Assessment of the European Hernia Society Classification of Ventral Hernias and Clinical Outcomes.

Background: Ventral hernias are a common but heterogeneous disease. Communication among key stakeholders (eg, patients, clinicians, administrators, payers, and researchers) can be augmented by a widely utilized classification system. The European Hernia Society (EHS) developed an expert-opinion-based hernia classification system organized by hernia type (primary versus incisional) and size.

Return to Sport After Knee Injuries in Collegiate Wrestling.

Background: Wrestling is known to be a sport of relatively high injury incidence, and knee injuries account for a large percentage of those injuries. Treatment of these injuries varies considerably depending on injury and wrestler characteristics, leading to variability in complete recovery and return to sport (RTS). The purpose of this study was to evaluate injury trends, treatment strategies, and RTS characteristics after knee injuries in competitive collegiate wrestling.

Educational Factors and Financial Implications of Medical Students Choosing and Matching Into Orthopedic Surgery.

Background: Mentorship and research have been shown to be important decision factors influencing medical students to pursue a particular specialty. The cost of applying to orthopedic surgery residency is at an all-time high. The purpose of this study is to identify the factors which increase the likelihood of medical students matching into orthopedic surgery, identify the timing and strength of impact these factors have on medical students' career choices, determine how many students have chosen orthopedic surgery prior to beginning medical school, and compare the financial impact of applying to orthopedics.

COVID-19 Increased Residency Applications and How Virtual Interviews Impacted Applicants.

Background The number of residency applications submitted by medical students has risen at an alarming rate, causing increased cost of applications and subsequent interview travel. These both contribute to increased cost for medical students. In light of these concerns, specialty governing bodies have proposed ideas to fight these trends including, application limits, interview limits, using a preference signaling system, and continuing virtual interviews.

Preshaping DIEP Flaps: Simplifying and Optimizing Breast Reconstruction Aesthetics.

One key component of a successful autologous breast reconstruction is insetting the flap to accurately resemble an aesthetic breast. The authors describe a novel technique used to shape a deep inferior epigastric artery perforator flap into a coned breast mound before introducing it into the breast pocket. With the flap perfusing on the chest wall, an area of skin estimating the size and location of the skin paddle is marked.

Assessing factors for choosing a primary care specialty in medical students; A longitudinal study.

A shortage of primary care physicians exists in the US, and medical schools are investigating factors that influence specialty choice. To better understand the factors associated with medical students choosing primary care specialties, a longitudinal annual survey from 2013 to 2019 was administered to students at the University of Iowa Carver College of Medicine, starting pre-matriculation. A logistic regression model examined factors of interest.

Abdominal Wall Reconstruction Risk Stratification Tools: A Systematic Review of the Literature.

Background: Ventral hernias are a common pathology encountered by surgeons. Multiple risk stratification tools have been developed in attempts to predict a patient's postoperative risk for complication. The aim of this systematic review was to identify published stratification tools, to assess their generalizability, and develop an ensemble risk score model.

Choosing surgery as a career: Early results of a longitudinal study of medical students.

Background: Few studies have explored the factors associated with the preference of medical students to pursue a specific specialty, and even fewer have observed how these preferences and factors change over time.

Methods: A longitudinal survey of medical students was administered at the beginning of first year, second year, and clerkships from 2013-2016. Surveys included demographics and factors associated with their choice of specialty.

Patient-Reported Social, Psychological, and Urologic Outcomes After Adult Buried Penis Repair.

Objective: To assess changes in hygiene, urination, and sexual activity after surgery for adult-acquired buried penis.

Materials And Methods: The study included men who underwent buried penis repair from 2011 to 2015. Patients were asked pre- and postoperative questions on hygiene, urinary difficulties, sexual difficulties, and difficulties with activities of daily living (modified Post-Bariatric Surgery Quality of Life Questionnaire).

Ventral Hernia Management: Expert Consensus Guided by Systematic Review.

Objective: To achieve consensus on the best practices in the management of ventral hernias (VH).

Background: Management patterns for VH are heterogeneous, often with little supporting evidence or correlation with existing evidence.

Methods: A systematic review identified the highest level of evidence available for each topic.

Analysis of model development strategies: predicting ventral hernia recurrence.

Background: There have been many attempts to identify variables associated with ventral hernia recurrence; however, it is unclear which statistical modeling approach results in models with greatest internal and external validity. We aim to assess the predictive accuracy of models developed using five common variable selection strategies to determine variables associated with hernia recurrence.

