Comparison of Complication Risks Following Lower Extremity Free Flap Reconstruction Based on Seven Pre-Operative Indications: Analysis of the ACS-NSQIP Database.

Free tissue transfer is a valuable surgical option for the reconstruction of a myriad of complex lower extremity defects. Currently, there is a paucity of data that examines the risks of complications for each of these unique indications. Patients undergoing lower extremity free flap reconstruction from the ACS-NSQIP 2011-2019 database were stratified into groups based on the etiology and indication for reconstruction.

Enlarged Breast Size (Macromastia) and Associated Neurologic Risks: A Scoping Review.

Background And Objectives: Symptomatic macromastia (enlarged breasts) is a syndrome of persistent headache, neck and shoulder pain, thoracic kyphosis, painful shoulder grooving from bra straps, inframammary rash, backache, and upper extremity paresthesias. Up to 89% of the 100,000 US women undergoing breast reduction surgery (reduction mammoplasty) annually report headache preoperatively with many endorsing postoperative headache improvement. Headache is one insurance indication to cover surgical reduction, and peak prevalence of migraine matches the average age of women with macromastia at time of surgery.

The Upcoming Pass/Fail USMLE Step 1 Score Reporting: An Impact Assessment From Medical School Deans.

The US Medical Licensing Examination (USMLE) Step 1 change to pass/fail has been met with mixed reviews, and the impact on medical student education and residency match is unknown. We surveyed medical school student affairs deans regarding their thoughts on the upcoming transition of Step 1 to pass/fail. A questionnaire was emailed to medical school deans.

Perspectives on the Plastic Surgery Common Application (PSCA): A Survey of 2021-2022 Integrated Plastic Surgery Applicants.

Unlabelled: The Plastic Surgery Common Application (PSCA) was introduced as a free and specialty-specific application for plastic surgery applicants in the 2020-2021 cycle. Now in its second year, the PSCA is being piloted by all integrated residency programs with future plans to replace Electronic Residency Application Service (ERAS) in the 2022-2023 cycle. This study aimed to explore applicant perspectives related to the PSCA and ERAS applications.

Outpatient Prosthetic-Based Reconstruction during COVID-19 Pandemic Possible in Selected Patients without Increased Complications.

Background: Following the reopening of elective surgery, the authors' division transitioned from inpatient admission to same-day discharge for immediate prosthetic breast reconstruction in an effort to decrease the hospital's clinical burden and minimize potential coronavirus disease of 2019 exposure. This study aims to compare complication rates following this acute transition for patients who had inpatient and outpatient mastectomy with immediate alloplastic reconstruction.

Methods: A retrospective chart review was performed on patients who underwent mastectomy with immediate prosthetic reconstruction.

Public Confidence for Undergoing Elective Plastic Surgery Procedures during the COVID-19 Pandemic.

Background: The COVID-19 vaccine rollout has since been followed by a gradual resumption of elective surgery. Many individuals remain cautious about visiting a hospital or clinic to undergo surgery. As plastic surgeons are starting to resume elective surgery at this time, it is important to understand the perspectives of potential patients and the concerns they may have.

Neurotization in Innervated Breast Reconstruction: A Systematic Review of Techniques and Outcomes.

Background: Significant improvements in sensory recovery after innervated breast reconstruction have been reported. However, surgical approaches and sensory testing methods have been widely variable. This systematic review aimed to synthesize neurotization techniques and outcomes in breast reconstruction surgery.

A national analysis of outpatient mastectomy and breast reconstruction trends from 2013 through 2019.

Background: Traditionally, patients with breast reconstruction (BR) were hospitalized at least one day postoperatively. However, new trends suggest that outpatient surgery is a viable and safe alternative. This study aims to assess trends among patients with breast cancer who underwent outpatient mastectomy alone, with immediate BR (IBR) or delayed BR (DBR).

Current Applications of Ultrasound Imaging in the Preoperative Planning of DIEP Flaps.

Background:  The deep inferior epigastric artery perforator (DIEP) flap has become the gold standard for autologous breast reconstruction at many institutions. Although the deep inferior epigastric artery displays significant anatomic variability in its intramuscular course, branching pattern and location of perforating vessels, the ability to preoperatively visualize and map relevant vascular anatomy has increased the efficiency, safety and reliability of the DIEP flap. While computed tomography angiography (CTA) is often cited as the preoperative imaging modality of choice for perforator flaps, more recent advances in ultrasound technology have made it an increasingly attractive alternative.

Evaluation of Social Media Utilization by Academic Plastic Surgery Programs during the COVID-19 Pandemic.

Background: In response to the cancellation of away rotations and the shift to virtual interviews due to the coronavirus disease of 2019 (COVID-19) pandemic, residency programs have pursued other methods of sharing program details, most notably with the use of social media. This study aimed to evaluate the extent of social media utilization in the setting of the COVID-19 pandemic by plastic surgery residency programs.

Methods: Instagram, Twitter, and Facebook accounts of plastic surgery programs, program directors, and chiefs were identified.

Trends and characteristics of neurotization during breast reconstruction: perioperative outcomes using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP).

This study aimed to investigate the impact of performing neurotization during breast reconstruction on total operating time and post-operative morbidity. The 2015 through 2019 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) databases were utilized to identify patients who underwent breast reconstruction with and without neurotization. Baseline demographics, comorbidities, operative characteristics and outcomes were examined for each group.

A Systematic Review and Meta-Analysis Evaluating the Impact of Tranexamic Acid Administration in Aesthetic Plastic Surgery.

Background: Recent evidence suggests tranexamic acid (TXA) may improve outcomes in aesthetic surgery patients.

Objectives: This systematic review aimed to investigate the impact of TXA use in aesthetic plastic surgery on bleeding and aesthetic outcomes.

Methods: A systematic literature search was conducted to identify studies evaluating TXA use in aesthetic plastic surgery.

Multidisciplinary Heart Team Approach for Complex Coronary Artery Disease: Single Center Clinical Presentation.

Background The Heart Team approach is ascribed a Class I recommendation in contemporary guidelines for revascularization of complex coronary artery disease. However, limited data are available regarding the decision-making and outcomes of patients based on this strategy. Methods and Results One hundred sixty-six high-risk coronary artery disease patients underwent Heart Team evaluation at a single institution between January 2015 and November 2018.

Aortic valve replacement associated with survival in severe regurgitation and low ejection fraction.

Objectives: Although guidelines support aortic valve replacement (AVR) in patients with severe aortic regurgitation (AR) and left ventricular ejection fraction (LVEF) <50%, severe left ventricular dysfunction (LVEF <35%) is thought to confer high surgical risk. We sought to determine if a survival benefit exists with AVR compared with medical management in this high-risk, relatively rare population.

Methods: A large institutional echocardiography database was queried to identify patients with severe AR and LVEF <35%.

Functional Analysis of the 60-Nucleotide Duplication in the Respiratory Syncytial Virus Buenos Aires Strain Attachment Glycoprotein.

Unlabelled: There are two subgroups of respiratory syncytial virus (RSV), A and B, and within each subgroup, isolates are further divided into clades. Several years ago, multiple subgroup B isolates which contained a duplication of 60 nucleotides in the glycoprotein (G) gene were described. These isolates were given a new clade designation of BA based on the site of isolation, Buenos Aires, Argentina.