Feasibility study on epithelial cells regeneration after excising the demucosalized ileum for ureteral reconstructive surgery.

This study aimed to investigate the regeneration of epithelial cells in the long-term observation of ureter reconstruction by excising the demucosalized ileum. First, 8 Beagle dogs were anesthetized and the abdominal cavity was inspected for abnormalities via an abdominal incision. The right kidney and ureter were subsequently separated, and the ureter was severed from its connection to the renal pelvis and bladder and ligated distally. The 10-15 cm of ileum was used to reconstruct the ureter. The biopsies of the proximal, middle, and distal reconstructed ureter (neo-ureter) were collected at the first, third, fifth, and sixth month postoperatively. The regeneration of ileal mucosa at the first, third, fifth, and sixth month was observed by hematoxylin-eosin (HE) staining and immunofluorescence staining cytokeratin 18 (CK18). HE staining results showed irregular cytoarchitecture, severe nuclear consolidation, and inflammatory infiltration in the proximal, middle, and distal neo-ureters of dogs at the first month after ureteral reconstruction. With longer follow-up, the injuries of the proximal, middle, and distal neo-ureters were alleviated at the third, fifth, and sixth month after surgery. The expression of CK18 was higher in the middle neo-ureters than that in the proximal and distal neo-ureters at different time points after ureteral reconstruction and decreased with time. In summary, the present study demonstrated that demucosalized ileum was feasible for ureteral reconstructive surgery with satisfying prognostic effects.

Deaths of U.S. Citizens Undergoing Cosmetic Surgery - Dominican Republic, 2009-2022.

Although infections resulting from cosmetic surgery performed outside the United States have been regularly reported, deaths have rarely been identified. During 2009-2022, 93 U.S. citizens died after receiving cosmetic surgery in the Dominican Republic. The number of deaths increased from a mean of 4.1 per year during 2009-2018 to a mean of 13.0 during 2019-2022 with a peak in of 17 in 2020. A subset of post-cosmetic surgery deaths occurring during peak years was investigated, and most deaths were found to be the result of embolic events (fat emboli or venous thromboembolism) for which a high proportion of the patients who died had risk factors, including obesity and having multiple procedures performed during the same operation. These risk factors might have been mitigated or prevented with improved surgical protocols and postoperative medical care, including prophylactic measures against venous thromboembolism. U.S. citizens interested in receiving elective cosmetic surgery outside the United States should consult with their health care professionals regarding their risk for adverse outcomes. Public health authorities can support provider education on the importance of preoperative patient evaluation and the potential danger of performing multiple cosmetic procedures in one operation.

Improving Readability and Automating Content Analysis of Plastic Surgery Webpages With ChatGPT.

INTRODUCTION: The quality and readability of online health information are sometimes suboptimal, reducing their usefulness to patients. Manual evaluation of online medical information is time-consuming and error-prone. This study automates content analysis and readability improvement of private-practice plastic surgery webpages using ChatGPT. METHODS: The first 70 Google search results of "breast implant size factors" and "breast implant size decision" were screened. ChatGPT 3.5 and 4.0 were utilized with two prompts (1: general, 2: specific) to automate content analysis and rewrite webpages with improved readability. ChatGPT content analysis outputs were classified as hallucination (false positive), accurate (true positive or true negative), or omission (false negative) using human-rated scores as a benchmark. Six readability metric scores of original and revised webpage texts were compared. RESULTS: Seventy-five webpages were included. Significant improvements were achieved from baseline in six readability metric scores using a specific-instruction prompt with ChatGPT 3.5 (all P ≤ 0.05). No further improvements in readability scores were achieved with ChatGPT 4.0. Rates of hallucination, accuracy, and omission in ChatGPT content scoring varied widely between decision-making factors. Compared to ChatGPT 3.5, average accuracy rates increased while omission rates decreased with ChatGPT 4.0 content analysis output. CONCLUSIONS: ChatGPT offers an innovative approach to enhancing the quality of online medical information and expanding the capabilities of plastic surgery research and practice. Automation of content analysis is limited by ChatGPT 3.5's high omission rates and ChatGPT 4.0's high hallucination rates. Our results also underscore the importance of iterative prompt design to optimize ChatGPT performance in research tasks.

Beyond Accreditation Council for Graduate Medical Education Required Scholarship: The Academic Journey of Plastic Surgery Residents.

