JPRAS Open最新文献_第7页

Evaluating the quality and reliability of oncologic breast reconstruction videos on youtube 评估 youtube 上肿瘤乳房重建视频的质量和可靠性

IF 1.5 Q3 SURGERY

JPRAS Open

Pub Date : 2024-10-11 DOI: 10.1016/j.jpra.2024.10.006

Daniel Soroudi , Israel Falade , Nina Mehta , Alexis Gursky , Raymond Yin , Siyou Song , Esther Kim

Oncologic breast reconstruction (OBR) is a complex process that requires consideration of multiple factors, including chemoradiation, extent of cancer treatment, and surgical approach. Patients often feel uncertain about the numerous surgical options and may turn to popular social media platforms like YouTube for information. Thus, this study aims to assess the quality and reliability of YouTube videos related to OBR.

We conducted a retrospective, cross-sectional analysis of YouTube videos related to OBR. Search terms were obtained from plasticsurgery.org and Google Trends. The first ten videos for each search term were analyzed. Videos were categorized by source and subject matter and independently reviewed by three evaluators using the DISCERN scale.

This study examined 172 YouTube videos. Five video source categories were identified: Health Care Administrations, Physicians, Non-physician Providers, News Organizations, and Patients. Health Care Administration accounts received the highest overall DISCERN score of 3.6 ± 0.51, followed by Physicians at 2.98 ± 0.93, with News Organization accounts scoring the lowest at 2.22 ± 0.60 (p < 0.001). Videos from academic sources (Physicians and Health Care Administrators) had higher DISCERN scores compared to non-academic sources (News Organizations and Patients), 2.98 ± 0.95 versus 2.28 ± 0.77, respectively (p < 0.001).

Our findings indicate that videos from academic sources generally exhibit higher DISCERN scores, pointing to a higher content quality and reliability standard. Given the increasing reliance on YouTube for healthcare information, our study underscores the need for healthcare professionals to engage more actively in content creation and dissemination.

肿瘤乳房重建（OBR）是一个复杂的过程，需要考虑多种因素，包括化疗、癌症治疗程度和手术方法。患者往往对众多的手术方案感到不确定，可能会求助于 YouTube 等流行的社交媒体平台来获取信息。因此，本研究旨在评估YouTube上与OBR相关视频的质量和可靠性。我们对YouTube上与OBR相关的视频进行了回顾性横断面分析。搜索词来自 plasticsurgery.org 和 Google Trends。我们对每个搜索词的前十个视频进行了分析。视频按照来源和主题进行分类，并由三位评估者使用 DISCERN 量表进行独立审查。确定了五个视频来源类别：本研究共检查了 172 个 YouTube 视频来源类别：医疗保健管理机构、医生、非医生提供者、新闻机构和患者。医疗保健管理机构账户的 DISCERN 总得分最高，为 3.6 ± 0.51，其次是医生账户，为 2.98 ± 0.93，新闻机构账户得分最低，为 2.22 ± 0.60（p < 0.001）。与非学术来源（新闻机构和患者）相比，学术来源（医生和医疗管理人员）的视频具有更高的 DISCERN 分数，分别为 2.98 ± 0.95 对 2.28 ± 0.77（p < 0.001）。鉴于人们越来越依赖 YouTube 获取医疗保健信息，我们的研究强调了医疗保健专业人员更积极地参与内容创建和传播的必要性。

{"title":"Evaluating the quality and reliability of oncologic breast reconstruction videos on youtube","authors":"Daniel Soroudi , Israel Falade , Nina Mehta , Alexis Gursky , Raymond Yin , Siyou Song , Esther Kim","doi":"10.1016/j.jpra.2024.10.006","DOIUrl":"10.1016/j.jpra.2024.10.006","url":null,"abstract":"<div><div>Oncologic breast reconstruction (OBR) is a complex process that requires consideration of multiple factors, including chemoradiation, extent of cancer treatment, and surgical approach. Patients often feel uncertain about the numerous surgical options and may turn to popular social media platforms like YouTube for information. Thus, this study aims to assess the quality and reliability of YouTube videos related to OBR.</div><div>We conducted a retrospective, cross-sectional analysis of YouTube videos related to OBR. Search terms were obtained from <span><span>plasticsurgery.org</span><svg><path></path></svg></span> and Google Trends. The first ten videos for each search term were analyzed. Videos were categorized by source and subject matter and independently reviewed by three evaluators using the DISCERN scale.</div><div>This study examined 172 YouTube videos. Five video source categories were identified: Health Care Administrations, Physicians, Non-physician Providers, News Organizations, and Patients. Health Care Administration accounts received the highest overall DISCERN score of 3.6 ± 0.51, followed by Physicians at 2.98 ± 0.93, with News Organization accounts scoring the lowest at 2.22 ± 0.60 (<em>p</em> < 0.001). Videos from academic sources (Physicians and Health Care Administrators) had higher DISCERN scores compared to non-academic sources (News Organizations and Patients), 2.98 ± 0.95 versus 2.28 ± 0.77, respectively (<em>p</em> < 0.001).</div><div>Our findings indicate that videos from academic sources generally exhibit higher DISCERN scores, pointing to a higher content quality and reliability standard. Given the increasing reliance on YouTube for healthcare information, our study underscores the need for healthcare professionals to engage more actively in content creation and dissemination.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 311-314"},"PeriodicalIF":1.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

