Plastic Surgery in the Gulf Cooperation Council Countries: Role of Telemedicine.

Internationally, telemedicine is finding its way into common day plastic surgery practice as a result of the COVID-19 pandemic. Nonetheless, no data about its practice in the Gulf region are available to date. Methodology: This is a cross-sectional survey-based study that was sent online to the plastic surgeons practicing in the Gulf region. The study aimed to look into the integration of telemedicine into the practice and the surgeons' attitude and future vision about it. Participation was voluntary, and confidentiality was preserved. Results: A total of 229 plastic surgeons enrolled in this study in mid-2020. There were 192 male participants (83.8%) and 37 female participants (16.2%). Of these, 99 (43.2%) practiced in Saudi Arabia, 85 (37.1%) in the United Arab Emirates, 24 (10.5%) in Oman, 18 (7.9%) in Kuwait, and three (1.3%) in Bahrain. In total, 85 (37.1%) used telemedicine during lockdown, and 144 (62.9%) thought that its usage will remain beneficial in the future. There was no significant difference in practicing telemedicine in different plastic surgery subspecialties, varying level of experience, and country of practice. Among those who used virtual consultations, 62 (72.9%) did not charge for consultation fees. Conclusion: The tendency toward telemedicine integration in plastic surgery practice is growing worldwide, especially after COVID-19. Its limitations are outweighed by its advantages and, with time, many of these will be bypassed. New innovations driven by advancement in technology will further embed telemedicine into the practice.

Posterior Tibial Artery Perforator V-Y Advancement Flap for Small-Medium Size Lower Limb Defects.

The posterior tibial artery perforator flap has been described as a good option for small to moderate lower extremity defects with consistent anatomy and caliber. Different geometrical designs are found in the literature for posterior tibial artery perforator flaps and are mostly executed as propeller, peninsular, and island flaps. Upon literature review, V-Y advancement flaps were not commonly used, despite the clear design, persistent anatomy, and straight execution. Our aim was to report our case series to present the validity of such design and the success of reconstruction. METHOD: Over 1 year, three cases were reconstructed successfully with posterior tibial artery perforator flaps with V-Y advancement design. Clinical evaluation was done for all patients as well as follow-up in the outpatient clinic until complete healing of the wounds was achieved. Multiple modifications were done intraoperatively to enhance flap reach and minimize the complications, including designing V-Y advancement flaps larger than the defect, careful perforator dissection, and finally, strict postoperative course. RESULTS: All three cases healed completely with no complications. The average follow-up time in the clinic was 3 months. CONCLUSIONS: Posterior tibial artery perforator flap with V-Y advancement design is a viable option for reconstructing medium sized lower limb defects, but requires careful design and execution. The suggested steps will increase the survival of the flap and reconstruct the defect successfully.

Plastic Surgery and COVID-19 in the GCC: Fears, Lessons Learned, and the Plan for the Future.

BACKGROUND: With the labeling of Coronavirus Disease 2019 (COVID-19) as a pandemic by the World Health Organization, national directives were issued instructing to close all cosmetic clinics, suspend all cosmetic procedures, and only operate on an emergency basis. As a result, many plastic surgeons faced challenges sustaining their practice. We aimed to investigate the effect of these national directive instructions on the surgeons and to review their strategies for adapting their practices during this new pandemic. METHODS: A cross-sectional descriptive study was conducted using an online questionnaire. It was constructed to assess the attitudes and practices of plastic surgeons in the Gulf Cooperation Council countries during the COVID-19 lockdown. It also explored their strategies on reopening their practice, as well as their plans on modifications of practice during and after the lockdown. RESULTS: In total, 197 surgeons responded to the survey. The majority were from Saudi Arabia (42.1%), followed by the United Arab Emirates (37.6%), with relatively smaller participation from the remaining countries. Over two-thirds (69.5%) indicated that the pandemic had affected their practice. Surgeons in private practices were significantly affected (P < 0.001) compared with those in the public sector. Only 39% of respondents mentioned COVID-19 testing as part of their post-pandemic surgical protocol. CONCLUSIONS: Surgeons' responses to the pandemic varied. Fear and future uncertainty significantly led to a surge in the utilization of different technical means to maintain the patient pool. Surgeons' education about post-pandemic precautions is essential to maintain high standards of care in the region.

Pseudotumor of hemophilia of the thumb.

[No Abstract Available].