INTRODUCTION: Research productivity is an important part of required Accreditation Council for Graduate Medical Education scholarship during residency training and critical to trainees who intend to pursue careers in academia. This study aims to determine plastic surgery residents' experiences with and attitudes toward research. METHODS: Accredited independent (52) and integrated (86) plastic surgery program websites were manually searched for currently active residents' names and email addresses. Identified residents were emailed a survey consisting of 25 questions through Research Electronic Data Capture. RESULTS: A total of 45 plastic surgery residents responded to the survey request (14.6% response rate). Respondents were 57% female and 43% male, with an average age of 30.7 y. At the time of survey participation, 95% of surgery residents were involved in research endeavors, voluntarily or as part of their residency training. Of the respondents, 13 (32%) previously participated in a research fellowship compared to 28 (68%) respondents who did not. Interestingly, respondents who completed fellowships were 2.84 times (95% confidence interval: 0.52-15.38, P = 0.2269) more likely to intend continuing research endeavors after residency. Participants were most in agreement with statements suggesting their research fellowship benefitted their application in the plastic surgery match process (4 [interquartile range (IQR): 4, 4]), improved their ability to conduct research (4 [IQR: 4, 4]), and helped to better understand medical literature (4 [IQR: 3, 4]). CONCLUSIONS: Plastic surgery programs' robust research emphasis has a favorable translation into residents' self-perceived understanding of medical literature and clinical knowledge.

A Comparison of Plastic Surgery Authorship Trends Under Single Versus Double-Blinded Review.

INTRODUCTION: Research is key to academic advancement in plastic surgery. However, access to publication opportunities may be inequitable as seen in other fields. We compared authorship trends of plastic surgery manuscripts that underwent single-blinded review (SBR) versus double-blinded review (DBR) to identify potential disparities in publication opportunities. METHODS: Publications from two plastic surgery journals using SBR and two using DBR from September 2019 to September 2021 were evaluated. Name and institution of the article's first and senior author and journal's editor-in-chief (EIC) were recorded. Chi-squared and Fisher's exact analyses were used to compare author characteristics between SBR and DBR articles. RESULTS: Of 2500 manuscripts, 65.7% underwent SBR and 34.3% underwent DBR. SBR articles had higher percentages of women as first authors (31.9% versus 24.3%, P < 0.001) but lower percentages of first (50.7% versus 71.2%, P < 0.001) and senior (49.6% versus 70.3%, P < 0.001) authors from international institutions. First (26.0% versus 12.9%, P < 0.001) and senior (27.9% versus 18.0%, P = 0.007) authors of SBR articles tended to have more plastic surgery National Institutes of Health funding. Journals using SBR tended to have higher rates of authorship by EICs or authors sharing institutions with the EIC (P ≤ 0.005). CONCLUSIONS: While associated with greater female first authorship suggesting potential efforts toward gender equity in academia, SBR of plastic surgery articles tends to favor authors from institutions with higher National Institutes of Health funding and disadvantage authors from international or lower-resourced programs. Careful consideration of current peer-review proceedings may make publication opportunities more equitable.

A Review of Meta-Analyses in Plastic Surgery: Need for Adequate Assessment of Publication Bias.

INTRODUCTION: Publication bias describes a phenomenon in which significant positive results have a higher likelihood of being published compared to negative or nonsignificant results. Publication bias can confound the estimated therapeutic effect in meta-analyses and needs to be adequately assessed in the surgical literature. METHODS: A review of meta-analyses published in five plastic surgery journals from 2002 to 2022 was conducted. The inclusion criteria for meta-analyses were factors that demonstrated an obligation to assess publication bias, such as interventions with comparable treatment groups and enough power for statistical analysis. Acknowledgment of publication bias risk, quality of bias assessment, methods used in assessment, and individual article factors were analyzed. RESULTS: 318 unique meta-analyses were identified in literature search, and after full-text reviews, 143 met the inclusion criteria for obligation to assess publication bias. 64% of eligible meta-analyses acknowledged the confounding potential of publication bias, and only 46% conducted a formal assessment. Of those who conducted an assessment, 49% used subjective inspection of funnel plots alone, while 47% used any statistical testing in analysis. Overall, only 9/143 (6.3%) assessed publication bias and attempted to correct for its effect. Journals with a higher average impact factor were associated with mention and assessment of publication bias, but more recent publication year and higher number of primary articles analyzed were not. CONCLUSIONS: This review identified low rates of proper publication bias assessment in meta-analyses published in five major plastic surgery journals. Assessment of publication bias using objective statistical testing is necessary to ensure quality literature within surgical disciplines.