“Lymphatic vessels preserving descending genicular artery perforator (LpDGAP) flap for a skin defect on the anterior knee: A single case report” "保留淋巴管的膝降支动脉穿孔器（LpDGAP）皮瓣治疗膝关节前部皮肤缺损：单例报告"。

IF 1.5 Q3 SURGERY

JPRAS Open

Pub Date : 2024-10-02 DOI: 10.1016/j.jpra.2024.09.018

Yushi Suzuki, Tatsuya Kato, Noriko Seguchi, Kazuo Kishi

The medial thigh, rich in lymphatic vessels, presents risks of seroma and lymphoedema after flap elevation. This study discusses a novel approach using indocyanine green (ICG) to preserve lymphatic vessels while harvesting a descending genicular artery perforator (DGAP) flap for knee reconstruction. Here, we present the case of a 44-year-old woman who developed a skin defect below the right knee after cellulitis and abscess debridement. Preoperative ICG lymphography identified the lymphatic pathways, allowing for a meticulous flap design to avoid vessel damage. The surgery resulted in successful flap integration and a full range of knee motion without complications. Follow-up ICG lymphography confirmed the preservation of the lymphatic vessels. This case underscores the importance of lymphatic preservation in medial thigh flap procedures to minimise postoperative complications, such as seroma, cellulitis, and transient lymphoedema. Further research is required to explore the applications of this technique in broader clinical settings.

大腿内侧淋巴管丰富，皮瓣隆起后存在血清肿和淋巴水肿的风险。本研究讨论了一种使用吲哚菁绿（ICG）保留淋巴管的新方法，同时将降支膝动脉穿孔器（DGAP）皮瓣用于膝关节重建。在此，我们介绍了一例 44 岁女性的病例，她在蜂窝组织炎和脓肿清创后，右膝盖下方出现皮肤缺损。术前 ICG 淋巴造影术确定了淋巴通路，使皮瓣设计细致入微，避免了血管损伤。手术成功整合了皮瓣，膝关节活动范围完全恢复，没有出现并发症。后续的 ICG 淋巴造影证实淋巴管得到了保留。该病例强调了在大腿内侧皮瓣手术中保留淋巴管对减少血清肿、蜂窝织炎和一过性淋巴水肿等术后并发症的重要性。还需要进一步的研究来探索这种技术在更广泛临床环境中的应用。

{"title":"“Lymphatic vessels preserving descending genicular artery perforator (LpDGAP) flap for a skin defect on the anterior knee: A single case report”","authors":"Yushi Suzuki, Tatsuya Kato, Noriko Seguchi, Kazuo Kishi","doi":"10.1016/j.jpra.2024.09.018","DOIUrl":"10.1016/j.jpra.2024.09.018","url":null,"abstract":"<div><div>The medial thigh, rich in lymphatic vessels, presents risks of seroma and lymphoedema after flap elevation. This study discusses a novel approach using indocyanine green (ICG) to preserve lymphatic vessels while harvesting a descending genicular artery perforator (DGAP) flap for knee reconstruction. Here, we present the case of a 44-year-old woman who developed a skin defect below the right knee after cellulitis and abscess debridement. Preoperative ICG lymphography identified the lymphatic pathways, allowing for a meticulous flap design to avoid vessel damage. The surgery resulted in successful flap integration and a full range of knee motion without complications. Follow-up ICG lymphography confirmed the preservation of the lymphatic vessels. This case underscores the importance of lymphatic preservation in medial thigh flap procedures to minimise postoperative complications, such as seroma, cellulitis, and transient lymphoedema. Further research is required to explore the applications of this technique in broader clinical settings.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 250-255"},"PeriodicalIF":1.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11513435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating the Efficacy and Complications of the Scapular Osseous Free Flap for Head and Neck Reconstruction: Results from a Population-based Cohort 评估肩胛骨骨性游离瓣用于头颈部重建的疗效和并发症：基于人群的队列研究结果

