Ethics in Global Plastic Surgery Missions.

Background: Delivering ethical care in global plastic surgery is challenging due to the unique complexities of resource-limited settings. Additionally, the rise of medical tourism has highlighted the importance of informed consent and awareness of the potential risks that are associated with seeking medical care in foreign countries. This article aims to consider core medical ethics principles and apply them in the context of delivering global plastic surgery.

The Cost-effectiveness of Enhanced Recovery after Surgery Protocols in Abdominally Based Autologous Breast Reconstruction.

Background: The purpose of this study was to conduct a systematic review on the cost-effectiveness of enhanced recovery after surgery (ERAS) protocols in abdominally based autologous breast reconstruction. Further, we reviewed the use of liposomal bupivacaine transversus abdominis plane (TAP) blocks in abdominal autologous reconstruction.

Methods: PubMed, Embase, Cochrane, and Scopus were used for literature review, and PRISMA guidelines were followed.

Tandem Reconstruction of the Femoral Diaphysis Using an Intercalary Prosthesis and a Fibular Free Flap.

Background: Femoral diaphyseal reconstructions with metal prostheses have mediocre results because of high mechanical forces that result in eventual implant failure. Biological alternatives require prolonged restrictions on weight-bearing and have high rates of infection, nonunion, and fracture. A novel method of utilizing a vascularized fibula in combination with an intercalary prosthesis was developed to complement the immediate stability of the prosthesis with the long-term biological fixation of a vascularized fibular graft.

Ethics Education in U.S. Allopathic Medical Schools: A National Survey of Medical School Deans and Ethics Course Directors.

Unlabelled: AbstractPurpose: to characterize ethics course content, structure, resources, pedagogic methods, and opinions among academic administrators and course directors at U.S. medical schools.

Palliative lower leg reconstruction.

Palliative care is a multidisciplinary field that aims to relieve physical pain and psychological suffering with the goal of improving quality of life rather than focusing on curing or prolonging life. Plastic surgeons may have a role in this near end-of-life care through palliative reconstruction. The use of palliative reconstruction has been frequently described in the setting of head and neck and thoracic malignancies However, there is a paucity in the literature about the role of palliative reconstruction in the lower extremity.

A Retrospective Study Analyzing Opioid Prescription Practices in Hand Surgery from 2013 to 2019.

Background: The potential for opioid prescription medication addiction and abuse has been a growing concern in healthcare. It is not uncommon for hand surgery patients to be overprescribed opioid medication for postoperative pain management. The objective of this study was to characterize changes in opioid prescription practices of hand surgeons treating Medicare Part D patients from 2013 to 2019.

How Should Surgeons Consider Emerging Innovations in Artificial Intelligence and Robotics?

Artificial intelligence (AI)-assisted robotic surgery seems to offer promise for improving patients' outcomes and innovating surgical care. This commentary on a hypothetical case considers ethical questions that AI-facilitated surgical robotics pose for patient safety, patient autonomy, confidentiality and privacy, informed consent, and surgical training. This commentary also offers strategies for mitigating risk in surgical innovation.

Pushing the DIEP Envelope with ERAS: 24 Hour Discharge is Safe in Appropriately Selected Patients.

Unlabelled: Enhanced recovery after surgery protocols have become increasingly adopted for autologous breast reconstruction, demonstrating improved quality of care and reduced hospital stays. Despite this, average length of stay remains over 3 days. We have found, in appropriately selected patients, hospital length of stay can be safely reduced to less than 48 hours.

A Scoping Review of Mobile Apps in Plastic Surgery: Patient Care, Trainee Education, and Professional Development.

Unlabelled: Over the past 10 years, smartphones have become ubiquitous, and mobile apps serve a seemingly endless number of functions in our everyday lives. These functions have entered the realm of plastic surgery, impacting patient care, education, and delivery of services. This article reviews the current uses of plastic surgery mobile apps, app awareness within the plastic surgery community, and the ethical issues surrounding their use in patient care.

Operating in an Opioid Crisis: A Temporal Analysis of Pain Medication Prescribing Practices in Plastic Surgery.