The Impact of Health Literacy on Trust in Online Plastic Surgery Content: A Nationwide Analysis.

INTRODUCTION: On most online platforms, just about anyone can disseminate plastic surgery (PS) content regardless of their educational or professional background. This study examines the general public's perceptions of the accuracy of online PS content and the factors that contribute to the discernment of credible information. METHODS: The Amazon Mechanical Turk crowdsourcing platform was used to survey adults in the United States. The survey assessed respondent demographics, health literacy (HL), and perceptions of online PS content accuracy. T-tests, Chi-square tests, and post hoc analyses with Bonferroni corrections assessed differences between HL groups. Multivariate linear regressions assessed associations between sociodemographic variables and perceptions of online content. RESULTS: In total, 428 (92.0%) of 465 complete responses were analyzed. The median age of respondents was 32 y (interquartile range: 29-40). Online sources were predominantly perceived to have a high degree of accuracy, with mean scores of various platforms ranging from 3.8 to 4.5 (1 = not accurate at all; 5 = extremely accurate). The low HL group perceived social media sites and review sites to be more accurate than the high HL respondents, particularly for Reddit (P = 0.004), Pinterest (P = 0.040), and Snapchat (P = 0.002). CONCLUSIONS: There is a concerning relationship between low HL and the perceptions of the accuracy of online PS sources. This study underscores the need for education campaigns, the development of trustworthy online resources, and initiatives to improve HL. By fostering a more informed public, individuals seeking PS can make better informed decisions.

LinkedIn Usage Trends Among Surgeons at a Large Academic Institute.

INTRODUCTION: Social networking platforms have evolved into a self-promotional space. The LinkedIn platform allows users to share knowledge, research accomplishments, and network in an academic setting. Our objective was to determine LinkedIn usage trends among surgeons at a large academic institution. METHODS: A list of surgeons within the department of surgery at a large academic institute was compiled. All publicly available profiles were analyzed for their LinkedIn activity and followership. Active accounts were defined as users who have posted or interacted with any posts within the last year. Comparisons of LinkedIn usage grouped by gender, surgery division, and rank were analyzed. RESULTS: A total of 133 surgeons were included. Among these surgeons, 88 had a LinkedIn profile (66.2%); however, only 43 surgeons had active usage on this platform (32.3%). The median number of followers among surgeons with a profile was 110 (IQR [24-427]). Male surgeons had a higher median of followers (167 IQR [38-502]) compared to female (54 IQR [21-209]). A greater percentage of male surgeons had a profile compared to female surgeons (68.5% M versus 61.0% F, P = 0.12). The transplant surgery division had the highest percentage of LinkedIn accounts (90.9%) followed by surgical oncology (87.5%). However, active usage was led by the pediatric surgery division (80.0%), followed by the plastic surgery division (71.4%). Instructors, assistant professors, associate professors, and professors all had LinkedIn accounts; however, instructors were the least active users with 33.3% being active on their LinkedIn. The lowest percentage of those with LinkedIn accounts were instructors (50%). Professors were found to be the most active users at 57.1%. CONCLUSIONS: Social media use is on the rise in academic surgery. Within a department of surgery at a large academic institution, only 32.3% were active users of LinkedIn, suggesting that there is room for improvement in utilizing this resource as a tool for mentorship, professional development, and networking.

The Perceived Impact of COVID-19 on Graduate Medical Education and Recommendations for Bridging the Educational Gap.