IF 1.5 Q3 SURGERY

JPRAS Open

Pub Date : 2024-10-01 DOI: 10.1016/j.jpra.2024.09.020

Henrik Guné , Johanna Sjövall , Magnus Becker , Karin Elebro , Anna Hafström , Linda Tallroth , Stina Klasson

Introduction

The scapular osseous free flap (SOFF) is being increasingly used for complex head and neck reconstructions. This study examined the surgical outcomes, focusing on post-operative complications and sequelae in patients who underwent SOFF for maxillary and mandibular reconstructions.

Material and Methods

This retrospective, observational, population-based study included patients who underwent SOFF reconstruction at a tertiary referral centre, the Department of Otorhinolaryngology-Head and Neck Surgery, Skåne University Hospital, Sweden, from November 2016 to March 2023. All patients were followed-up for at least six months after surgery.

Results

Forty-two of the 44 consecutive patients (60 % men) consented to the study and were evaluated with a median follow-up time of 49 months (range 8–85 months). The study divided the patients into two groups; maxillary (n = 29) and mandibular (n = 13) reconstructions. The World Health Organisation performance status and the Charlson comorbidity index were lower in the maxillary group (p = 0.025 and p = 0.011, respectively). The maxillary group experienced high complication rates including six total flap failures and nine oronasal fistulas. Conversely, the mandibular group had no flap failures but a similar rate of general post-operative complications were observed. Dental rehabilitation was more common in the maxillary group.

Conclusion

The SOFF is an option for complex reconstructions of the maxilla but is associated with a relatively high rate of complications. Methods that can prevent or minimise sequelae, e.g., oronasal fistulas, in future patients are warranted. The SOFF is an excellent alternative for mandibular reconstructions.

导言肩胛骨骨性游离皮瓣（SOFF）越来越多地被用于复杂的头颈部重建手术。本研究探讨了手术效果，重点关注接受肩胛骨游离皮瓣上颌骨和下颌骨重建术的患者的术后并发症和后遗症。材料和方法这项回顾性、观察性、基于人群的研究纳入了2016年11月至2023年3月期间在瑞典斯科纳大学医院耳鼻咽喉头颈外科这一三级转诊中心接受肩胛骨游离皮瓣重建术的患者。所有患者均在术后接受了至少 6 个月的随访。结果44 名连续患者中有 42 人（60% 为男性）同意接受研究，随访时间中位数为 49 个月（8-85 个月）。研究将患者分为两组：上颌骨重建组（29 人）和下颌骨重建组（13 人）。上颌组患者的世界卫生组织表现状态和查尔森合并症指数较低（分别为 p = 0.025 和 p = 0.011）。上颌组的并发症发生率较高，包括六例全皮瓣失败和九例口鼻瘘。相反，下颌组没有皮瓣失败，但观察到的一般术后并发症发生率相似。结论SOFF是上颌骨复杂重建的一种选择，但并发症发生率相对较高。我们需要采取一些方法来预防或尽量减少后遗症，如未来患者的口鼻瘘。SOFF是下颌骨重建的绝佳选择。

{"title":"Evaluating the Efficacy and Complications of the Scapular Osseous Free Flap for Head and Neck Reconstruction: Results from a Population-based Cohort","authors":"Henrik Guné , Johanna Sjövall , Magnus Becker , Karin Elebro , Anna Hafström , Linda Tallroth , Stina Klasson","doi":"10.1016/j.jpra.2024.09.020","DOIUrl":"10.1016/j.jpra.2024.09.020","url":null,"abstract":"<div><h3>Introduction</h3><div>The scapular osseous free flap (SOFF) is being increasingly used for complex head and neck reconstructions. This study examined the surgical outcomes, focusing on post-operative complications and sequelae in patients who underwent SOFF for maxillary and mandibular reconstructions.</div></div><div><h3>Material and Methods</h3><div>This retrospective, observational, population-based study included patients who underwent SOFF reconstruction at a tertiary referral centre, the Department of Otorhinolaryngology-Head and Neck Surgery, Skåne University Hospital, Sweden, from November 2016 to March 2023. All patients were followed-up for at least six months after surgery.</div></div><div><h3>Results</h3><div>Forty-two of the 44 consecutive patients (60 % men) consented to the study and were evaluated with a median follow-up time of 49 months (range 8–85 months). The study divided the patients into two groups; maxillary (<em>n</em> = 29) and mandibular (<em>n</em> = 13) reconstructions. The World Health Organisation performance status and the Charlson comorbidity index were lower in the maxillary group (<em>p</em> = 0.025 and <em>p</em> = 0.011, respectively). The maxillary group experienced high complication rates including six total flap failures and nine oronasal fistulas. Conversely, the mandibular group had no flap failures but a similar rate of general post-operative complications were observed. Dental rehabilitation was more common in the maxillary group.</div></div><div><h3>Conclusion</h3><div>The SOFF is an option for complex reconstructions of the maxilla but is associated with a relatively high rate of complications. Methods that can prevent or minimise sequelae, e.g., oronasal fistulas, in future patients are warranted. The SOFF is an excellent alternative for mandibular reconstructions.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 296-305"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment of trunk defects using perforator flaps: A case series introducing suprascapular artery perforator flap 使用穿孔器皮瓣治疗躯干缺损：引入肩胛上动脉穿孔器皮瓣的病例系列

