerged in overall preferences for physician's gender (p&amp;lt;0.001), as well as preferences for the gender of plastic surgeons conducting aesthetic non-surgical (p&amp;lt;0.001), aesthetic surgical (p&amp;lt;0.001), and reconstructive surgical procedures (p&amp;lt;0.001), particularly favoring the same-gender preference. A higher percentage of male participants believed that the plastic surgeon's gender impacts surgical outcomes (77.4% vs. 62.0%, p&amp;lt;0.001), associating better outcomes with male surgeons (91.2%). The majority of female responders favored female surgeons for better outcomes (63.9%, p&amp;lt;0.001). Following exposure to an excerpt from the Wallis, et al. (2023) published article, preferences for female plastic surgeons increased among both groups, with statistically higher rates in the male group (79.4% vs. 69.6%; p=0.010) (Table 3). Multivariate logistic regression analysis demonstrated that for aesthetic surgical procedures, female gender [10.65 OR; 95% CI (5.65–1.29); p&amp;lt;0.001], living in the Southwest region [1.88 OR; 95% CI (1.11–12.62); p=0.033], were factors independently linked to a higher preference for female plastic surgeons. Conversely, age [0.97 OR; 95% CI (0.94–0.99); p=0.025], and having a background/interest in reconstructive procedures [0.57 OR; 95% CI (0.35–0.93); p=0.027] were associated with a lower preference for female plastic surgeons in this category (Table 5). Following presentation of an excerpt from the Wallis, et al. (2023) article, Hispanic ethnicity [2.67 OR; 95% CI (1.31–5.48); p=0.007], residing in the Southeast region [3.12 OR; 95% CI (1.43–6.81); p=0.004], having a background/interest in aesthetic [2.05 OR; 95 %CI (1.16–3.63); p=0.014], and reconstructive procedures [3.86 OR; 95% CI (2.29–6.51); p&amp;lt;0.001] were associated with a higher likelihood of shifting preference towards female plastic surgeons (Table 7). Conclusion Participants demonstrated a predominant preference for surgeons of the same gender across aesthetic non-surgical, aesthetic surgical, and reconstructive procedures. Initially, gender biases affected perceptions of surgeon gender and surgical outcomes, particularly notable among male participants. However, this preference notably changed following exposure to a segment of published literature on surgeon outcomes based on gender. These findings support the importance of gender diversity in plastic surgery due to patient preference, and suggests that implicit gender biases in patient surgeon-selection persist, but can potentially be addressed with patient education. Rigorous future studies are required to expand hypothesizes generated from this proof-of-concept study, and should emphasize including non-binary populations.

The Journal of Bone and Joint Surgery. British volumeVol. 52-B, No. 2 Clinical StudiesFree AccessDELAYED PRIMARY SUTURE OF FLEXOR TENDONS CUT IN THE DIGITAL SHEATHErin MadsenErin MadsenSearch for more papers by this authorPublished Online:1 May 1970https://doi.org/10.1302/0301-620X.52B2.264AboutSectionsPDF/EPUB ToolsAdd to FavouritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited ByPrimary Care of Flexor Tendon InjuriesLong-term functional results of primary reconstruction of severe forearm injuriesJournal of Plastic, Reconstructive & Aesthetic Surgery, Vol. 60, No. 4The Scientific Basis for Advances in Flexor Tendon SurgeryJournal of Hand Therapy, Vol. 18, No. 2Development of flexor tendon surgery: Twenty-five years of progressThe Journal of Hand Surgery, Vol. 25, No. 2Surgical Treatment of the Divided Flexor Digitorum Profundus Tendon in Zone 2, Delayed More than 6 Weeks, by Tendon Grafting in 50 Cases29 August 2016 | Journal of Hand Surgery, Vol. 21, No. 1Flexor sheath closure during delayed primary tendon repairThe Journal of Hand Surgery, Vol. 19, No. 4Acute Flexor Tendon InjuriesOrthopedic Clinics of North America, Vol. 23, No. 1Long-term follow-up of primary flexor pollicis longus tenorrhaphiesThe Journal of Hand Surgery, Vol. 16, No. 4Zone II flexor tendon repair: Effects of vitamins A, E, β-caroteneJournal of Surgical Research, Vol. 49, No. 1Primary Care of Flexor Tendon InjuriesHand Clinics, Vol. 5, No. 3Early Mobilisation after Flexor Tendon Repair17 January 2017 | Journal of Hand Surgery, Vol. 14, No. 4Flexor Tendon Surgery17 January 2017 | Journal of Hand Surgery, Vol. 14, No. 4Flexor Tendon InjuriesHand Clinics, Vol. 2, No. 1Flexor Tendon RepairHand Clinics, Vol. 1, No. 1Management of Acute Flexor Tendon InjuriesOrthopedic Clinics of North America, Vol. 14, No. 4Unterarm, Handgelenk und HandDigital function following flexor tendon repair in Zone II: A comparison of immobilization and controlled passive motion techniquesThe Journal of Hand Surgery, Vol. 5, No. 6Delayed Primary Suture of Flexor Tendons Cut in the Digital Theca4 December 2016 | Hand, Vol. os-12, No. 2Flexor Tendon Repair in No Man's Land8 July 2009 | Scandinavian Journal of Plastic and Reconstructive Surgery, Vol. 14, No. 3Flexor Tendon Repair in No Man's Land8 July 2009 | Scandinavian Journal of Plastic and Reconstructive Surgery, Vol. 14, No. 3Primary Repair Of Flexor Tendons Within The Digital Theca Of The Hand18 July 2017 | Hand, Vol. os-10, No. 2Delayed flexor tendon repair in no man's landThe Journal of Hand Surgery, Vol. 2, No. 6Tendon HealingClinics in Plastic Surgery, Vol. 4, No. 3Vascular changes in flexor tendons after injury and repair: an experimental studyInjury, Vol. 8, No. 3Assessment of the influence of the timing of repair on flexor tendon injuries in chickensBritish Journal of Plastic Surgery, Vol. 29, No. 1Diagnosis and Management of the Severed Flexor Tendon of the HandSurgical Clinics of North America, Vol. 54, No. 4Surgery of the HandNew England Journal of Medicine, Vol. 287, No. 23Delayed Primary Suture in Flexor Tendon Division6 December 2016 | Hand, Vol. 3, No. 2 Vol. 52-B, No. 2 Metrics Downloaded 32 times History Published online 1 May 1970 Published in print 1 May 1970 InformationCopyright © 1970, The British Editorial Society of Bone and Joint Surgery: All rights reservedPDF download

