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  1. Dow T, ElAbd R, McGuire C, Corkum J, Youha SA, Samargandi O, et al.
    J Reconstr Microsurg, 2023 Sep;39(7):526-539.
    PMID: 36577497 DOI: 10.1055/a-2003-8789
    BACKGROUND:  Free flap reconstruction of the lower limb following trauma often suffers higher complication rates than other areas of the body. The choice of muscle or fasciocutaneous free flap is an area of active debate.

    METHODS:  A systematic review of EMBASE, MEDLINE, PubMed, and Cochrane Register from inception to April 1, 2022 was performed. Articles were assessed using the methodological index for non-randomized studies instrument. The primary outcome was to assess and compare the major surgical outcomes of partial or total flap failure, reoperation, and amputation rates.

    RESULTS:  Seventeen studies were included. All studies were retrospective in nature, of level three evidence, and published between 1986 and 2021. The most common muscle and fasciocutaneous free flaps used were latissimus dorsi flap (38.1%) and anterolateral thigh (ALT) flap (64.8%), respectively. Meta-analysis found no significance difference in rates of total flap failure, takeback operations, or limb salvage, whereas partial flap failure rate was significantly lower for fasciocutaneous flaps. The majority of studies found no significant difference in complication rates, osteomyelitis, time to fracture union, or time to functional recovery. Most, 82.4% (14/17), of the included studies were of high methodological quality.

    CONCLUSION:  The rate of total flap failure, reoperation, or limb salvage is not significantly different between muscle and fasciocutaneous free flaps after lower limb reconstruction following trauma. Partial flap failure rates appear to be lower with fasciocutaneous free flaps. Outcomes traditionally thought to be managed better with muscle free flaps, such as osteomyelitis and rates of fracture union, were comparable.

  2. Alshawaf SM, McGuire C, ElAbd R, Fakih-Gomez N, Williams J, AlYouha S, et al.
    Aesthet Surg J, 2023 Sep 20.
    PMID: 37738132 DOI: 10.1093/asj/sjad309
    BACKGROUND: The perception of an ideal nose is influenced by a variety of factors, with demographic characteristics playing a significant role in what is considered an ideal nose. The nasolabial angle (NLA) is considered one of the defining features shaping the nose.

    OBJECTIVES: This study set out to capture the perception of the ideal nasolabial angle among Canadian, Saudi, Kuwaiti, and Lebanese populations.

    METHODS: An online questionnaire-based cross-sectional study was conducted to investigate the ideal nasolabial angle among Canadian, Saudi, Kuwaiti, and Lebanese populations (N = 197). Participants were patients attending outpatient clinics, plastic surgery residents and medical students. The questionnaire consisted of demographics and perception of respondents on the ideal NLA for each gender: Male (85, 90, 95, 100, 110) and Females (95, 100, 110, 115).

    RESULTS: The majority of respondents were female (81.2%) aged between 20 and 39 (84.3%). The mean and standard deviation of ideal NLA choices in both male and female models were 97.1 +/- 6.39 and 109.5 +/- 5.32 respectively. The ideal male NLA choices were found to correlate significantly with age (p 0.044) and work status (p 0.019). In choosing the ideal female NLA, age was a significant factor (p 0.012).

    CONCLUSIONS: Identifying the ideal NLA is essential for establishing aesthetic goals for patients and surgeons alike. It is important to understand the effects of demographics on the choice of the ideal NLA, which ultimately influences the planning and outcome of rhinoplasty procedure.

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