IF 1.5 Q3 SURGERY

JPRAS Open

Pub Date : 2024-10-01 DOI: 10.1016/j.jpra.2024.09.015

Sebastian Dietrich , Irakli Panchulidze

This case series explores the efficacy of freestyle perforator flaps, including the newly introduced suprascapular artery perforator flap (SSAP), in reconstructing trunk defects. Over a five-year period, 24 perforator flap procedures were performed on 19 patients, primarily for defect reconstruction after skin tumor and ulcer resections. Flap design was customized using preoperative doppler ultrasound and they were then transferred to defects in a V-Y or propeller fashion. The most frequently utilized flaps were the dorsal intercostal artery perforator (DICAP) flap and the lumbar artery perforator (LAP) flap. Notably, SSAP flaps were successfully employed for shoulder defects resulting from squamous cell carcinoma resections.

Complications occurred in 29 % of cases, including seroma evacuation, hematoma, and wound dehiscence, with one patient experiencing severe liver failure post-surgery. The versatility of perforator-based reconstruction was demonstrated through the combination of DICAP and LAP flaps for large trunk defects. Additionally, internal mammary artery perforator (IMAP) and lateral thoracic artery perforator (LTAP) flaps were utilized for parasternal and infraclavicular defects, respectively.

The introduction of the SSAP flap expands the options for dorsal shoulder area reconstruction, offering faster healing and superior cosmetic results compared to traditional methods like secondary intention healing or skin grafting. Although this study showcases promising outcomes, further research is warranted to validate the effectiveness of SSAP flaps and to explore their applications in a broader patient population.

本系列病例探讨了自由式穿孔器皮瓣（包括新引入的肩胛上动脉穿孔器皮瓣（SSAP））在重建躯干缺损方面的疗效。在五年时间里，共为 19 名患者实施了 24 例穿孔器皮瓣手术，主要用于皮肤肿瘤和溃疡切除术后的缺损重建。术前使用多普勒超声对皮瓣进行定制设计，然后以 V-Y 或螺旋桨方式将皮瓣转移到缺损处。最常用的皮瓣是背肋间动脉穿孔器皮瓣（DICAP）和腰动脉穿孔器皮瓣（LAP）。29% 的病例出现并发症，包括血清肿疏散、血肿和伤口裂开，其中一名患者术后出现严重肝功能衰竭。通过结合DICAP和LAP皮瓣治疗大面积躯干缺损，证明了穿孔器重建的多功能性。此外，乳内动脉穿孔器皮瓣（IMAP）和胸外侧动脉穿孔器皮瓣（LTAP）分别用于胸骨旁和锁骨下缺损。SSAP皮瓣的引入扩大了肩背区域重建的选择范围，与二次意向愈合或植皮等传统方法相比，SSAP皮瓣愈合更快，美容效果更好。尽管这项研究展示了良好的结果，但仍需进一步研究以验证 SSAP 皮瓣的有效性，并探索其在更广泛患者群体中的应用。

