Vastus lateralis flap for trochanteric sarcoma reconstruction following prior main pedicle dissection: A case report.

The reconstruction of trochanteric defects presents a challenge to the reconstructive surgeon. There have been a number of locoregional reconstructive options described in the literature. These include flaps based on the lateral circumflex femoral artery and its branches, such as the tensor fascia lata, vastus lateralis (VL), anterolateral thigh (ALT) flaps. The present case further complicated this challenge as the patient had multiple recurrences of a sarcoma overlying the trochanteric region, with previous surgical resections, reconstruction and radiotherapy. The present case study describes an approach to harvesting the VL flap in a patient with previously harvested ALT.

Effectiveness and Role of Using Hyaluronic Acid Injections for Gluteal Augmentation: A Comprehensive Systematic Review of Techniques and Outcomes.

INTRODUCTION: There has been a rapid increase in the number of patients undergoing non-surgical gluteal augmentation in recent years, leading to an increase in the number of articles in the literature regarding the use of hyaluronic acid (HA) for gluteal augmentation. No systematic review has been published on the effectiveness of HA for gluteal augmentation. This study aimed to provide a comprehensive review regarding the effectiveness and role of using HA for gluteal augmentation. METHODS: This review was conducted according to the PRISMA guidelines for reporting systematic reviews and meta-analyses. We conducted a search across MEDLINE, EMBASE, Cochrane, and Google Scholar, using the following search keywords: gluteus, buttocks, gluteoplasty, gluteal augmentation, hyaluronic acid, and filler. RESULTS: Ten articles published between 2013 and 2022 that included 168 patients. The estimated duration of product effectiveness is 16.16 months. Most studies showed statistically significant improvements in patients' satisfaction. Mean volume of HA injected for optimal gluteal fat augmentation was 206.71 ml. Of included studies, two reported major complications, five patients experienced bruising and erythema as minor complications, five patients experienced effusion and inflammation at the injection site, three patients experienced gel dislocation, and one patient experienced irregular contours. CONCLUSIONS: Based on our findings, HA is a predictable method for gluteal augmentation. Patients were satisfied with their outcomes. Despite gluteal augmentation with HA having a modest complication rate, it can still involve serious complications such as diffuse alveolar hemorrhage and death. There is a need for further research in a randomized control trial. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Use and Influence of Social Media on the Private Practice of Plastic Surgeons in Saudi Arabia.

Today, social media platforms are more popular than ever in Saudi Arabia. Despite the influence of social media on patients' decisions to undergo cosmetic surgery, it is still unclear how social media platforms affect the private practice of plastic surgeons around Saudi Arabia. This study aimed to assess Saudi plastic surgeons' use of social media and its impact on their practices. Methods: The study was based on a self-administered questionnaire that was built on previous literature and distributed to practicing Saudi plastic surgeons. A survey consisting of 12 items was conducted to assess patterns of social media use and its impact on plastic surgery practice. Results: This study included 61 participants. Thirty-four surgeons (55.7%) were using social media platforms in their practice. The use of social media was significantly different among surgeons with different levels of practice in cosmetic surgery (P = 0.004) and reconstructive surgery (P = 0.049). Social media presence was significantly more prevalent among surgeons in private practice (70.6%, P = 0.034). The use of social media in plastic surgery is overall positive for the field (60.7%). Conclusions: Despite plastic surgeons' differing views on social media, its role within the field of plastic surgery is evidently on the rise. The use of social media is not equal across all practice types. Surgeons practicing in private hospitals and specializing in aesthetic surgery are more likely to view social media favorably and use it in their practice.

Establishment of Saudi Arabia's Plastic Surgery Interest Club: First-year Outcomes and Future Directions.

