Physician demography in Lebanon 2024: identifying gaps and proposing solutions for sustainable healthcare system.

Background: Lebanon continues to experience dramatic changes in its medical demography following the ongoing economic crisis of 2019, including brain drain of physicians across different specialties. This paper assesses the landscape of physicians in Lebanon in 2024 to highlight gaps and propose solutions.

Methods: A List of registered physicians is obtained from the Lebanese Order of Physicians (LOP) in Beirut and Tripoli.

Shortage of Plastic Surgeons in Lebanon: Impact of the 2019 Economic Crisis.

Background: Lebanon's ongoing economic crisis since 2019 has seen an unprecedented migration of professional healthcare workers. This article analyzes the adequacy of registered plastic surgeons in Lebanon in 2023.

Methods: A list of registered plastic surgeons was obtained from the Lebanese Order of Physicians.

Double Trigger Wrist Caused by 2 Flexor Tendon Sheath Giant Cell Tumors.

Trigger finger is a relatively common condition affecting the smooth gliding of tendons in the hand. When this entity affects the gliding motion of the wrist, it is termed as trigger wrist. In this article, we report the extremely rare case of a double trigger wrist caused by 2 tendon sheath tumors resulting in 2 trigger points in the motion of the wrist and carpal tunnel syndrome.

Omega "Ω" Pulley Plasty for Surgical Management of DeQuervain's Disease.

Background: DeQuervain tenosynovitis, refractory to medical conservative treatment, has been traditionally treated by a simple division of the pulley, a procedure associated with several complications. Many authors attempted to prevent these complications by describing techniques of pulley reconstruction after its release necessitating suturing the different flaps and subsequently promoting extensor tendons adhesions. The authors present an alternative procedure for the first extensor compartment pulley decompression: "Omegaplasty".

The V-Plasty: A Novel Microsurgical Technique for Anastomosis of Vessels with Marked Size Discrepancy.

Background: The art of reconstructive microsurgery is still progressing after Carrel's original description of "vascular repair" in 1902. Reports of the successful repair of vessels smaller than 1 mm in diameter are currently commonplace. However, the technique of microvascular anastomosis to connect vessels with large diameter discrepancy, greater than 1 mm, has not yet been perfected.

Iatrogenic penile glans amputation: major novel reconstructive procedure.

Circumcision is a very common urological practice. Even though it is relatively safe, it is not a complication-free procedure. We describe a patient that underwent a neonatal circumcision complicated by iatrogenic complete glans amputation.

Reconstruction of blast injuries of the hand and upper limb.

Over recent years, hand surgeons in the Middle East and Arabic region have particularly had to deal with an increasing number of war blast injuries to the upper extremity, in the acute, subacute and chronic phases. Many have been referred from War Zone countries such as Iraq and, more recently, Syria, where the resources to treat such complex injuries are scarce. The present article is a comprehensive review of the basic principles of management of blast injuries based on the available literature merged with the authors' personal experience of these injuries.

Xenotransplantation of cryopreserved composite organs on the rabbit.

Nowadays, It is easy to define optimal conditions (cryoprotective agent, speed and steps of freezing, speed of warming) for the cryopreservation of a homogeneous cell population or a one cell-layer tissue. Meanwhile, It is still hard to obtain cryopreservation of composite organs. Each tissue has its own requirements and its own reactivity to the cryopreservation process.

The cryopreservation of composite tissues: Principles and recent advancement on cryopreservation of different type of tissues.

Cryopreservation of human cells and tissue has generated great interest in the scientific community since 1949, when the cryoprotective activity of glycerol was discovered. Nowadays, it is possible to reach the optimal conditions for the cryopreservation of a homogeneous cell population or a one cell-layer tissue with the preservation of a high pourcentage of the initial cells. Success is attained when there is a high recovery rate of cell structures and tissue components after thawing.

Experimental and clinical experience with small composite tissue allotransplants and cryopreservation techniques.

Reconstruction surgery requires imagination, inventiveness, and creation-a quest that entails overcoming obstacles never before encountered. Over the past 25 years, with the advent in microsurgery of free revascularized transfers, it was believed that this fundamental breakthrough would be sufficient to resolve difficulties of whatever nature, and that little else would be necessary. Undoubtedly, the results obtained by using free autotransfers have been so remarkable that it is no longer possible to undertake reconstruction in plastic surgery without fully mastering these techniques.

Use of the eponychial flap to restore the length of a short nail: a review of 30 cases.

Background: Distal digital amputations may result in composite tissue loss, affecting both the fingertip and the nail complex. Most surgical procedures that are used for fingertip reconstruction do not restore the nail defect.

Methods: The eponychial flap is a new technique where a backward plication of the nail wall is used to expose the nail root and lengthen the visible part of the nail of the amputated digit.