{"title":"Treatment of trunk defects using perforator flaps: A case series introducing suprascapular artery perforator flap","authors":"Sebastian Dietrich , Irakli Panchulidze","doi":"10.1016/j.jpra.2024.09.015","DOIUrl":"10.1016/j.jpra.2024.09.015","url":null,"abstract":"<div><div>This case series explores the efficacy of freestyle perforator flaps, including the newly introduced suprascapular artery perforator flap (SSAP), in reconstructing trunk defects. Over a five-year period, 24 perforator flap procedures were performed on 19 patients, primarily for defect reconstruction after skin tumor and ulcer resections. Flap design was customized using preoperative doppler ultrasound and they were then transferred to defects in a V-Y or propeller fashion. The most frequently utilized flaps were the dorsal intercostal artery perforator (DICAP) flap and the lumbar artery perforator (LAP) flap. Notably, SSAP flaps were successfully employed for shoulder defects resulting from squamous cell carcinoma resections.</div><div>Complications occurred in 29 % of cases, including seroma evacuation, hematoma, and wound dehiscence, with one patient experiencing severe liver failure post-surgery. The versatility of perforator-based reconstruction was demonstrated through the combination of DICAP and LAP flaps for large trunk defects. Additionally, internal mammary artery perforator (IMAP) and lateral thoracic artery perforator (LTAP) flaps were utilized for parasternal and infraclavicular defects, respectively.</div><div>The introduction of the SSAP flap expands the options for dorsal shoulder area reconstruction, offering faster healing and superior cosmetic results compared to traditional methods like secondary intention healing or skin grafting. Although this study showcases promising outcomes, further research is warranted to validate the effectiveness of SSAP flaps and to explore their applications in a broader patient population.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 268-274"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessing the accuracy of artificial intelligence in the diagnosis and management of orbital fractures: Is this the future of surgical decision-making? 评估人工智能诊断和处理眼眶骨折的准确性：这是手术决策的未来吗？

IF 1.5 Q3 SURGERY

JPRAS Open

Pub Date : 2024-09-30 DOI: 10.1016/j.jpra.2024.09.014

Steven Gernandt , Romain Aymon , Paolo Scolozzi

Orbital fractures are common, but their management remains controversial. The aim of the present study was to assess the accuracy of an advanced artificial intelligence (AI) model, ChatGPT-4, in surgical decision-making, with a focus on orbital fracture diagnosis and management.

A retrospective observational analysis was conducted by involving a sample of 30 orbital fracture cases diagnosed and managed at the Geneva University Hospital, Switzerland. The process involved creating patient vignettes from anonymised medical records and presenting them to ChatGPT-4 in three stages: initial diagnosis, refinement with radiological reports and surgical intervention decisions. The performance of ChatGPT-4 in providing the appropriate surgical strategy was evaluated through measures of sensitivity, specificity, positive predictive value and negative predictive value, with the actual management used as the benchmark for accuracy.

The AI model could correctly diagnose the fracture in 100 % of the cases. It demonstrated a specificity of 100 % and sensitivity of 57 % for treatment recommendation, indicating its effectiveness in recognising patients who truly required an intervention; however, it demonstrated a moderate performance in correctly identifying cases that were better suited for conservative treatment. Cohen's Kappa statistic for interrater reliability of the choice of treatment was 0.44, indicating a weak level of agreement between ChatGPT and the physician's choice of treatment.

The study demonstrates that AI tools such as ChatGPT-4 can offer a high degree of accuracy in diagnosing orbital fractures and recognising patients requiring surgical intervention; however, it performed less satisfactorily in correctly identifying patients who were better suited for non-surgical treatment.

眼眶骨折很常见，但其治疗方法仍存在争议。本研究旨在评估高级人工智能（AI）模型 ChatGPT-4 在手术决策中的准确性，重点是眼眶骨折的诊断和管理。研究人员对瑞士日内瓦大学医院诊断和管理的 30 例眼眶骨折病例进行了回顾性观察分析。分析过程包括从匿名病历中创建患者小故事，并分三个阶段将其提交给 ChatGPT-4：初步诊断、根据放射学报告完善诊断和手术干预决策。通过灵敏度、特异性、阳性预测值和阴性预测值等指标评估了 ChatGPT-4 在提供适当手术策略方面的性能，并将实际管理作为准确性的基准。在治疗建议方面，该模型的特异性为 100%，灵敏度为 57%，这表明它能有效识别真正需要干预的患者；但在正确识别更适合保守治疗的病例方面，该模型的表现一般。该研究表明，ChatGPT-4 等人工智能工具在诊断眼眶骨折和识别需要手术治疗的患者方面具有很高的准确性；但在正确识别更适合非手术治疗的患者方面，其表现却不尽如人意。