The purpose of this article is to share our first-year outcomes and the overall impact of the plastic surgery interest club (PSIC) since its establishment, and to discuss the future directions that any interested club may follow and benefit from. Methods: This cross-sectional study utilized a self-developed questionnaire that experts in the field revised. The authors recruited active PSIC members during the year 2021-2022 to assess the overall impact of the club in their various interests of the field as well as to have an overview of their opinions of this newly done initiative in Saudi Arabia. The data collection spanned from October 2021 to September 2022. Results: The authors analyzed the responses from 66 active members with a response rate of 78%. We found various significant positive impacts of the PSIC in the community of plastic surgery in Saudi Arabia. There was a significant difference in the interest in pursuing a career in plastic surgery before and after being a member of PSIC, with a P value of 0.0001. The members became noticeably more interested in pursuing an academic career and publishing field data after enrolling in PSIC research activities. Conclusions: The authors provided an analysis of 1-year outcomes of the PSIC in Saudi Arabia; there were many positive impacts of such an initiative in enhancing the local community of plastic and reconstructive surgery. The authors strongly encourage the adaption of such initiatives in various parts of the globe to develop the field of plastic surgery further.

Patient Perceptions and Determinants of Choice for Breast Reconstruction after Mastectomy among Saudi Patients.

BACKGROUND: Undergoing mastectomy is often associated with a negative impact on the mental well-being of patients. Patients who undergo postmastectomy breast reconstruction (BR) have a better self-image and higher self-esteem. Many patients with breast cancer (BC) are unaware of the availability of BR options. This study aimed to assess BC patient perceptions and identify the determinants of patient choices to undergo BR after mastectomy. METHODS: This study was conducted between May 10, 2019 and February 29, 2020 via an interview-based questionnaire, among BC patients at King Abdul Aziz University Hospital, Jeddah, Saudi Arabia. Ethical approval was obtained from the research ethics committee before the data collection. RESULTS: Altogether, 400 patients (an overall 82% response rate) were included, of whom 155 (38.75%) were group 1 (willing to undergo BR). The mean age for group 1 was 46.04 ± 8.79, which was younger than for group 2 (unwilling to undergo BR) (P < 0.001). Furthermore, 117 (75.5%) of group 1 had no history of any chronic illness compared with 145 (59.2%) of group 2 (P < 0.001). Group 1 had more knowledge about BR (69.7%, P < 0.001), and the main reason to undergo BR was to regain femininity (26.8%). The remaining patients (31.3%) were unwilling to undergo BR in order to avoid additional surgery. CONCLUSIONS: The lack of knowledge and misconception about BR is one factor preventing BC patients from undergoing BR. Spreading awareness and providing accurate information regarding the procedure will allow women with BC to overcome postmastectomy fear.

Metadata Correction: Perception of Plastic Surgery and the Role of Media Among Medical Students: Cross-Sectional Study.

[This corrects the article DOI: 10.2196/12999.].

Perception of Plastic Surgery and the Role of Media Among Medical Students: Cross-Sectional Study.

BACKGROUND: Although plastic surgery has been gaining a lot of popularity recently, there seems to be limited perception and a poor understanding of this field by both medical professionals, including medical students, and the general public. This might alter referral patterns as well as medical students' choice to pursue a career in plastic surgery. OBJECTIVE: The purpose of this study was to assess knowledge and perception of plastic surgery among medical students and to explore the influencing factors underlying particular beliefs. METHODS: Data for this cross-sectional study were collected between August 22 and December 22, 2017. The questionnaire was formulated on the basis of our own study objectives and from available questionnaires with similar objectives. It was composed of 14 questions divided into three main parts: demographics, the specialty of plastic surgery, and media involvement and its effect on plastic surgery. The study was conducted via an online questionnaire among medical students in all years at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Data were considered significant at P<.05. All analyses were performed using SPSS, version 20. RESULTS: A total of 886 medical students participated in this study. We achieved a response rate of 56.79%. The mean age of the participants was 21.2 years. The mean awareness score was 9.7 (SD 4.2) for female students and 8.3 (SD 4.2) for male students (P<.001). The condition most commonly known to be treated by a plastic surgeon was burns (70.3% of responses). CONCLUSIONS: Medical students do not have adequate awareness of plastic surgery, and early exposure to this specialty may enhance their awareness.

