Prediction of mortality and prioritisation to tertiary care using the 'OUR-ARCad' risk score gleaned from the second wave of COVID-19 pandemic-A retrospective cohort study from South India.

Background: Judicious utilisation of tertiary care facilities through appropriate risk stratification assumes priority, in a raging pandemic, of the nature of delta variant-predominated second wave of COVID-19 pandemic in India. Prioritisation of tertiary care, through a scientifically validated risk score, would maximise recovery without compromising individual safety, but importantly without straining the health system.

Methods: De-identified data of COVID-19 confirmed patients admitted to a tertiary care hospital in South India, between April 1, 2021 and July 31, 2021, corresponding to the peak of COVID-19 second wave, were analysed after segregating into 'survivors' or 'non-survivors' to evaluate the risk factors for COVID-19 mortality at admission and formulate a risk score with easily obtainable but clinically relevant parameters for accurate patient triaging.

Clinical, Preclinical, and Educational Applications of Robotic-Assisted Flap Reconstruction and Microsurgery: A Systematic Review.

Introduction: Microsurgery and super-microsurgery allow for highly technical reconstructive surgeries to be performed, with repairs of anatomical areas of less than 1 mm. Robotic-assisted surgery might allow for further advances within microsurgery, providing higher precision, accuracy, and scope to operate in previously inaccessible anatomical areas. However, robotics is not well-established within this field.

The emerging role of robotics in plastic and reconstructive surgery: a systematic review and meta-analysis.

The role of robotics has grown exponentially. There is an active interest amongst practitioners in the transferability of the potential benefits into plastic and reconstructive surgery; however, many plastic surgeons report lack of widespread implementation, training, or clinical exposure. We report the current evidence base, and surgical opportunities, alongside key barriers, and limitations to overcome, to develop the use of robotics within the field.

Fostering innovation and sustainable thinking in surgery: an evaluation of a surgical hackathon.

Introduction: Surgery represents a major source of carbon emissions, with numerous initiatives promoting more sustainable practices. Healthcare innovation and the development of a digitally capable workforce are fundamental in leveraging technologies to tackle challenges, including sustainability in surgery.

Methods: A surgical hackathon was organised with three major themes: (1) how to make surgery greener, (2) the future of plastic surgery in 10 years, and (3) improving healthcare outcomes using machine learning.

Facial Beauty and the Correlation of Associated Attributes: An Empirical Aesthetic Database Study.

Background: The pursuit of understanding facial beauty has been the subject of scientific interest since time immemorial. How beauty is associated with other perceived attributes that affect human interaction remains elusive. This article aims to explore how facial attractiveness correlates with health, happiness, femininity, and perceived age.

Patient-Reported Outcome Measures in a Facial Reconstruction Case Series Following the Implementation of an Integrated Craniofacial Multidisciplinary Team Clinic, Three-Dimensional Photography, and Computer Modeling.

Background: Facial reconstruction surgery is often a complex and staged process, leading to lengthy reconstructive journeys for patients. The integration of a clinical pathway can give patients a clearer understanding of what to expect at each stage of their reconstructive journey.

Objectives: The authors demonstrate how the incorporation of multidisciplinary team clinics, three-dimensional (3D) photography, and 3D modeling into an integrated pathway can streamline the process for patients undergoing facial reconstructive surgeries and aid their understanding of their surgeries.

Facial Aesthetic Ideals: A Literature Summary of Supporting Evidence.

Background: To achieve the goal of enhancing facial beauty it is crucial for aesthetic physicians and plastic surgeons to have a deep understanding of aesthetic ideals. Although numerous aesthetic criteria have been proposed over the years, there is a lack of empirical analysis supporting many of these standards.

Objectives: This aim of this review was to undertake the first exploration of the empirical evidence concerning the aesthetic ideals of the face in the existing literature.

3D photography and computer modelling in nasal reconstruction.

Advances in high resolution 3D photography and computer modelling are revolutionising patient workup, surgical planning, patient satisfaction, clinical outcomes, and surgical training. We present a case in which this technology is utilised for a patient undergoing a forehead flap for reconstruction of a nasal defect, allowing us to develop a novel reconstructive algorithm. 3D photographs were taken pre-operatively, a computer model rendered and follow up photographs taken at each stage of the reconstruction using a Vectra XT camera.

Repair of a postaural fistula with a suprafascial radial forearm free flap.

We describe the case of a patient with the rare complication of a chronic postaural fistula following repeated and extensive surgery and adjuvant radiotherapy to the head and neck for a pleomorphic adenoma of the parotid gland. This case demonstrates the importance and value of thorough preoperative planning for major head and neck reconstruction, particularly if the area for reconstruction has distorted anatomy due to prior treatment or damage. In complex free flap reconstruction, it is important to investigate the recipient site with the help of arteriography and give due consideration to the donor site and its postoperative management.

Convolutional mesh autoencoders for the 3-dimensional identification of FGFR-related craniosynostosis.

Clinical diagnosis of craniofacial anomalies requires expert knowledge. Recent studies have shown that artificial intelligence (AI) based facial analysis can match the diagnostic capabilities of expert clinicians in syndrome identification. In general, these systems use 2D images and analyse texture and colour.