{"title":"Assessing the accuracy of artificial intelligence in the diagnosis and management of orbital fractures: Is this the future of surgical decision-making?","authors":"Steven Gernandt , Romain Aymon , Paolo Scolozzi","doi":"10.1016/j.jpra.2024.09.014","DOIUrl":"10.1016/j.jpra.2024.09.014","url":null,"abstract":"<div><div>Orbital fractures are common, but their management remains controversial. The aim of the present study was to assess the accuracy of an advanced artificial intelligence (AI) model, ChatGPT-4, in surgical decision-making, with a focus on orbital fracture diagnosis and management.</div><div>A retrospective observational analysis was conducted by involving a sample of 30 orbital fracture cases diagnosed and managed at the Geneva University Hospital, Switzerland. The process involved creating patient vignettes from anonymised medical records and presenting them to ChatGPT-4 in three stages: initial diagnosis, refinement with radiological reports and surgical intervention decisions. The performance of ChatGPT-4 in providing the appropriate surgical strategy was evaluated through measures of sensitivity, specificity, positive predictive value and negative predictive value, with the actual management used as the benchmark for accuracy.</div><div>The AI model could correctly diagnose the fracture in 100 % of the cases. It demonstrated a specificity of 100 % and sensitivity of 57 % for treatment recommendation, indicating its effectiveness in recognising patients who truly required an intervention; however, it demonstrated a moderate performance in correctly identifying cases that were better suited for conservative treatment. Cohen's Kappa statistic for interrater reliability of the choice of treatment was 0.44, indicating a weak level of agreement between ChatGPT and the physician's choice of treatment.</div><div>The study demonstrates that AI tools such as ChatGPT-4 can offer a high degree of accuracy in diagnosing orbital fractures and recognising patients requiring surgical intervention; however, it performed less satisfactorily in correctly identifying patients who were better suited for non-surgical treatment.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 275-283"},"PeriodicalIF":1.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Necrotising cellulitis occurring after cosmetic blepharoplasty: A case report 眼睑整容术后发生坏死性蜂窝组织炎：病例报告

IF 1.5 Q3 SURGERY

JPRAS Open

Pub Date : 2024-09-28 DOI: 10.1016/j.jpra.2024.09.016

Rhyme Timoumi, Laura Moyal, Jean-Philippe Nordmann, Amin Bennedjai

Periorbital necrotising cellulitis is a rare localisation of fasciitis and an exceptional complication of cosmetic blepharoplasty.

We discuss here the case of a 52-year-old woman who presented with orbital cellulitis 2 days after undergoing a bilateral cosmetic lower blepharoplasty. The diagnosis was confirmed on magnetic resonance imaging. Cellulitis was complicated by ocular hypertension resistant to local treatment and intravenous acetazolamide, leading to a decrease in visual acuity.

Infection management consisted of intravenous antibiotics, corticosteroid bolus and drainage surgery. Bacteriological samples yielded Staphylococcus epidermidis resistant to all betalactamines. Anatomopathological analysis of the drained sample revealed an aspect compatible with necrotising cellulitis.

To our knowledge, this is the seventh case of necrotising cellulitis occurring after blepharoplasty reported in the literature. The other cases were due to the virulent Streptococcus pyogenes and required surgical debridement and antibiotics. Our case is unique, as it is the first reported case of necrotising cellulitis due to another pathogen, Staphylococcus epidermidis, which appears less virulent.

眶周坏死性蜂窝组织炎是一种罕见的局部筋膜炎，也是眼睑整容术的一种特殊并发症。我们在此讨论一例 52 岁女性的病例，她在接受双侧下眼睑整容术 2 天后出现眼眶蜂窝组织炎。磁共振成像证实了她的诊断。蜂窝织炎并发眼压升高，局部治疗和静脉注射乙酰唑胺均无效，导致视力下降。感染处理包括静脉注射抗生素、皮质类固醇和引流手术。细菌学样本显示，表皮葡萄球菌对所有巴内酰胺类药物均耐药。据我们所知，这是文献中报道的第七例眼睑成形术后发生坏死性蜂窝组织炎的病例。据我们所知，这是文献报道的第七例眼睑整形术后坏死性蜂窝组织炎，其他病例都是由毒性化脓性链球菌引起的，需要手术清创和抗生素治疗。我们的病例比较特殊，因为这是第一例由另一种病原体--表皮葡萄球菌--引起的坏死性蜂窝组织炎，这种病原体似乎毒性较弱。

