The Practices and Attitudes of Saudi Plastic Surgeons in Managing Contaminated Autologous Grafts.

Background: The use of autologous grafts is a standard reconstructive option in plastic surgery. The absence of a well-established protocol for decontamination after accidental contamination increases the risk of postoperative infection. We aimed to explore the current practice and decontamination methods among Saudi plastic surgeons. This would help develop a well-established, unified method of decontamination intraoperatively. Methods: A validated self-administered questionnaire cross-sectional study was conducted in February 2022. The questionnaire was distributed through social media to all board-certified plastic surgeons in Saudi Arabia. The questionnaire was designed to obtain data on incidents, treatment preferences, and management of autograft contamination. Results: A total sample size of 61 participants was included, with an overall response rate of 64.58%. Out of the 61 respondents, 73.8% (n = 45) had previously experienced graft contamination. Regarding the methods of graft contamination, the most common way was accidentally dropping the graft on the floor (39.7%, n = 25). The majority of the surgeons answered that they decontaminated the graft using povidone-iodine (44.6%, n = 29) and then used it (45.9%, n = 28). The lower extremity area was the most common anatomical location having surgery at the time of the graft contamination, accounting for 32.5% of the cases (n = 25). Conclusions: Our study indicates that graft contamination is a common occurrence among our population, but we lack national guidelines on dealing with these situations. Although most responders used adequate decontamination methods, the lack of standardization could pose a risk to patients.

The Preoperative Management of Oral Contraceptive Pills in Aesthetic Plastic Surgery Practice in Saudi Arabia.

INTRODUCTION: Oral contraceptive pills (OCPs) are the most popular contraception method in Saudi Arabia due to their accessibility and reversibility. However, there is no recommendation to stop OCP medication before or after elective aesthetic surgery. The study involves identifying plastic surgeons' behaviors and current practices in perioperative OCPs management in aesthetic surgery in Saudi Arabia, which is the first of its kind. METHODS: A validated self-administered survey was distributed in February 2022 among all board-certified plastic surgeons in Saudi Arabia via social media. The questionnaire was developed to gather information on the perioperative management of OCPs in aesthetic surgery. RESULTS: A total of 46 board-certified plastic surgeons participated (overall response rate of 48.4%). Among the participants, 32 surgeons (69.6%) indicated that they instruct their patients to discontinue OCPs preoperatively. More than half of surgeons have instructed their patients to stop OCPs after plastic surgery (52.2%). Based on the three occupational characteristics of the surgeons, we found no significant associations between surgeons' practice patterns regarding OCP discontinuation preoperatively or postoperatively. CONCLUSION: In light of the fact that OCPs are reported to pose a risk for venous thromboembolic events, our survey found that most aesthetic surgeons cease their use both preoperatively and postoperatively. There is a need for a guideline regarding perioperative measures for OCPs.

Perceptions of Saudi Plastic Surgery Residents and Attendings of Online Education during the COVID-19 Pandemic.

BACKGROUND: The world has faced an unprecedented challenge in controlling the spread of COVID-19-a rapid reshaping of the healthcare system and education was inevitable. Consequently, residency programs adopted e-learning as a social distancing tool for the continuity of the learning process. In this study, we explore the opinions and perspectives of plastic surgery attending doctors and residents on the implications of e-learning. METHODS: After obtaining ethical approval, this cross-sectional study was conducted electronically between October and December 2020 among plastic surgery residents and board-certified plastic surgeons in Saudi Arabia. Participants completed a validated, anonymous, self-administered questionnaire. The questionnaire gathered participants' demographic data, perceptions of online webinars, and audiovisual evaluations. Finally, we compared traditional (in-person) teaching with online webinars. The analysis was performed at a 95% confidence interval using the Statistical Package for Social Sciences (SPSS), version 23.0 (IBM, Armonk, N.Y.). RESULTS: A total of 61 responses were included in this study. The majority of respondents (78.7%) were comfortable during webinars, with 38 (62.3%) believing they should supplement traditional teaching methods. Overall, 50.8% were satisfied with the webinars. However, 37.7% were neutral. Most believed that the webinars increased their clinical (67.2%) and surgical skills (67.2%) to reasonable levels. CONCLUSIONS: Online education provided an excellent educational tool as a viable option to supplement traditional face-to-face training, with most residents being satisfied, supporting the use of this educational tool. More objective research is required to refine existing online plastic surgery teaching methods while creating novel distance e-learning approaches for the future.

Comparing the Diagnostic Accuracy of Clinical and Radiological Measures in Hand Soft-Tissue Masses.

Introduction Imaging modalities are imperative to aid in diagnosing hand soft-tissue tumors. Limited insight is available into the diagnostic accuracy of history and physical examination in comparison to radiological diagnosis.  Methods In this retrospective analysis, data of patients with hand soft-tissue tumors that were surgically treated and diagnosed through biopsy were extracted; taking this as a reference, the sensitivity, specificity and positive and negative predictive values and likelihood ratios of the clinical approach and radiological tools were contrasted against each other.  Results Data of a total of 34 patients were revised in this study. With a mean age of 40.1 years, the most common anatomical area of the hand to be affected by the tumors was the index (n = 7, (18.9%); ganglion cysts were the most common tumor (n = 9, 26.5%) and magnetic resonance imaging was the most commonly used imaging modality (n = 24, 70.6%). Clinical diagnosis scored a sensitivity and specificity of 44.4% and 100% in ganglion cysts and 62.5% and 86.2% in giant cell tumors in contrast to the sensitivity and specificity of 66.7% and 100% for ganglion cysts and 50% and 90% for giant cell tumors scored by radiological modalities. Conclusion Clinical diagnosis could be non-inferior to radiological diagnosis, yet radiological examination remains a valuable adjunct to clinical examination. Larger scale, prospective studies are required before generalizing our results.

Academic and Clinical Background of Plastic Surgery Residents of the Saudi Training Program.

Plastic surgery residents are required to contribute to the scientific milieu, apart from honing their surgical skills. Data regarding their academic and clinical background are limited locally in comparison with their counterparts. This is the first study of its kind on the Saudi training program, with suggested potential solutions to shortcomings. METHODS: This is a cross-sectional study based on an electronic, 27-element, self-administered questionnaire sent to a WhatsApp group gathering all 40 plastic surgery residents of the Saudi program, with the exclusion of a single participant. RESULTS: The mean of overall residents' publications was 2.29 articles. No significant difference (P = 0.438) was found in the number of publications among residents of different levels. However, seniors have published significantly (P = 0.002) more articles (mean = 1.6; SD = 1.24) during residency compared with juniors (mean = 0.42; SD = 1). The group that had taken rotations in plastic surgery abroad published more articles (P = 0.02) than the group that did not. Using η correlation, a positive correlation (η = 0.36) was found between taking courses in research and publication. CONCLUSIONS: The Saudi plastic surgery residents are ahead of their colleagues in other local specialties but fall behind their counterparts internationally. The relatively poor contribution in terms of research, posters, and oral presentations could be remedied with measures such as providing protected research time and mentorship. They should be emboldened to pursue postgraduate studies, as only 3 residents had a Master of Science degree.