INTRODUCTION: COVID-19 generated a system-wide shock causing an unbalanced equilibrium between producing adequately trained physicians and meeting extraordinary operational needs. Previous studies report the experience of surgical residents during COVID-19 at a regional level. This study measures the learning losses related with the redeployment of highly specialized medical professionals to the care of COVID-19 patients, while we systematically investigate proposed remedial strategies. METHODS: We administered an online cross-sectional survey in 67 countries capturing training inputs (i.e., surgeries and seminars residents participated in) before and during the pandemic and retrieved residents' expected learning outputs, career prospects and recommended remedial measures for learning losses. We compared responses of residents working in (treatment group) and out (control group) of hospitals with COVID-19 patients. RESULTS: The analysis included 432 plastic surgery residents who were in training during the pandemic. Most of the learning losses were found in COVID-19 hospitals with 37% and 16% loss of surgeries and seminars, respectively, per week. Moreover, 74%, 44%, and 55% of residents expected their surgical skill, scientific knowledge, and overall competence, respectively, to be lower than those of residents who graduated before COVID. Residents in COVID-19 hospitals reported participating in significantly (P < 0.001) fewer surgeries and having significantly (P < 0.001) lower surgical skill relative to those not in COVID-19 hospitals. CONCLUSIONS: The perceived lower competence and the fall-off in surgical skill and scientific knowledge among future surgeons suggest that health-care systems globally may have limited capacity to perform specialized and costly procedures in the future.

Trends and current aspects of reconstructive surgery for gynecological cancers.

Gynecologic cancers can lead to gynecologic tract destruction with extension into both the gastrointestinal and urinary tracts. Recurrent disease can also affect the surrounding bony pelvis and pelvic musculature. As opposed to advanced ovarian cancer, where cytoreduction is the goal, in these scenarios, an oncologic approach to achieve negative margins is critical for benefit. Surgeries aimed at achieving a R0 resection in gynecologic oncology can have a significant impact on pelvic anatomy, and require reconstruction. Overall, it appears that these types of radical surgery are less frequently performed; however, when required, multidisciplinary teams at high-volume centers can potentially improve short-term morbidity. There are few data to examine the long-term, quality-of-life outcomes after reconstruction following oncologic resection in advanced and recurrent gynecologic cancers. In this review we outline considerations and approaches for reconstruction after surgery for gynecologic cancers. We also discuss areas of innovation, including minimally invasive surgery and the use of 3D surgical anatomy models for improved surgical planning.In the era of 'less is more', pelvic exenteration in gynecologic oncology is still indicated when there are no other curative-intent alternatives in persistent or recurrent gynecological malignancies confined to the pelvis or with otherwise unmanageable symptoms from fistula or radiation necrosis. Pelvic exenteration is one of the most destructive procedures performed on an elective basis, which inevitably carries a significant psychologic, sexual, physical, and emotional burden for the patient and caregivers. Such complex ultraradical surgery, which requires removal of the vagina, vulva, urinary tract, and/or gastrointestinal tract, subsequently needs creative and complex reconstructive procedures. The additional removal of sidewall or perineal structures, like pelvic floor muscles/vulva, or portions of the musculoskeletal pelvis, and the inclusion of intra-operative radiation further complicates reconstruction. This review paper will focus on the reconstruction aspects following pelvic exenteration, including options for urinary tract restoration, reconstruction of the vulva and vagina, as well as how to fill large empty spaces in the pelvis. While the predominant gastrointestinal outcome after exenteration in gynecologic oncology is an end colostomy, we also present some novel new options for gastrointestinal tract reconstruction at the end.

Impact of childbirth on pelvic floor dysfunction in women who have undergone previous pelvic floor reconstructive surgery: systematic review and meta-analysis.

INTRODUCTION AND HYPOTHESIS: The aim of the study was to perform a systematic review and meta-analysis of the impact of pregnancy and childbirth (vaginal delivery [VD]) or cesarean section (CS) on the recurrence of pelvic floor disorders in women who had previously undergone pelvic floor reconstructive surgery for pelvic organ prolapse (POP) or stress urinary incontinence (SUI), to facilitate future evidence-based counseling. METHODS: PubMed, Cochrane, Embase, BJOG, Scopus, etc. were screened, from 1990 to date. Inclusion criteria included cohort studies, case-control studies, case series, and case reports that reported on the primary outcome measure of the review. Exclusion criteria included studies on surgical procedures whose outcomes are unlikely to be impacted by pregnancy and childbirth or are obsolete. Meta-analysis was performed using Review Manager 5.3. RESULTS: Seven papers on midurethral slings (MUS; 181 women in both VD and CS groups respectively) and three papers on different hysteropexy techniques (47 and 29 women in the VD and CS groups respectively), were included in the meta-analysis. No difference was seen between the two groups regarding the recurrence of SUI in women who had previously undergone MUS surgery (OR: 1.18 [0.66, 2.09]; Z = 0.56; p = 0.58) or the recurrence of POP following hysteropexy using various apical suspension procedures (OR: 1.81 [0.04, 80.65]; Z = 0.31; p = 0.76). There are insufficient data to support meta-analyses for individual MUS sub-types or hysteropexy procedures. CONCLUSION: Current literature does not demonstrate a protective effect of CS in preventing recurrent SUI in women who had undergone MUS surgery for SUI. When hysteropexy is considered irrespective of the apical suspension procedure employed, the incidence of recurrent POP appears similar after CS and VD.