Background: In response to the opioid epidemic, the United States declared a public health emergency in 2017. We evaluated pain medication prescribing practices among plastic and reconstructive surgeons, assessing pain medication prescription rates and opioid-related mortality both nationally and regionally within the United States.

Methods: A retrospective analysis of Medicare Part D prescriber data among plastic surgeons from 2013 through 2017 was conducted.

A 20-Year Analysis of Medicare Reimbursement for Abdominal Wall Reconstruction (2000 to 2020).

Background: The purpose of this study was to evaluate monetary trends in Medicare reimbursement rates for 30 abdominal wall reconstruction surgical procedures over a 20-year period (2000 to 2020).

Methods: The Physician Fee Schedule Look-Up Tool from the Centers for Medicare and Medicaid Services was used for each of the 30 included current CPT codes, and reimbursement data were extracted. Monetary data were adjusted for inflation to 2020 U.

Outcomes and Perioperative Risk Factors after Oncologic Free-Flap Scalp Reconstruction.

Background:  Little is known about the risk factors associated with complications after free flap scalp reconstruction. The purpose of this study was to identify patient, scalp defect, and flap characteristics associated with increased risk of surgical complications.

Methods:  A retrospective study was performed of free-flap scalp reconstruction in oncologic patients at Memorial Sloan Kettering Cancer Center from 2002 to 2017.

Management of Free Fillet Flap Transfers in Large Oncologic Resections.

Unlabelled: The fillet flap is a reliable flap for reconstruction of large deformities following oncologic resection. It provides healthy, nonradiated tissue for coverage with the secondary benefit of preserving other potential donor sites for reconstruction.

Methods: A retrospective review of the medical records of eight patients who underwent fillet flap reconstruction from 2013 to 2021 at Mayo Clinic, Arizona, were analyzed.

Can Montgomery tubercles impact aesthetic 3D nipple-areolar complex tattooing? An anatomical, quantitative analysis of breast cancer patients.

Purpose: We aimed to establish a relationship between the amount of Montgomery tubercles (MTs) per nipple-areolar complex (NAC) given patient characteristics such as age, BMI, menopausal status, race/ethnicity, and NAC size to better inform current 3D NAC tattooing practices.

Methods: Preoperative photographs of patients pursuing breast reconstruction after mastectomy in 2010 through 2018 were reviewed. The number of MTs on each native NAC was quantified.

Outcomes of Lymphovenous Anastomosis for Lower Extremity Lymphedema: A Systematic Review.

Unlabelled: Lymphovenous anastomosis (LVA) is a microsurgical treatment for lymphedema of the lower extremity (LEL). This study systematically reviews the most recent data on outcomes of various LVA techniques for LEL in diverse patients.

Methods: A comprehensive literature search was conducted in the Ovid MEDLINE, Ovid EMBASE, and Scopus databases to extract articles published through June 2021.

Characterization of National Medical Societies' Accessible Resources to Support Underrepresented Minority and Female Trainees.

Importance: The lack of racial, ethnic, and gender diversity in medicine has been recognized as problematic, but the question of what medical educators and societies are doing to rectify and promote representation of historically marginalized groups persists.

Objective: To examine what easily accessible resources are offered by medical and surgical societies to support women and individuals in minority groups that are underrepresented in medicine (URiM).

Design, Setting, And Participants: This cross-sectional study evaluated transparent and accessible resources on the webpages of societies recognized by the Council of Medical Specialty Societies.

A Comparative Analysis of the Common Injections Performed by Plastic Surgeons: 2012 and 2019.

Background: Plastic surgeons regularly perform injections for both cosmetic and functional purposes. This article examines the most common injections utilized by plastic surgeons under Medicare and how their usage and billing has changed between 2012 and 2019.

Methods: Using the earliest and latest data available on the Centers for Medicare and Medicaid Services' Provider Utilization and Payment Data File, we first determined Healthcare Common Procedure Coding System injection codes most billed to Medicare in 2012 and 2019.