{"title":"Necrotising cellulitis occurring after cosmetic blepharoplasty: A case report","authors":"Rhyme Timoumi, Laura Moyal, Jean-Philippe Nordmann, Amin Bennedjai","doi":"10.1016/j.jpra.2024.09.016","DOIUrl":"10.1016/j.jpra.2024.09.016","url":null,"abstract":"<div><div>Periorbital necrotising cellulitis is a rare localisation of fasciitis and an exceptional complication of cosmetic blepharoplasty.</div><div>We discuss here the case of a 52-year-old woman who presented with orbital cellulitis 2 days after undergoing a bilateral cosmetic lower blepharoplasty. The diagnosis was confirmed on magnetic resonance imaging. Cellulitis was complicated by ocular hypertension resistant to local treatment and intravenous acetazolamide, leading to a decrease in visual acuity.</div><div>Infection management consisted of intravenous antibiotics, corticosteroid bolus and drainage surgery. Bacteriological samples yielded <em>Staphylococcus epidermidis</em> resistant to all betalactamines. Anatomopathological analysis of the drained sample revealed an aspect compatible with necrotising cellulitis.</div><div>To our knowledge, this is the seventh case of necrotising cellulitis occurring after blepharoplasty reported in the literature. The other cases were due to the virulent <em>Streptococcus pyogenes</em> and required surgical debridement and antibiotics. Our case is unique, as it is the first reported case of necrotising cellulitis due to another pathogen, <em>Staphylococcus epidermidis</em>, which appears less virulent.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 306-310"},"PeriodicalIF":1.5,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Submental flap: A reconstructive option in head and neck surgery 下额皮瓣：头颈部手术中的一种重建选择

IF 1.5 Q3 SURGERY

JPRAS Open

Pub Date : 2024-09-28 DOI: 10.1016/j.jpra.2024.09.019

Vincenzo Filomena , María Antón Almero , Eduardo Ferrandis Perepérez

Objective

The submental flap is a fasciocutaneous flap used in head and neck reconstruction. The aim of this study was to share the indications and outcomes of submental flap reconstruction based on our experience.

Methods

A retrospective descriptive study was conducted on a group of 14 patients who underwent reconstructive surgery of the orofacial region with the submental flap. All reconstructions were performed following oncologic resections.

Results

The submental flap was employed for the reconstruction of mobile tongue in 5 cases, maxilla and hard palate in 4 cases, cheek in 2 cases, floor of the mouth in 1 case, retromolar trigone in 1 case and oropharyngeal defects in 1 case. Satisfactory oral cavity opening was achieved in all cases. No transfer of metastatic lymph nodes to the recipient area was detected in this study.

Conclusions

The submental flap significantly shortens the surgical time compared to microvascular flaps. In our experience, the necessity for neck lymph node surgery does not preclude the use of the submental flap. Meticulous dissection of the flap greatly reduces the risk of potential transfer of tumours through the flap to the recipient area.

目的下颌骨皮瓣是一种用于头颈部重建的筋膜皮瓣。本研究的目的是根据我们的经验，分享下颌角皮瓣重建的适应症和结果。方法我们对 14 位使用下颌角皮瓣进行口面部重建手术的患者进行了回顾性描述性研究，所有的重建手术都是在肿瘤切除术后进行的。结果5例患者的活动舌、4例患者的上颌骨和硬腭、2例患者的颊部、1例患者的口底、1例患者的三叉神经后突以及1例患者的口咽部缺损均采用了牙下皮瓣重建。所有病例都获得了满意的口腔开放效果。结论与微血管瓣相比，下颌角皮瓣能显著缩短手术时间。根据我们的经验，有必要进行颈部淋巴结手术时并不排除使用皮瓣。仔细解剖皮瓣可大大降低肿瘤通过皮瓣转移到受区的潜在风险。

{"title":"Submental flap: A reconstructive option in head and neck surgery","authors":"Vincenzo Filomena , María Antón Almero , Eduardo Ferrandis Perepérez","doi":"10.1016/j.jpra.2024.09.019","DOIUrl":"10.1016/j.jpra.2024.09.019","url":null,"abstract":"<div><h3>Objective</h3><div>The submental flap is a fasciocutaneous flap used in head and neck reconstruction. The aim of this study was to share the indications and outcomes of submental flap reconstruction based on our experience.</div></div><div><h3>Methods</h3><div>A retrospective descriptive study was conducted on a group of 14 patients who underwent reconstructive surgery of the orofacial region with the submental flap. All reconstructions were performed following oncologic resections.</div></div><div><h3>Results</h3><div>The submental flap was employed for the reconstruction of mobile tongue in 5 cases, maxilla and hard palate in 4 cases, cheek in 2 cases, floor of the mouth in 1 case, retromolar trigone in 1 case and oropharyngeal defects in 1 case. Satisfactory oral cavity opening was achieved in all cases. No transfer of metastatic lymph nodes to the recipient area was detected in this study.</div></div><div><h3>Conclusions</h3><div>The submental flap significantly shortens the surgical time compared to microvascular flaps. In our experience, the necessity for neck lymph node surgery does not preclude the use of the submental flap. Meticulous dissection of the flap greatly reduces the risk of potential transfer of tumours through the flap to the recipient area.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 284-291"},"PeriodicalIF":1.5,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Delayed unilateral eyelid oedema following non-periocular hyaluronic acid injection: A case report and literature review 非眼周注射透明质酸后的延迟性单侧眼睑水肿：病例报告和文献综述

