Quality Assessment of Online Information on Body Contouring Surgery in Postbariatric Patient.

BACKGROUND: Nowadays, we have to face the fact that the Web represents one of the most important sources of information for patients. Postbariatric patients in particular are usually very motivated, and they are enthusiastic users of the Web as a source of information on the different types of surgery they could undergo after their weight loss in order to reshape and remodel their body thus regaining physical and functional wellness and dignity. The aim of the study was to assess information on the four most commonly performed postbariatric procedures worldwide, tummy tuck, breast, arm and thigh lift, with the same scale. METHODS: Google and Yahoo have been probed for the keywords "Post bariatric Mastopexy OR breast lift" and "Post bariatric abdominoplasty OR tummy tuck" and "Post bariatric brachioplasty OR arm lift" and "post bariatric thigh lift". The first 50 hits were included, and the quality of information was evaluated with the expanded EQIP scale. RESULTS: There was a critical lack of information about qualitative risks and side-effect description, treatment of potential complications, alert signs for the patient and precautions that the patient may take. Moreover, there was poor information about the sequence of the medical procedure, quantitative benefits and risks and quality of life issues after the procedure, and often, there were no other sources of information. CONCLUSIONS: Due to the poor and not reliable information offered by the Web, health professionals should seek for a good communication practice with their patients. LEVEL OF EVIDENCE V: 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.

The keystone flap: A multi-centric experience in elderly patients treatment.

Soft tissue reconstruction in elderly patients must be rapid and reliable. The keystone island flap (KF) offers an effective solution, with low complication rates and quick recovery. This multi-centric study aims to show authors' experience with KFs in treating soft tissue defects of trunk and limbs. Patients with soft tissue defects suitable for KF reconstruction were recruited from March 2019 to December 2019. Active inflammation and previous surgeries in the same region were considered exclusion criteria. Complications that occurred during follow-up were recorded, and their incidence pattern was assessed with the Fisher test. Seventy-two patients with mean age of 76.2 years old were selected. They presented lesions in torso (46; 63.9%) or in upper (4; 5.6%) or lower (22; 30.6%) limb regions. Fifteen (20.8%) wounds were non-oncologic lesions, and the others were oncologic lesions, mostly non-melanoma skin cancers. KF type I was carried out in 42 (58.3%) cases, KF type II-A in 13 (18%) cases, double opposed type III KF in 16 (22.2%) patients, and 1 (1.4%) case required partial flap's undermining (IV KF). Mean post-operative recovery period was 4.3 days (range, 1-9 days). Post-surgical complications occurred in 15 (20.8%) cases, 7 (9.7%) of them were considered major complications. No statistically significant difference in complications' incidence, nor among different surgical sites nor among KF types, was registered. Reconstructive surgeons have to adapt their work to elderly patients. The KF allows rapid operative times, low morbidity rates, and short post-operative recovery time, thus appearing as a feasible solution.