Methods: Two multicenter ventral hernia databases were used.

Do risk calculators accurately predict surgical site occurrences?

Introduction: Current risk assessment models for surgical site occurrence (SSO) and surgical site infection (SSI) after open ventral hernia repair (VHR) have limited external validation. Our aim was to determine (1) whether existing models stratify patients into groups by risk and (2) which model best predicts the rate of SSO and SSI.

Methods: Patients who underwent open VHR and were followed for at least 1 mo were included.

YouTube is the Most Frequently Used Educational Video Source for Surgical Preparation.

Objective: The purpose of this study was to evaluate surgical preparation methods of medical students, residents, and faculty with special attention to video usage.

Design: Following Institutional Review Board approval, anonymous surveys were distributed to participants. Information collected included demographics and surgical preparation methods, focusing on video usage.

Laparoscopic ventral hernia repair with primary fascial closure versus bridged repair: a risk-adjusted comparative study.

Background: Laparoscopy, specifically the bridged mesh technique, is a popular means used for ventral hernia repair. While laparoscopy has decreased the incidence of surgical site infection (SSI), hernia recurrence rates remain unchanged. Some surgeons advocate laparoscopic primary fascial closure (PFC) with placement of intraperitoneal mesh to decrease recurrence rates.

Suture, synthetic, or biologic in contaminated ventral hernia repair.

Background: Data are lacking to support the choice between suture, synthetic mesh, or biologic matrix in contaminated ventral hernia repair (VHR). We hypothesize that in contaminated VHR, suture repair is associated with the lowest rate of surgical site infection (SSI).

Methods: A multicenter database of all open VHR performed at from 2010-2011 was reviewed.

Component Separation vs. Bridged Repair for Large Ventral Hernias: A Multi-Institutional Risk-Adjusted Comparison, Systematic Review, and Meta-Analysis.

Background: Repair of large ventral hernia defects is associated with high rates of surgical site occurrences (SSO), including surgical site infection (SSI), site dehiscence, seroma, hematoma, and site necrosis. Two common operative strategies exist: Component separation (CS) with primary fascial closure and mesh reinforcement (PFC-CS) and bridged repair (mesh spanning the hernia defect). We hypothesized that: (1) ventral hernia repair (VHR) of large defects with bridged repair is associated with more SSOs than is PFC, and (2) anterior CS is associated with more SSOs than is endoscopic, perforator-sparing, or posterior CS.

A novel supermicrosurgery training model: the chicken thigh.

Background: Supermicrosurgery is an increasingly important technique in reconstructive surgery. It requires a more technically refined skill set compared with standard microsurgery. All currently available biologic training models involve the use of live rats.

The timing of preoperative prophylactic low-molecular-weight heparin administration in breast reconstruction.

Background: Venous thromboembolism continues to be problematic despite increased recognition and advancements in venous thromboembolism prophylaxis. Although migration toward preoperative chemoprophylaxis increases, plastic surgeons seem reticent to adopt this practice. This study evaluates preoperative enoxaparin administration in breast reconstruction patients.

A tailored approach to the surgical treatment of cubital tunnel syndrome.

Multiple studies have compared the outcome of surgery for cubital tunnel syndrome (CUTS), yet there remains no clear guidelines for treatment. We describe an approach to CUTS that includes tailoring the procedure to the pathology found at surgery. Patients treated surgically were retrospectively reviewed.

L-brachioplasty: an adaptable technique for moderate to severe excess skin and fat of the arms.

The L-brachioplasty is an L-shaped pattern of excision with the long limb from the elbow to the axilla and the short limb extending at right angles through the axilla and along the lateral chest. The width of the excisions through the arm, axilla and chest is based on preoperative assessment through anatomical point locations followed by pinch and gathering maneuvers. The following modifications have improved aesthetics and reduced complications: 1) improved geometric design, 2) anchor fixation of the posterior V-shaped advancement flap to the deltopectoral fascia, 3) excision site liposuction (ESL), and 4) and barbed suture closure.

Combined dislocation of the trapezoid and finger carpometacarpal joints-the steering wheel injury: case report.

Two cases of combined dorsal trapezoid dislocation and multiple finger carpometacarpal joint dislocations are described. In both cases, a common mechanism involved a head-on motor vehicle collision while the subjects held tightly to the steering wheel. The patients were treated with open reduction and pinning, with good short-term results.