IF 1.5 Q3 SURGERY

JPRAS Open

Pub Date : 2024-09-27 DOI: 10.1016/j.jpra.2024.09.017

Cecilia Soldini , Luigi Schiraldi , Pietro Giovanni Di Summa

引用次数: 0

Fowler syndrome post liposculpture and augmentation mammoplasty: Case report and literature review 脂肪塑形和隆乳术后 Fowler 综合征：病例报告和文献综述

IF 1.5 Q3 SURGERY

JPRAS Open

Pub Date : 2024-09-26 DOI: 10.1016/j.jpra.2024.09.013

Rodrigo Domínguez-Millán , Tatiana Luna Pisciotti , Pamela Fernández Cuesta , Miguel Angel Bonilla Becerril

Fowler syndrome is a rare entity that occurs in young women, with a high incidence of polycystic ovary syndrome. It consists of episodes of acute urinary retention that have a characteristic electromyographic pattern. Its etiology is unclear and is usually preceded by a trigger such as a surgical procedure, childbirth, other acute medical conditions, and opioid use. There is no report in the literature that links any Plastic Surgery procedure to Fowler Syndrome. We present the case of a 31-year-old female patient who had an episode of acute urinary retention 36 hours after liposculpture and augmentation mammoplasty. Infectious, anatomical and functional causes were ruled out upon admission to the emergency room, confirming the diagnosis of Fowler Syndrome. The patient was treated with bladder catheterization for 72h and tamsulosin for 15 days, with adequate response. Subsequent to this she presented a favorable evolution without new episodes of difficulty for urination, without functional sequelae or complications in the aesthetic surgical result.

福勒综合征是一种罕见的疾病，好发于年轻女性，多囊卵巢综合征的发病率很高。它包括具有特征性肌电图模式的急性尿潴留发作。其病因尚不明确，通常在发病前有诱因，如外科手术、分娩、其他急性病和阿片类药物的使用。目前还没有文献报道任何整形外科手术与福勒综合征有关。我们介绍了一例 31 岁女性患者的病例，她在脂肪塑形和隆乳术后 36 小时出现急性尿潴留。急诊入院后排除了感染、解剖和功能性原因，确诊为福勒综合征。患者接受了 72 小时的膀胱导尿治疗和 15 天的坦索罗辛治疗，效果良好。此后，她的病情发展良好，没有再出现排尿困难，也没有功能性后遗症或手术美学效果方面的并发症。

{"title":"Fowler syndrome post liposculpture and augmentation mammoplasty: Case report and literature review","authors":"Rodrigo Domínguez-Millán , Tatiana Luna Pisciotti , Pamela Fernández Cuesta , Miguel Angel Bonilla Becerril","doi":"10.1016/j.jpra.2024.09.013","DOIUrl":"10.1016/j.jpra.2024.09.013","url":null,"abstract":"<div><div>Fowler syndrome is a rare entity that occurs in young women, with a high incidence of polycystic ovary syndrome. It consists of episodes of acute urinary retention that have a characteristic electromyographic pattern. Its etiology is unclear and is usually preceded by a trigger such as a surgical procedure, childbirth, other acute medical conditions, and opioid use. There is no report in the literature that links any Plastic Surgery procedure to Fowler Syndrome. We present the case of a 31-year-old female patient who had an episode of acute urinary retention 36 hours after liposculpture and augmentation mammoplasty. Infectious, anatomical and functional causes were ruled out upon admission to the emergency room, confirming the diagnosis of Fowler Syndrome. The patient was treated with bladder catheterization for 72h and tamsulosin for 15 days, with adequate response. Subsequent to this she presented a favorable evolution without new episodes of difficulty for urination, without functional sequelae or complications in the aesthetic surgical result.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 292-295"},"PeriodicalIF":1.5,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter is in response to a published manuscript, “Quality of the Information provided by ChatGPT for patients in breast plastic surgery: Are we already in the future?” 这封信是对一篇已发表的手稿 "ChatGPT 为乳房整形手术患者提供的信息质量：我们已经进入未来了吗？

IF 1.5 Q3 SURGERY

JPRAS Open

Pub Date : 2024-09-19 DOI: 10.1016/j.jpra.2024.09.006

Abdul Rahman, Irfan Alam

引用次数: 0