Practice-Based Learning in Aesthetic Medicine: Assessing Scientific Literacy Among Cosmetic Practitioners.

BACKGROUND: The field of aesthetic medicine has expanded substantially in the past decade, with significant practitioner diversification and departure from core-specialty supervision. The increased autonomy of nonphysician practitioners in a rapidly evolving field has raised accentuated the importance of scientific literacy and practice-based learning standards in the delivery of aesthetic medical care. OBJECTIVE: To assess the degree of scientific literacy among aesthetic medicine practitioners of different educational and training backgrounds in the United States and abroad. MATERIALS AND METHODS: A cross-sectional survey of 52 national and international aesthetic medicine practitioners employing a validated, 28-item, scientific literacy tool. RESULTS: The average score for all participants was 76% (SD = 18%, range = 43%-100%). Physician practitioners scored higher in all competencies compared non-physicians (86% vs 68%, p < 0.001), with a greater discrepancy among US practitioners (95% vs 71%, p < 0.001). Competencies relating to identification of bias/confounding variables, graphical data representation, and statistical inference/correlation showed the lowest proficiency. Practitioners with a doctorate or equivalent degree were significantly more likely to report frequent engagement with medical literature than non-physicians ( p = 0.02). CONCLUSION: There exists a significant disparity in scientific literacy between physician and nonphysician aesthetic medicine practitioners. This gap underscores the need for enhanced educational programs and continuous professional development to ensure safe and effective patient care in the evolving field of aesthetic medicine.

Voiding Dysfunction in Patients With Advanced Pelvic Organ Prolapse and Bladder Outlet Obstruction Following Pelvic Reconstructive Surgery: Urodynamic Profile and Predictive Risk Factors.

STUDY OBJECTIVE: To determine the outcome of voiding function 1 year after pelvic reconstructive surgery (PRS) in women with bladder outlet obstruction (BOO). DESIGN: Retrospective cohort study. SETTING: Tertiary referral hospital. PATIENTS: A total of 1894 women underwent PRS for advanced pelvic organ prolapse (POP) stages 3 to 4 with urodynamic findings of BOO. INTERVENTIONS: PRS. MEASUREMENTS: The primary outcome measured was the resumption of normal voiding function, defined clinically with multichannel urodynamic testing at 1 year postoperatively. The secondary outcomes were to identify the different risk factors for persistence voiding dysfunction (VD) 1 year after PRS. MAIN RESULTS: A total of 431 women with Pelvic Organ Prolapse Quantification stages 3 and 4, urodynamic study of maximum urinary flow rate ≤15 mL/s, and detrusor pressure at maximum flow ≥20 cm H2O were included. Resumption of normal voiding function was found in 91% (n = 392 of 431), whereas 9% (n = 39 of 431) remained to have VD 1 year postoperatively. Those with persistent VD, 20.5% (n = 8 of 39) remained having urodynamic diagnosis of BOO. Univariate and multivariate logistic regression revealed factors associated with postoperative VD were pre-operative maximal cystometric capacity ≥500 mL and postvoid residual volume ≥200 mL. CONCLUSION: VD may persist in women with BOO after PRS, particularly in those with preoperative maximal cystometric capacity of >500 mL and postvoid residual volume >200 mL.

ical Efficacy of Early Plastic Surgery Treatment for Patients with Deep Hand Burns.

Objective: This study aims to assess the effectiveness of early plastic surgery for deep hand burns by examining variables like VAS scores, wound healing time, and excellent hand function recovery rates. Methods: A total of 130 patients with deep hand burns admitted to our hospital between January 2020 and October 2021 were enrolled in this study. They were randomly assigned to either a control group (n = 65, deferred reconstructive surgery) or an observation group (n = 65, early reconstructive surgery) using a random number table. We compared the VAS scores, wound healing time, rates of excellent hand function recovery, complications, and overall treatment efficacy between the two groups. Results: The preoperative VAS scores were comparable between the observation and control groups (P > .05). Postoperative VAS scores in the observation group were significantly lower than those in the control group at 1, 3, and 7 days following surgery (P < .05). Additionally, the observation group exhibited shorter wound healing times and higher rates of excellent hand function recovery (P < .05). The incidence of complications such as numbness, infection, and necrosis of implants was lower in the observation group compared to the control group (P < .05). The overall treatment efficacy was also significantly better in the observation group than in the control group (P < .05). Conclusions: These findings underscore the high clinical value of early surgical intervention, supporting its broader application in the treatment of deep hand burns and potentially improving patient outcomes.

