RESUMO
Recent studies indicate that YouTube has become a primary source of healthcare information for patients. Videos about skin graft procedures on YouTube have accumulated millions of views, yet there lacks a publication investigating the educational quality of this content. With current literature revealing misleading healthcare information found on YouTube, this study aims to evaluate the educational quality of videos related to skin graft procedures. YouTube was searched for various terms such as "Skin Graft Procedures" and "Skin Graft Surgery." 105 videos were assessed, with 21 excluded. Four independent reviewers rated the material with the Global Quality Scale (5 = highest quality, 1 = lowest quality) to judge educational value. Viewership, source, modality, and date of upload were also collected from each video and compiled for further analysis. The average Global Quality Scale was 2.60 amongst all videos, with videos led by physicians recording significantly higher scores than those not led by physicians (p<0.01). In comparing educational modalities, physician-led presentations provided the highest educational value, whereas live surgeries and consumer-friendly content contained low educational quality (p<0.01). Assessing videos split into cohorts based on viewership noted a significantly higher Global Quality Scale in videos with lower view counts (p<0.05). Skin graft videos on YouTube largely provide low quality information. Videos performed by physicians, particularly physician-led presentations, significantly improved the educational quality of skin graft content. Physicians must involve themselves in enhancing the quality of online content to better guide patients in navigating treatment options and making healthcare decisions.
RESUMO
Background: We conducted a review of current literature to examine the effects of smoking and smoking cessation on shoulder arthroplasty surgery. Methods: A literature search was performed using the search terms "shoulder arthroplasty AND [smoke OR smoking OR tobacco OR nicotine]." Studies included English-language clinical outcomes studies on anatomic total shoulder arthroplasty (TSA), reverse TSA, and partial shoulder arthroplasty with evidence levels 1 through 4. Descriptive statistics calculated in the included studies were used during the analysis. Categorical variables were reported as proportions, while continuous variables were reported as means with minimum to maximum absolute ranges. Results: Twenty-four studies were included and analyzed. Following TSA, patients who quit smoking at least 1 month preoperatively had improved outcomes compared to current smokers. Current smokers had statistically significant higher pain scores or opioid use. Five studies found increased rates of revision surgery in smokers. Smokers were significantly (p < 0.05) more likely to have increased rates of surgical, wound, superficial, and deep surgical site complications. Discussion: Former smokers had lower complication rates and visual analog scale scores when compared to current users. A period of four weeks or more of preoperative smoking cessation is recommended. Level of Evidence: Level III, Systematic Review.