The impact of digitisation of a virtual fracture clinic on referral quality, outcomes and assessment times.

Background: Virtual fracture clinics (VFCs) have become widely adopted, aiming to improve efficiency, standardise patient care and reduce clinic appointments for injuries that can be managed conservatively. A variety of means exist to manage VFC referrals and assessment, including paper-based and digital methods. This study assesses VFC referral quality and outcomes before and after implementation of a digital VFC referral and management system.

Breast cancer treatment-related arm lymphoedema and morbidity: A 6-year experience in an Australian tertiary breast centre.

Aim: Recent surgical de-escalation of the axilla in breast cancer management has led to reduced number of immediate and delayed axillary lymph node dissections (ALND) after sentinel lymph node biopsies (SLNBs). We aim to assess the postoperative impact of SLNB versus immediate and delayed ALND on arm lymphoedema and morbidity.

Methods: A retrospective analysis from a prospectively collected institutional database was performed reviewing the rates of lymphoedema and arm morbidity in terms of shoulder restriction and patient-reported functional deficit in women undergoing axillary surgery for breast cancer between 2013 and 2018.

B3 lesion upgrade rates in a tertiary Australian breast centre: a 8-year experience (2012-2019).

Background: B3 breast lesions identified on core needle biopsy have uncertain malignant potential. Traditional management of these lesions has been surgical excision, but there is growing interest in less invasive and more cost-effective alternatives such as vacuum-assisted excisional biopsy (VAEB). Determining the rate of malignant upgrade for B3 lesions is important as it may identify low-risk lesions where VAEB could be considered.

Design and manufacturing of a patient-specific nasal implant for congenital arhinia: Case report.

Arhinia (congenital absence of the nose) is a congenital rare disease, which has been reported in less than 60 cases in the literature. It consists of the absence of external nose, nasal cavities and olfactory apparatus and is generally associated with midline defects, microphthalmia, blepharophimosis and hypotelorism. Aesthetic problems as well as associated functional anomalies can potentially impact on the development and interpersonal relationships of the child at a later stage in life.

Large Scale 3D Morphable Models.

We present large scale facial model (LSFM)-a 3D Morphable Model (3DMM) automatically constructed from 9663 distinct facial identities. To the best of our knowledge LSFM is the largest-scale Morphable Model ever constructed, containing statistical information from a huge variety of the human population. To build such a large model we introduce a novel fully automated and robust Morphable Model construction pipeline, informed by an evaluation of state-of-the-art dense correspondence techniques.

Proof of Concept Study for the Design, Manufacturing, and Testing of a Patient-Specific Shape Memory Device for Treatment of Unicoronal Craniosynostosis.

Treatment of unicoronal craniosynostosis is a surgically challenging problem, due to the involvement of coronal suture and cranial base, with complex asymmetries of the calvarium and orbit. Several techniques for correction have been described, including surgical bony remodeling, early strip craniotomy with orthotic helmet remodeling and distraction. Current distraction devices provide unidirectional forces and have had very limited success.

Assessment of spring cranioplasty biomechanics in sagittal craniosynostosis patients.

OBJECTIVE Scaphocephaly secondary to sagittal craniosynostosis has been treated in recent years with spring-assisted cranioplasty, an innovative approach that leverages the use of metallic spring distractors to reshape the patient skull. In this study, a population of patients who had undergone spring cranioplasty for the correction of scaphocephaly at the Great Ormond Street Hospital for Children was retrospectively analyzed to systematically assess spring biomechanical performance and kinematics in relation to spring model, patient age, and outcomes over time. METHODS Data from 60 patients (49 males, mean age at surgery 5.

Spring-Assisted Cranioplasty for the Correction of Nonsyndromic Scaphocephaly: A Quantitative Analysis of 100 Consecutive Cases.

Background: Spring-assisted cranioplasty has been proposed as an alternative to total calvarial remodeling for sagittal craniosynostosis. Advantages include its minimally invasive nature, and reduced morbidity and hospital stay. Potential drawbacks include the need for a second procedure for removal and the lack of published long-term follow-up.

The utility of a medical admissions pharmacist in a hospital in Australia.

Background Medication-related hospital admissions in Australia have previously been estimated to account for approximately 3% of all hospital admissions, with hospital entry points being a point of vulnerability. The timely medication review and reconciliation by a pharmacist at the early stage of an admission for patients admitted to the Acute Medical Unit (AMU) would be beneficial. Setting The Emergency Department (ED) and AMU in a 300 bed tertiary teaching hospital, in South Australia.

Evaluating the Efficacy of Monobloc Distraction in the Crouzon-Pfeiffer Craniofacial Deformity Using Geometric Morphometrics.

Background: Crouzon-Pfeiffer syndrome is caused by mutations predominantly in the FGFR2 gene leading to syndromic craniosynostosis and midfacial hypoplasia. Monobloc distraction aims to correct both functional and aesthetic disharmony as a result of midfacial hypoplasia. This study evaluates the corrective effects and effectiveness of monobloc distraction in Crouzon-Pfeiffer patients.