Analysis of modified ilib therapy in patients submitted to plastic surgery.

The sample comprised 44 volunteers who had undergone some surgical procedure and were equally divided into four groups. G1 started the therapy 24 h after the surgical procedure with the device off. G2 followed the same time pattern, 24 h, but with the device turned on. G3 and G4 started therapy three days after the surgical procedure; in G3, the device was turned off, and in G4, the device remained on during therapy; each session lasted 30 min, using 660 nm (red), energy 180 J. For all groups, the therapy started with daily use for seven days and followed the interval use of three times a week until completed 21 days. The revaluation was performed after 7 and 21 days. The results found show changes in HR at rest, systolic and diastolic BP, and in peripheral oxygen saturation, which showed a significant difference in the groups that used on-therapy (p < 0.05). In the MCGILL Scale evaluation, the mean total score showed a more accentuated drop in the groups that used ILIB, (p < 0.05). ILIB may have prevented a more significant evolution of firosis levels; however, no changes were observed in the evaluation of sleep and anxiety. The application of the ILIB in patients undergoing plastic surgery was supported in terms of hemodynamics and pain; in addition, starting the ILIB application 24 h after the procedure proved to be more advantageous.

Posterior epistaxis management: review of the literature and proposed guidelines of the hellenic rhinological-facial plastic surgery society.

PURPOSE: Posterior epistaxis is a common emergency in ENT practice varying in severity and treatment. Many management guidelines have been proposed, all of which are a product of retrospective analyses due to the nature of this pathology, as large-scale double-blind studies are impossible-even unethical-to conduct. The purpose of this review is to perform a thorough analysis and comparison of every treatment plan available and establish guidelines for the best possible outcome in accordance to every parameter studied. Given the extensive heterogeneity of information and the multitude of studies on this topic, along with the comparison of various treatment options, we opted for a literature review as our research approach. METHODS: A review of the literature was performed using PubMed Database and search terms included "posterior epistaxis", "treatment", "management", "guidelines", "algorithm" "nasal packing", "posterior packing", "surgery", "SPA ligation", "embolization", "risk factors" or a combination of the above. RESULTS: Initial patients' assessment invariably results in most cases in posterior packing. There seems to be a superiority in recent literature of early surgery over nasal packing as a definitive treatment. Embolization is usually used after surgery failure, except for specific occasions. CONCLUSION: Despite the vast heterogeneity of information, there seems to be a need for re-evaluation of the well-established treatment plans according to more recent studies.

An Analysis of the Characteristics and Trends in Practicing Plastic Surgeons in California.

BACKGROUND: Studies suggest an increasing trend of plastic surgeons choosing private practice after training, with up to 90% pursuing private practice without future fellowships.1 Previous data showed that 66.7% of graduates from plastic surgery residency programs chose to pursue private practice without future fellowship, while more recent studies estimate this statistic has risen close to 90%.1,2 The literature has yet to characterize the current plastic surgery workforce and changes in its composition over time. This study aims to analyze the characteristics and training of plastic surgeons in California through a comparative study with general surgeons. METHODS: Surgeon demographics were extracted from the Centers for Medicare and Medicaid Services open database. Urban/rural classification and academic affiliation were crosslinked from the Inpatient Prospective System database and sole proprietorship status was cross-linked from the NPI Registry. Summary statistics and logistic regressions with chi-squared analysis were analyzed using STATA/MP17. RESULTS: Our analysis consisted of 3871 plastic and general surgeons in California. Compared to general surgeons, plastic surgeons were less likely to be females (P < 0.000), and more likely to be sole proprietors (P < 0.000), and affiliated with a teaching hospital (P < 0.005). There was no statistically significant difference in the percentage of rural-practicing plastic and general surgeons (P = 0.590). More recent plastic surgery graduates were more likely to be affiliated with an academic hospital (P < 0.0000). The composition of females significantly increased from the older graduated cohort to the most recent one. There was no significant difference in sole proprietorship and rural practice status between the oldest and youngest graduating cohorts. CONCLUSIONS: Although the California plastic surgery workforce is gaining female plastic surgeons and shifting to academic institutions, significant progress in serving rural communities is yet to be made. Our study suggests that there may be a shift in the trend of plastic surgeons opting for private practice, possibly driven by a desire for more stable positions in academia. Continued improvement in diversity and training of future plastic surgeons is needed to alleviate the rural care gap.

