Xylazine-Associated Necrotic Upper-Extremity Wounds: A Single Hospital System's Experience with 82 Patients and 125 Wounds.

Background: The rise in xylazine-adulterated heroin and fentanyl poses novel challenges to hand surgeons and a rising epidemic of necrotic upper-extremity wounds. While prior case studies have focused on particularly severe and complex xylazine-associated necrotic (XAN) wounds, the aim of this consecutive case series was to characterize the variability of presentations (ranging from mild to severe) at a single institution at the epicenter of the xylazine epidemic.

Methods: Patients presenting to a tertiary referral center for XAN upper-extremity wounds were retrospectively identified from emergency department visits and hospital admissions between January 2021 and December 2023.

The Performance of a Customized Generative Pre-trained Transformer on the American Society for Surgery of the Hand Self-Assessment Examination.

Introduction:  Multimodal large language models (MLLMs), such as OpenAI's ChatGPT (San Francisco, CA), have the potential to improve medical care delivery and education, although important shortcomings in accuracy and image interpretation have been noted. The aim of this study was to assess the multimodal performance of a ChatGPT model customized with hand surgery-specific knowledge.

Methods: A customized generative pre-trained transformer (GPT) was trained using peer-reviewed literature recommended by the American Society for Surgery of the Hand (ASSH).

The Performance of ChatGPT on the American Society for Surgery of the Hand Self-Assessment Examination.

Background: This study aims to compare the performance of ChatGPT-3.5 (GPT-3.5) and ChatGPT-4 (GPT-4) on the American Society for Surgery of the Hand (ASSH) Self-Assessment Examination (SAE) to determine their potential as educational tools.