Dorsal Wrist Placement for Vascularized Submental Lymph Node Transfer Significantly Improves Breast Cancer-Related Lymphedema.

BACKGROUND: Vascularized submental lymph node flap transfer to the wrist is an effective treatment for breast cancer-related lymphedema. Dorsal placement was hypothesized to offer superior outcomes due to favorable venous drainage; however, the flap is more visible in this position compared with the volar side and was a cosmetic concern for patients. This study compared the treatment response of breast cancer-related lymphedema with the placement of vascularized submental lymph node flaps at the wrist, between dorsal and volar recipient sites. METHODS: A retrospective longitudinal study examined 15 patients receiving vascularized submental lymph node flaps at the wrist performed by a single surgeon with a mean follow-up of 17 months. Clinical and biometric analyses, including quality of life questionnaires, circumference measurements, and number of infections were conducted. RESULTS: All patients showed improvements in quality of life, reduced episodes of cellulitis, and reduced limb circumference measurements compared with preoperative data. Dorsal placement (n = 7) delivered significant reductions in limb circumference at all levels after 1 year (P = 0.04) and in overall function domains in the Lymphedema Specific Quality of Life Questionnaires (P = 0.04) compared with volar placement (n = 8). Venous outflow was greater in the dorsal recipient veins (P < 0.0001). CONCLUSIONS: Patients electing to undergo vascularized lymph node transfer to the wrist should be aware that when both options are effective, dorsal placement offers improvement in outcomes despite reduced cosmesis. These results have been incorporated into an evidence-based treatment algorithm that can inform the patient and physician on the decision-making in the breast and plastic surgical spheres.

Effect of Erythropoietin on Transfusion Requirements for Craniosynostosis Surgery in Children.

BACKGROUND: Pediatric craniosynostosis surgery is associated with significant blood loss often requiring allogenic blood transfusion (ABT). This study explores the clinical effectiveness of preoperative erythropoietin (EPO) administration in pediatric craniosynostosis surgery in reducing transfusion requirements. METHODS: A systematic review and meta-analysis of the literature was performed for studies published in English language between 1946 and 2015. Inclusion criteria included original studies in the pediatric population (0-8 years of age) involving preoperative use of EPO in craniofacial procedures with quantitative reporting of perioperative blood transfusion. Extracted data included demographics, hematocrit, hemoglobin, estimated blood loss, number of patients transfused, and amount of ABT. RESULTS: Four studies met the inclusion criteria with a total of 117 patients. Patients were divided into 2 groups: EPO versus control. No statistical differences were found in the demographics between the 2 groups. Mean preoperative hematocrit level was higher in the EPO group compared with control (43% vs 35%). The percentage of patients who required ABT and the volume of transfused blood were less in the EPO group (54% vs 98% and 84 vs 283 mL, respectively). Meta-analysis of 3 comparable studies showed a lower proportion of patients who needed blood transfusion in the EPO group. CONCLUSIONS: The present meta-analysis demonstrated that preoperative administration of EPO in pediatric craniosynostosis surgery decreased the proportion of patients requiring ABT. In addition, the volume of transfusion was reduced in patients who received EPO. Future randomized studies are needed to establish the cost-effectiveness of routine preoperative EPO administration in craniosynostosis surgery.

Vertical PAP Flap: Simultaneous Longitudinal Profunda Artery Perforator Flaps for Bilateral Breast Reconstructions.

Supplemental Digital Content is available in the text.

Single patent vessel over an embedded ring: a case report.

Embedded ring injury is rarely encountered in clinical practice, and most of the few reported cases share common features, including deliberate neglect, mental illness, poor social support, female gender, and adult age group. Ischemia has never been reported in such injuries. Here, we report the case of a 16-year-old girl who presented with a completely embedded ring in the right index finger and a partially embedded ring in the left ring finger. Revascularization after ring embedment probably explains the intact vessel that was observed on the outer aspect of the embedded ring during surgical exploration of the right index finger.