Conversion Rate of Abstracts Presented at Plastic Surgery The Meeting From 2010 to 2019: A 10-Year Analysis of Factors for Success.

BACKGROUND: Presentations are an important means of knowledge generation. Publication of these studies is important for dissemination of findings beyond meeting attendees. We analyzed a 10-year sample of presented abstracts at Plastic Surgery The Meeting and describe factors that improve rate and speed of conversion to peer-reviewed publication. METHODS: Abstracts presented between 2010 and 2019 at Plastic Surgery The Meeting were sourced from the American Society of Plastic Surgery Abstract Archive. A random sample of 100 abstracts from each year was evaluated. Abstract information and demographics were recorded. The title or author and keywords of each abstract were searched using a standardized workflow to find a corresponding published paper on PubMed, Google Scholar, and Google. Data were analyzed for trends and factors affecting conversion rate. RESULTS: A total of 983 presented abstracts were included. The conversion rate was 54.1%. Residents and fellows constituted the largest proportion of presenters (38.4%). There was a significant increase in medical student and research fellow presenters during the study period (P < 0.001). Conversion rate was not affected by the research rank of a presenter's affiliated institution (ß = 1.001, P = 0.89), geographic location (P = 0.60), or subspecialty tract (P = 0.73). US academics had a higher conversion rate (61.8%) than US nonacademics (32.7%) or international presenters (47.1%) (P < 0.001). Medical students had the highest conversion rate (65.6%); attendings had the lowest (45.0%). Research fellows had the lowest average time to publication (11.6 months, P = 0.007). CONCLUSIONS: Lower levels of training, factors associated with increased institution-level support, and research quality affect rate and time to publication. These findings highlight the success of current models featuring medical student and research fellow-led projects with strong resident and faculty mentorship.

Plastic Surgery in Burn Care: A Call for Enhanced Burn Surgery Training Within Plastic Surgery Residency Programs.

ABSTRACT: A 10 year cohort of patients admitted to a verified burn unit were analyzed to assess the role of plastic surgeons in the operative management of those patients. All 3843patients were admitted during this study period. Of these, 1509 of those patients underwent surgical procedures. Plastic surgeons performed 658 operations on these patients, including acute and delayed reconstruction of hand and facial burn injuries. In this population, plastic surgeons played a critical role in acute and reconstructive burn injuries in anatomically complex areas. This series illustrates the need for plastic surgery training in burn care.

Diversity, Equity, and Inclusion in Plastic Surgery: A Systematic Review.

BACKGROUND: The number of publications on the subject of diversity, equity, and inclusion has surged in the last 5 years. However, a systematic review of this topic has not been published. METHOD: Six top plastic surgery journals were queried from 2018 to 2023 using the search term "diversity." Methods, conclusions, and recommendations were tabulated. RESULTS: A total of 138 publications were identified; 68 studies presented data suitable for analysis. All studies were retrospective. Currently, over 40% of plastic surgery residency applicants are women. The proportion of women in integrated plastic surgery residents is now 43%. In 2021 and 2022, the percentage of female first-year residents exceeded men. The percentage of female presenters at meetings (34%) is double the number in the workforce (17%). Twenty-five percent of academic faculty positions and 22% of program director positions are now held by women. Underrepresented minorities account for fewer than 10% of applicants to integrated plastic surgery residencies. DISCUSSION: The proportion of Black and Hispanic applicants to integrated plastic surgery residencies (6% and 8%, respectively) mirrors the proportion of Black and Hispanic medical students (7% and 6%, respectively). Numerous recommendations have been made to increase the proportion of underrepresented minorities in plastic surgery programs. CONCLUSIONS: The representation of women in plastic surgery has increased dramatically. A lack of Hispanics and Blacks reflects a small pool of applicants, as opposed to a "leaky pipeline."