Clinical OtolaryngologyVolume 35, Issue 4 p. 332-336 CORRESPONDENCE: HOW WE DO IT: The internal mammary artery perforator pedicled island flap for reconstruction of the lower head and neck and supraclavicular region: how we do it P.P.A. Schellekens, P.P.A. Schellekens Departments of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, UtrechtSearch for more papers by this authorJ.J. Hage, J.J. Hage Department of Plastic and Reconstructive Surgery at the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The NetherlandsSearch for more papers by this authorE.C. Paes, E.C. Paes Departments of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, UtrechtSearch for more papers by this authorM. Kon, M. Kon Departments of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, UtrechtSearch for more papers by this author P.P.A. Schellekens, P.P.A. Schellekens Departments of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, UtrechtSearch for more papers by this authorJ.J. Hage, J.J. Hage Department of Plastic and Reconstructive Surgery at the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The NetherlandsSearch for more papers by this authorE.C. Paes, E.C. Paes Departments of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, UtrechtSearch for more papers by this authorM. Kon, M. Kon Departments of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, UtrechtSearch for more papers by this author First published: 25 August 2010 https://doi.org/10.1111/j.1749-4486.2010.02171.xCitations: 11 J.J. Hage, MD, PhD, Department of Plastic and Reconstructive Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, NL-1066 CX Amsterdam, The Netherlands. Tel.: +31 20 512 2979; fax: +31 20 512 2554; e-mail: j.jorishage@inter.nl.net Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume35, Issue4August 2010Pages 332-336 RelatedInformation

Within plastic surgery, a patient's most commonly used first point of information before consulting a surgeon is the internet. Free-to-use artificial intelligence (AI) websites like ChatGPT (Generative Pre-trained Transformers) are attractive applications for patient information due to their ability to instantaneously answer almost any query. Although relatively new, ChatGPT is now one of the most popular artificial intelligence conversational software tools. The aim of this study was to evaluate the quality and readability of information given by ChatGPT-4 on key areas in plastic and reconstructive surgery. The ten plastic and aesthetic surgery topics with the highest worldwide search volume in the 15 years were identified. These were rephrased into question format to create nine individual questions. These questions were then input into ChatGPT-4. The response quality was assessed using the DISCERN. The readability and grade reading level of the responses were calculated using the Flesch-Kincaid Reading Ease Index and Coleman-Liau Index. Twelve physicians working in a plastic and reconstructive surgery unit were asked to rate the clarity and accuracy of the answers on a scale of 1-10 and state 'yes or no' if they would share the generated response with a patient. All answers were scored as poor or very poor according to the DISCERN tool. The mean DISCERN score for all questions was 34. The responses also scored low in readability and understandability. The mean FKRE index was 33.6, and the CL index was 15.6. Clinicians working in plastics and reconstructive surgery rated the questions well in clarity and accuracy. The mean clarity score was 7.38, and the accuracy score was 7.4. This study found that according to validated quality assessment tools, ChatGPT-4 produced low-quality information when asked about popular queries relating to plastic and aesthetic surgery. Furthermore, the information produced was pitched at a high reading level. However, the responses were still rated well in clarity and accuracy, according to clinicians working in plastic surgery. Although improvements need to be made, this study suggests that language models such as ChatGPT could be a useful starting point when developing written health information. With the expansion of AI, improvements in content quality are anticipated.

EURAPS at 20 years. A brief history of European Plastic Surgery from the Société Européenne de Chirurgie Structive to the European Association of Plastic Surgeons (EURAPS)

Burn injury caused by flammable flying toy balloons