Exploring the application of CHATGPT in plastic surgery: a comprehensive systematic review.

OBJECTIVE: To determine the impact of ChatGPT in plastic surgery research and assess the authenticity of such contributions. METHODS: The study conducted a literature search in Sep'23 from databases like Pubmed, Google Scholar, SCOPUS, and OVID Medline.The following keywords 'ChatGPT', 'chatbot', 'reconstruction', 'aesthetic' and 'plastic surgery' were used. 32 papers were included from the initial 131 results of articles. English language articles from November 2022 to July 2023 discussing ChatGPT's role in plastic and aesthetic surgery were included whereas non-English documents, irrelevant content, and non-academic sources were excluded from the study. RESULTS: The manuscripts included in the systematic review had a diverse range, including original research articles, case reports, letters to the editor, and editorials. Among the included studies, there were 9 original research articles, 1 case report, 23 letters to the editor, and 2 editorials. Most publications originated from the United States (18) and Australia (7). Analysis suggested concerns, such as inaccuracies, plagiarism, outdated knowledge, and lack of personalized advice. Various authors recommend using ChatGPT as a supplementary tool rather than a replacement for human decision-making in medicine. CONCLUSIONS: ChatGPT shows potential in plastic surgery research, concerns about inaccuracies and outdated knowledge may provide deceiving information and it always requires human input and verification.

Robotic-assisted free flap harvesting for diverse soft tissue reconstruction: a PRISMA scoping review of clinical outcomes over the last decade.

Introduction: The aim of our study was to assess the advantages and limitations of robotic technology in diverse reconstructive procedures. METHODS: A scoping review was conducted in Oct'23, on published studies from 2013 to 2023, focussing on robotic-assisted free flap harvesting. Three databases Ovid-MEDLINE, Scopus, and PubMed were searched. Original research studies reporting robotic-assisted free flap harvest were included. Studies on lesion excision, microvascular anastomosis, local flap harvest, roboticassisted flap inset, review articles, abstract-only studies, non-English documents, and animal studies were excluded from this review. RESULTS: Sixteen studies met the inclusion criteria out of a total of 318, searched initially. These studies included a total of 128 patients, who underwent robotic-assisted free flap harvest for the reconstruction of various defects, with 140 free flaps harvested. The most common flaps harvested by robotic technique were deep inferior epigastric artery perforator (DIEP) flap 120 (85.7%), radial forearm free (RFF) flap 11 (7.9%), latissimus dorsii flap 4 (2.9%), rectus abdominus flap 4 (2.9%), and omental flap 1 (0.7%). Breast reconstruction was the major procedure done i.e. 120 (85.7%) followed by head and neck 11 (7.9%) and limb defects 9 (6.4%) reconstruction procedures. The reported clinical outcomes were acceptable in all the studies with a 99% flap success rate and minimal complications. Variability in operating time was observed depending upon surgical steps undertaken with robotic systems. CONCLUSIONS: This scoping review highlights the role of robotic-assisted free flap harvesting in plastic surgery and its potential benefits on clinical outcomes, due to its high precision and minimal invasiveness. However, challenges like cost effectiveness, resource distribution and learning curve are there.

Stem Cells On Youtube: National Vs International Content.

YouTube is one of the most popular video-based social media sites across the globe. The role of stem cell transplant has not been deeply explored on YouTube. The current narrative review was planned to assess the viewership of content available on YouTube related to stem cells. The videos were classified based on type of content, duration, number of views, comments and number of likes. A total of 40 videos were downloaded under the search terms "stem cells in Pakistan" and "stem cells". Of them, 6(15%) were repeat videos, and 34(85%) were unique. The findings revealed that in 10(25%) most viewed videos from Pakistan, 6(60%) contained opinions from non-expert physicians. Among the 10(25%) most viewed international videos, the information providers were science educators in 4(40%) videos and researchers in 2 (20%). Notably, no content from Pakistan was present among the top relevant international videos. Over 27 million views were included in the total number of videos that were analysed. YouTube is a powerful tool to spread knowledge and support public health decision-making. However, misleading information regarding stem cell can lead to adverse outcomes.

Adipose derived stem cells for the peripheral nerve regeneration: review of techniques and clinical implications.

Adipose tissue is considered as a multipotent organ with multiple cellular varieties, like adipose derived stem cells with ability to differentiate into nerve cells. This review is an attempt to summarize the techniques of harvesting, isolating and delivery of adipose derived stem cells to injured nerve area and various interactions involved in the release of neurotrophic and angiogenic factors from stem cells. Neuro-regenerative potential of ADSCs is explained on the basis of "Paracrine hypothesis", according to which ADSCs secrete multiple neurotrophic factors and upregulates secretion of these neurotrophic factors by Schwann cells, leading to improved myelination, regeneration and decreases nerve fibrosis. ADSCs are easily available in abundance and undergo multi-step processing before grafting to nerve injury site. Acute inflammation, hypoxia and co-culturing with Schwann cells promotes neural differentiation of ADSCs. ADSCs and Schwann cells are reported to have similar mitogenic and differentiation factors, moreover, the micro-environment containing various growth factors and extracellular matrix plays a crucial role in promoting myelin formation by stem cells. Various animal model studies have shown improved outcomes when ADSCs were used for the management of peripheral nerve injuries after direct repair, nerve grafting, nerve conduit, nerve allograft. This review contains various pre-clinical studies that have shown outcomes of adipose derived stem cells in nerve regeneration in different grades of nerve injuries.